Odisha Gopabandhu Jana Arogya Yojana (GJAY)

Gopabandhu Jana Arogya Yojana (GJAY) is Odisha’s flagship health assurance scheme, implemented by the Department of Health & Family Welfare, Government of Odisha, through the State Health Assurance Society (SHAS). The scheme provides free treatment at government health facilities for all patients and cashless health coverage of up to Rs. 5 lakh per family at empanelled private hospitals, with an additional Rs. 5 lakh cover for women beneficiaries. Eligible families are covered automatically through their NFSA or SFSS ration cards, with no separate application process required.

Introduction of Odisha Gopabandhu Jana Arogya Yojana: A Brief Insight

A serious illness can strike any family without warning, and the cost of treatment often becomes a burden far greater than the illness itself. Hospital bills, surgeries, medicines, and follow-up care can quickly exhaust a family’s savings. To protect citizens from such financial hardship, the Government of Odisha launched the Biju Swasthya Kalyan Yojana (BSKY) on 15 August 2018, which was later renamed the Gopabandhu Jana Arogya Yojana (GJAY) in July 2024.

The scheme is implemented by the Department of Health & Family Welfare, Government of Odisha through the State Health Assurance Society (SHAS). Its primary objective is to ensure that no eligible family is forced to delay or avoid medical treatment due to financial constraints. By offering free and cashless healthcare services, the scheme aims to reduce out-of-pocket medical expenses and improve access to quality healthcare across the state.

One of the biggest strengths of GJAY is its two-tier healthcare support system. Under the first tier, every patient can receive treatment free of cost at government health facilities across Odisha, regardless of income level, social category, or card status. This includes services ranging from routine consultations and diagnostics to major surgeries, dialysis, ICU care, and other specialised treatments.

Under the second tier, eligible NFSA and SFSS ration card holder families can avail cashless treatment at empanelled private hospitals. Each family receives health coverage of up to Rs. 5 lakh per year, while women members are entitled to an additional Rs. 5 lakh after the family limit is exhausted. This increases the total potential coverage for women beneficiaries to Rs. 10 lakh annually, providing stronger financial protection during medical emergencies.

The scheme also covers pre-existing diseases from Day 1, ensuring beneficiaries do not have to wait before accessing treatment. Following its integration with Ayushman Bharat PM-JAY, eligible GJAY beneficiaries can now receive cashless treatment at empanelled hospitals across India. This has proven particularly beneficial for Odisha’s migrant workers, students, and families who may require treatment outside the state.

Another important feature is that beneficiaries do not need to submit a separate application form. Eligibility is linked directly to NFSA and SFSS databases, and families previously covered under BSKY continue to remain eligible under GJAY. Existing Smart Health Cards remain valid, making the transition seamless for beneficiaries.

Whenever treatment is required, eligible beneficiaries can simply visit an empanelled hospital and present their Smart Health Card or ration card details along with Aadhaar for verification. A dedicated Swasthya Mitra available at the hospital help desk assists patients throughout the process, from verification to treatment approval, ensuring a smooth and hassle-free experience.

Residents can also check their eligibility under the Central Government’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), while senior citizens aged 70 years and above may explore the Ayushman Vay Vandana Card Scheme for additional healthcare protection. Beneficiaries can further complement their healthcare support through Odisha’s Niramaya Scheme, which provides free medicines at government health facilities across the state.

Families, patients, and individuals looking for more healthcare, welfare, and social security initiatives can explore our dedicated Odisha Government Welfare Schemes section, where detailed information about various state government schemes is available in one place.

Benefits Provided to Eligible Beneficiaries

The Government of Odisha, through the State Health Assurance Society (SHAS), provides comprehensive healthcare benefits under the Gopabandhu Jana Arogya Yojana (GJAY). The scheme operates through a two-tier model, ensuring that every resident can access healthcare services while eligible families receive additional cashless treatment benefits at private hospitals.

Tier 1 – Free Treatment at Government Health Facilities

• Free treatment at government health institutions across Odisha, from Sub-Centres and Primary Health Centres to District Hospitals and Government Medical Colleges
• Available to all patients without any income, category, or eligibility restriction
• Covers consultation, medicines, diagnostic tests, surgeries, hospital admission, ICU care, dialysis, cancer treatment, and other essential healthcare services
• No registration fee or premium is required

Tier 2 – Cashless Treatment at Empanelled Private Hospitals

• Health coverage of up to Rs. 5 lakh per family per year on a family-floater basis
• Additional coverage of up to Rs. 5 lakh exclusively for women members after exhaustion of the family’s base limit
• Total potential coverage of up to Rs. 10 lakh annually for an eligible family
• Cashless treatment available at empanelled private hospitals within Odisha and at eligible hospitals outside the state through Ayushman Bharat integration

