Odisha Gopabandhu Jana Arogya Yojana (GJAY)

Scheme Introduction: A Brief Overview

Access to timely and quality healthcare can make a significant difference to a family's financial security, especially when treatment involves hospitalisation, surgery, expensive medicines or specialised care. To make healthcare more accessible across the state, the Government of Odisha implements the Gopabandhu Jana Arogya Yojana (GJAY). The scheme combines free healthcare services through Government health facilities with financial protection for families covered under its health assurance component. Under the scheme, people can access applicable healthcare services at Government health institutions, while covered families can receive cashless treatment of up to ₹5 lakh per year at empanelled private hospitals. Women members can also receive an additional ₹5 lakh after the initial family coverage is exhausted, subject to the applicable provisions.

GJAY is implemented by the Health & Family Welfare Department, Government of Odisha. The scheme's family coverage is linked with Government beneficiary records, including families covered under the National Food Security Act (NFSA) and the State Food Security Scheme (SFSA). Eligible families are provided access to the applicable health assurance benefits without having to go through a conventional insurance enrolment process. Treatment under the private hospital component is provided through empanelled healthcare facilities, while the Government healthcare component works through Odisha's public health system.

The scope of healthcare access has also expanded following the integration of GJAY with Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in January 2025. Through this integration, beneficiaries can access a wider network of Government and private empanelled hospitals for cashless treatment under the applicable scheme provisions. The combined framework is intended to strengthen access to healthcare both within Odisha and, where applicable, outside the state.

GJAY is particularly relevant for people in Odisha who want to understand how Government-supported healthcare can reduce treatment-related expenses and where they can access cashless services. Readers looking for similar support can also explore Ayushman Bharat PM-JAY and other health-related Government schemes that may be relevant based on their state, eligibility and healthcare needs.

Scheme Benefits

GJAY provides healthcare support through Government health facilities and cashless treatment at empanelled private hospitals for eligible families. The major benefits are:

• Eligible beneficiaries can receive free healthcare services at Government health facilities, with applicable treatment costs borne by the State Government.
• Covered families can avail cashless treatment of up to ₹5 lakh per year at empanelled private hospitals, along with an additional ₹5 lakh for women after the initial family coverage is exhausted.
• Beneficiaries can access covered treatment at empanelled hospitals within and outside Odisha, including emergency treatment provisions where the Smart Health Card can be submitted within 72 hours of hospitalisation.
• Through the integration of Gopabandhu Jana Arogya Yojana with Ayushman Bharat PM-JAY, beneficiaries can access a wider network of Government and private hospitals for cashless treatment, as per the scheme rules.

Healthcare Coverage Under Gopabandhu Jana Arogya Yojana

GJAY provides healthcare support through both Government and empanelled private hospitals, but the benefits work differently under these two components. The Government health facility component provides free healthcare services through the public health system, while the private hospital component provides a fixed annual cashless treatment cover to families covered under the scheme.

At Government health facilities, people can receive applicable healthcare services without having to use the ₹5 lakh private-hospital coverage limit. The Government healthcare network covers different levels of public health institutions, including District Headquarters Hospitals and Government Medical College Hospitals. Services may include medicines, diagnostics, dialysis, cancer chemotherapy, surgery, ICU care, inpatient treatment and blood-bank services, as applicable.

For treatment at empanelled private hospitals, families covered under the applicable GJAY health assurance component can receive cashless treatment up to ₹5 lakh per year. After this ₹5 lakh family cover is exhausted, women members of the family can receive an additional ₹5 lakh under the scheme. Therefore, a woman may receive treatment of up to ₹10 lakh in total when the applicable conditions are met.

Eligibility Requirements

Eligibility depends on which component of GJAY the beneficiary is seeking to use. The Government-facility component is broadly available, while the private-hospital financial coverage is linked to the eligible beneficiary categories recognised under the scheme.

• All persons can access eligible healthcare services through Government health facilities covered under the Government-funded component.
• Families holding a valid NFSA card are covered under the eligible family component.
• Families holding a valid SFSA card are covered under the eligible family component.
• Eligible GJAY/BSKY Smart Health Card holders can access the applicable cashless treatment benefits at empanelled private hospitals.
• The beneficiary must satisfy the applicable scheme and hospital package conditions for the treatment being claimed.
• For changes in beneficiary details, the corresponding information in the NFSA/SFSA record may need to be corrected before the change can be reflected in the health card record.

Note: NFSA stands for National Food Security Act, 2013, while SFSA stands for State Food Security Scheme of Odisha. Families covered under these Government food-security programmes are included in the applicable GJAY health coverage.

Required Documents

The documents required can vary depending on whether the beneficiary is accessing Government healthcare or seeking cashless treatment under the eligible family component. For Smart Card and beneficiary-related services, the following records are particularly important:

• NFSA/SFSA ration card for beneficiaries covered through the eligible food-security database.
• GJAY/BSKY Smart Health Card, wherever issued and required for the relevant service.
• Aadhaar or other accepted identity document, where required for identification or verification.
• Mobile number for applicable online verification and OTP-based services.
• Relevant medical records, prescriptions, diagnostic reports or referral documents where required for the treatment process.
• Hospital-related documentsrequested by the empanelled hospital for admission, treatment or claim processing.

Steps to Apply

GJAY does not follow the usual application process used by individual subsidy schemes. For eligible NFSA/SFSA families, enrolment is linked to the Government's beneficiary database, so a separate application to purchase or enrol in the health assurance scheme is generally not required.

• Check beneficiary eligibility: Keep the NFSA/SFSA ration card available and verify whether the family is included in the eligible GJAY beneficiary database.
• Obtain or verify the Smart Health Card: If the family is eligible but has not received its Smart Card, approach a nearby Mo Seva Kendra with the relevant NFSA/SFSA card for assistance.
• Choose an empanelled hospital: For private-hospital treatment, identify a hospital included in the applicable GJAY/health assurance network.
• Approach the hospital help desk: On reaching the hospital, contact the designated Swasthya Mitra or scheme help desk for beneficiary verification and treatment-related assistance.
• Complete verification: Provide the required Smart Card, ration card or other accepted identification and medical documents for verification.
• Receive eligible treatment: Once the treatment is approved under the applicable package, eligible covered services are provided on a cashless basis subject to the available coverage and scheme rules.

For emergencies without the card: If an eligible beneficiary is admitted during an emergency without carrying the Smart Health Card, the required card/proof of eligibility should be submitted to the hospital help desk within the prescribed 72-hour period.

How The Smart Health Card Works

• The Smart Health Card serves as an important means of identifying eligible families for the cashless private-hospital component. Beneficiaries can use the designated Government systems to check card-related information and, where available, view information about their health benefits and utilisation.
• If a card is lost or damaged, the beneficiary can approach the nearest Mo Seva Kendra with the relevant NFSA/SFSA card to seek a duplicate or replacement card according to the applicable procedure.

Steps to Check GJAY Smart Card Details

Beneficiaries can check their GJAY Smart Card details and available balance through the official GJAY Dashboard by following these steps:

1. Open the official GJAY Dashboard
2. On the right side select Know your CARD BALANCE
3. Now, enter your GJAY/Ration Card Number.
4. Submit the details to view your available balance and Smart Card information.
5. Check the health benefits already availed under the card.
6. Use the search option to find nearby hospitals and Mo-Seva Kendras.

Gopabandhu Jana Arogya Yojana and Ayushman Bharat PM-JAY Integration

Odisha integrated GJAY with the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in January 2025. This integration allows eligible beneficiaries to access the combined health assurance network under the applicable Government rules and expands the geographical reach of empanelled healthcare facilities.

The integration should not be interpreted as replacing the State's GJAY framework. Instead, GJAY and AB-PMJAY operate through a coordinated health assurance framework, allowing eligible beneficiaries to receive treatment through the wider network subject to their entitlement and the applicable scheme provisions.

Relevant Links

• Official Gopabandhu Jana Arogya Yojana Portal – Government of Odisha
• GJAY Dashboard – Government of Odisha
• Health & Family Welfare Department – Government of Odisha
• Find Your Near by Mo-Seva Kendras
• Demography Wise Hospital Details Under Gopabandhu Jana Arogya Yojana 

Contact Information

Gopabandhu Jana Arogya Yojana

• General Helpline: 104
• Smart Card Helpline: 155369
• Feedback Helpline: 14545

Health & Family Welfare Department, Government of Odisha

• Phone: 6742395235
• Email: [email protected]
• Address: First Floor, Kharavel Bhavan, Unit-V, Bhubaneswar, Odisha, PIN-751001