Treatments and Services Covered

• Doctor consultations and hospital registration
• Diagnostic tests, pathology investigations, and imaging services
• Indoor patient (IPD) treatment and hospitalisation expenses
• Surgical procedures and post-treatment follow-up care
• Dialysis and kidney-related treatment
• Cancer diagnosis, chemotherapy, and related procedures
• Cardiology and heart-related interventions
• Cataract surgery and ophthalmic procedures
• Obstetrics and gynaecological treatment packages
• Organ and tissue transplant procedures as per approved packages
• Treatment for mental health conditions and polytrauma cases

Coverage for Pre-Existing Diseases

• Pre-existing illnesses are covered from the first day of enrolment
• No waiting period applies for eligible beneficiaries

Nationwide Cashless Treatment Facility

• Eligible beneficiaries can access cashless treatment at Ayushman Bharat PM-JAY empanelled hospitals across India
• Particularly beneficial for migrant workers, students, and families residing temporarily outside Odisha
• Ensures continuity of treatment even when beneficiaries are away from their home district or state

Scheme Impact Since Launch (Earlier Implemented as BSKY)

Eligibility Conditions Required to be Fulfilled

The Department of Health & Family Welfare of the Government of Odisha, through the State Health Assurance Society (SHAS), has laid down separate eligibility rules for treatment at government hospitals and cashless treatment at empanelled private hospitals under the Gopabandhu Jana Arogya Yojana (GJAY).

Eligibility for Free Treatment at Government Health Facilities

• All patients can avail treatment at government health facilities free of cost
• No income limit applies
• No NFSA or SFSS ration card is required
• No separate registration under GJAY is necessary

Eligibility for Cashless Treatment at Empanelled Private Hospitals

• Must be covered under the National Food Security Act (NFSA) or State Food Security Scheme (SFSS)
• Must possess a valid NFSA or SFSS ration card
• Families previously covered under the BSKY Smart Card system continue to remain eligible under GJAY
• No fresh application is required for existing eligible beneficiaries
• Must be a resident of Odisha

Coverage Beyond PM-JAY Criteria

GJAY follows the NFSA and SFSS database for beneficiary identification, making its coverage wider than the standard Ayushman Bharat PM-JAY eligibility criteria based on SECC 2011 data. As a result, some families covered under GJAY may not necessarily be eligible under PM-JAY in other states.

Who Is Not Eligible for Cashless Private Hospital Treatment?

• Families not covered under NFSA or SFSS
• Individuals who do not have a valid food security card
• Non-residents seeking eligibility under Odisha’s private hospital component

Documents Required to be Attached

One of the biggest advantages of the Gopabandhu Jana Arogya Yojana (GJAY) is that beneficiaries do not need to complete a separate enrolment process. Eligibility is linked to the state’s food security database, so only a few documents are generally required when visiting an empanelled hospital for treatment.

• GJAY/ BSKY Smart Health Card, or a valid NFSA (National Food Security Act) or SFSS (State Food Security Scheme) ration card
• Aadhaar Card for identity and biometric verification at the hospital help desk
• Doctor’s referral certificate (required for eligible beneficiaries seeking empanelled tertiary treatment outside Odisha)
• Any other valid photo identity proof, if requested by the hospital, such as a Voter ID Card or PAN Card

How Beneficiaries Can Apply to Avail the Benefit of the Scheme

You don’t need to fill out any application form to use Gopabandhu Jana Arogya Yojana (GJAY). If your family is already covered under the NFSA or SFSS food security scheme, your eligibility is generally available in the government’s database. Just visit the hospital and follow the simple steps below.

If You Want Treatment at a Government Hospital

Step 1: Visit your nearest government health facility. This can be a Sub-Centre, Primary Health Centre (PHC), Community Health Centre (CHC), District Headquarters Hospital, or a Government Medical College Hospital.

Step 2: Go to the registration counter and get yourself registered. Tell the staff your basic details and collect your OPD slip.

Step 3: Meet the doctor and explain your health problem. The doctor will examine you and decide what treatment, medicines, or tests you need.

Step 4: Follow the doctor’s advice and receive your treatment. Medicines, diagnostic tests, surgeries, dialysis, ICU services, and other eligible treatments are provided free of cost at government hospitals.

Step 5: If the doctor feels you need specialised treatment, the hospital may refer you to a higher-level facility for further care.

If You Want Cashless Treatment at a Private Hospital

Step 1: First, make sure your family has a valid NFSA or SFSS ration card. Families that were previously covered under BSKY are automatically covered under GJAY and do not need to register again.

Step 2: Keep your Aadhaar Card and GJAY/BSKY Smart Health Card ready. If you have not received your card yet, you can visit the nearest Mo Seva Kendra for assistance.

Step 3: Visit an empanelled private hospital covered under GJAY. You can choose any hospital that is part of the scheme network.

Step 4: After reaching the hospital, go directly to the GJAY help desk. Show your Smart Health Card or ration card details along with your Aadhaar Card.

Step 5: A Swasthya Mitra at the hospital will check your eligibility and guide you through the entire process. You do not need to run from counter to counter or complete complicated paperwork.

Step 6: The hospital will send your treatment request online for approval under the scheme. In emergencies, treatment can begin immediately while the approval process continues in the background.

Step 7: Once the treatment is approved, you can receive the required surgery, procedure, or hospital care without paying the hospital bill yourself. The payment is settled directly through the scheme, subject to the applicable coverage limit.

Step 8: If you are referred to an empanelled hospital outside Odisha for specialised treatment, carry your Aadhaar Card, Smart Health Card, and referral documents issued by your doctor.

Important: Never pay money for a treatment package that is approved under GJAY. If any empanelled hospital refuses cashless treatment or asks you to pay for an approved procedure, immediately contact the scheme helpline or report the matter to the hospital help desk.

Important Links Available of the Scheme

• Gopabandhu Jana Arogya Yojana (GJAY) Official Portal
• GJAY Dashboard Statistics and Beneficiary Information
• Department of Health & Family Welfare, Government of Odisha

Contact Details in Case of Help Needed

• Nodal Department: Department of Health & Family Welfare, Government of Odisha
• Implementing Body: State Health Assurance Society (SHAS)
• General Helpline: 104 (24 hours, available in local language)
• PM-JAY Helpline: 14555
• Smart Card Helpline: 155369
• Toll-Free (Outside Odisha): 1800120120104

Frequently Asked Questions (FAQs)

Q. What is Gopabandhu Jana Arogya Yojana (GJAY)?

Ans. Gopabandhu Jana Arogya Yojana (GJAY) is Odisha’s flagship health assurance scheme operated by the Department of Health & Family Welfare through the State Health Assurance Society (SHAS). The scheme was earlier known as Biju Swasthya Kalyan Yojana (BSKY) and was renamed as GJAY in 2024. It provides free treatment at government hospitals and cashless healthcare coverage for eligible families at empanelled private hospitals.

Q. Who can avail benefits under GJAY?

Ans. Every citizen can receive free treatment at government health facilities in Odisha. For cashless treatment at empanelled private hospitals, the family must possess a valid NFSA or SFSS ration card. Existing BSKY beneficiaries are automatically covered under GJAY.

Q. How much health coverage is available under the scheme?

Ans. Eligible families receive health coverage of up to Rs. 5 lakh per year. Women members can avail an additional Rs. 5 lakh after the family limit is exhausted, taking the total potential coverage to Rs. 10 lakh annually.

Q. Do I need to submit an application form to join GJAY?

Ans. No. There is no separate application or registration process. Eligibility is linked with NFSA and SFSS food security databases, and eligible families are covered automatically.

Q. Are pre-existing diseases covered under GJAY?

Ans. Yes. The scheme covers pre-existing illnesses from the very first day. Beneficiaries do not have to complete any waiting period before receiving treatment.

Q. Can I receive treatment outside Odisha using my GJAY card?

Ans. Yes. After integration with Ayushman Bharat PM-JAY, eligible GJAY beneficiaries can access cashless treatment at empanelled Ayushman Bharat hospitals across India, subject to scheme guidelines.

Q. Is GJAY different from Ayushman Bharat PM-JAY?

Ans. Yes. GJAY is Odisha’s state health assurance scheme, while PM-JAY is a Central Government scheme. However, both schemes are integrated for hospital access. GJAY eligibility is based primarily on NFSA and SFSS beneficiaries, which makes its coverage broader for many Odisha households.

Q. What is the role of a Swasthya Mitra?

Ans. A Swasthya Mitra is a support executive available at empanelled hospitals who helps beneficiaries with verification, treatment approval, documentation, and other scheme-related assistance.

Q. What should I do if an empanelled hospital asks me to pay for an approved treatment?

Ans. Approved treatment under GJAY is cashless. If a hospital demands money for a treatment package already approved under the scheme, immediately report the matter through the GJAY helpline for necessary action.

Q. I am eligible but have not received my GJAY/BSKY card. What should I do?

Ans. You can visit your nearest Mo Seva Kendra and request assistance for obtaining your Smart Health Card or verifying your beneficiary status.

Q. Is any premium payable by beneficiaries?

Ans. No. GJAY is completely funded by the Government. Eligible beneficiaries are not required to pay any registration fee, enrolment charge, or annual premium.

Q. What treatments are covered under GJAY?

Ans. The scheme covers a wide range of treatments, including hospitalisation, surgeries, dialysis, cancer care, cardiac procedures, maternal healthcare, organ and tissue transplants, diagnostics, and many other medical packages notified under the scheme.

Q. Can women members receive additional benefits under GJAY?

Ans. Yes. Women beneficiaries are entitled to an additional health coverage of up to Rs. 5 lakh after the family’s base coverage limit is utilized, providing greater financial protection during medical emergencies.

Q. Where can I get help regarding the scheme?

Ans. Beneficiaries can call the GJAY helpline on 104 or 14555 for assistance. They can also visit the official portal gjay.odisha.gov.in for the latest information, hospital lists, and scheme updates.

Tabassum

Tabassum is a government schemes researcher and writer with 5 years of experience tracking Central and State welfare scheme programmes across India. She has covered 500+ schemes spanning agriculture, women welfare, education, and housing, helping lakhs of beneficiaries understand their entitlements in simple language.