AB PM-JAY
Ayushman Bharat — Pradhan Mantri Jan Arogya Yojana
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is the world's largest government-funded health assurance scheme. Launched on 23 September 2018 by Prime Minister Narendra Modi at Ranchi, Jharkhand, it provides ₹5 lakh per family per year for secondary and tertiary hospitalisation — completely free, cashless, and paperless.
The scheme covers 1,949 medical and surgical packages across 27 specialties including: cancer treatment (chemotherapy, radiation, surgery), cardiac procedures (bypass surgery, angioplasty, valve replacement), orthopaedic surgeries (joint replacement, spine surgery), neurological treatments (brain tumour surgery, stroke care), dialysis, neonatal care, and COVID-19 treatment.
PM-JAY operates through empanelled hospitals — over 29,000 government and private hospitals across India that are certified to provide cashless treatment. A beneficiary walks in, authenticates via Aadhaar OTP or biometric at the Ayushman Mitra desk, and receives treatment without paying anything at the point of care. The hospital submits the claim electronically to the State Health Agency.
**Who is eligible?** Beneficiaries are identified primarily from SECC 2011 (Socio-Economic and Caste Census) data. Rural families with housing deprivation, low income, or belonging to SC/ST categories; and urban families in 11 occupational categories (construction workers, domestic workers, rag pickers, street vendors, beggars, home-based workers, etc.) are covered.
**Senior Citizens Expansion (2024):** In October 2024, the Government expanded PM-JAY to cover ALL citizens aged 70 and above — regardless of income or existing coverage. Senior citizens get a separate ₹5 lakh annual health cover (in addition to any existing family cover under PM-JAY). This adds 6 crore new beneficiaries.
**State-integrated schemes:** Many states have integrated or enhanced PM-JAY: Andhra Pradesh (YSR Aarogyasri covers up to ₹10 lakh), Tamil Nadu (CM Comprehensive Health Insurance extended to ₹5 lakh), Maharashtra (Mahatma Jyotiba Phule Jan Arogya Yojana), Karnataka (Arogya Karnataka), and Delhi (which operates its own scheme).
**How does cashless treatment work?** The Ayushman Mitra at every empanelled hospital verifies your eligibility and generates a pre-authorisation for the treatment package. You sign a consent form, the hospital provides treatment, and the entire billing goes electronically to the insurer — you pay nothing, not even for medicine, investigations, or ICU charges, within the package cost.
Key Objectives
- Reduce catastrophic out-of-pocket health expenditure for poor and vulnerable families.
- Provide access to quality secondary and tertiary healthcare at empanelled hospitals.
- Ensure financial protection against major health events for 55 crore beneficiaries.
- Bring tertiary care access to India's bottom 40% through public-private partnerships.
Benefits
Eligibility
- Rural families under SECC 2011 deprivation categories D1–D7 (housing, income, social deprivation)
- Urban families in 11 occupational categories: construction workers, domestic workers, rag pickers, home-based workers, street vendors, beggars, porters, cobblers, washermen, sanitation workers, mechanics
- All citizens aged 70 years and above (expanded October 2024 — no income restriction)
- ASHA workers and Anganwadi workers
- Families covered under RSBY (Rashtriya Swasthya Bima Yojana) — automatically migrated
- No pre-existing disease exclusion — all existing conditions covered from day one
- No age limit for treatment — newborns to elderly all covered
- Family size not restricted — entire family covered within ₹5 lakh annual limit
- Portable across India — valid at empanelled hospitals in any state
How to Apply
Step 1: Check eligibility — visit beneficiary.nha.gov.in or call 14555
Step 2: Enter your mobile number or Ration Card (NFSA) number to check eligibility
Step 3: If eligible, visit any Ayushman Mitra desk at empanelled hospital, or nearest CSC
Step 4: Authenticate via Aadhaar OTP (or biometric) — Ayushman Card generated instantly
Step 5: Download Ayushman Card from beneficiary.nha.gov.in (for future reference)
Step 6: For 70+ senior citizens: register at beneficiary.nha.gov.in with Aadhaar and age proof
For cashless treatment: Visit any empanelled hospital → Ayushman Mitra desk → show Aadhaar → treatment provided
Required Documents
Frequently Asked Questions
How do I check if I am eligible for Ayushman Bharat PM-JAY?
Visit beneficiary.nha.gov.in and enter your mobile number or NFSA Ration Card number to check instantly. Alternatively call helpline 14555. Your eligibility is based on SECC 2011 data — if your family was listed as economically deprived, you are eligible. People with yellow/pink/white ration cards in most states are eligible.
How do I get my Ayushman Card?
Visit any empanelled hospital's Ayushman Mitra desk or nearest Common Service Centre (CSC). Authenticate via Aadhaar OTP — the Ayushman Card (also called Golden Card or Ayushman Bharat Card) is generated immediately. You can also download it from beneficiary.nha.gov.in after registration.
What is covered under Ayushman Bharat's ₹5 lakh health cover?
1,949 medical and surgical packages across 27 specialties: cancer treatment (chemotherapy, surgery, radiation), cardiac procedures (bypass surgery, valve replacement, angioplasty), orthopaedic surgeries (joint replacement), neurological treatments, dialysis, neonatal ICU, COVID-19 care, and hundreds more. Pre and post-hospitalisation charges (3 days pre + 15 days post) are also included.
Can I use Ayushman Bharat at any hospital?
Only at empanelled hospitals — both public and private hospitals registered on the PM-JAY network. Search the full list at hospitals.pmjay.gov.in. Most government hospitals and major private hospital chains (Apollo, Fortis, Manipal, Columbia Asia, etc.) are empanelled. Always confirm before admission.
What is the Ayushman Bharat scheme for people above 70 years?
From October 2024, ALL Indian citizens aged 70 and above are eligible for PM-JAY regardless of income — even if they pay income tax or are government pensioners. They receive a separate ₹5 lakh annual cover (on top of any existing family PM-JAY cover). Register at beneficiary.nha.gov.in/senior with your Aadhaar.
My state (Delhi/West Bengal) has opted out of PM-JAY. What do I do?
Delhi residents should check the Mukhyamantri Aarogya Nidhi scheme at health.delhigovt.nic.in. West Bengal residents should check Swasthya Sathi at swasthyasathi.gov.in. Both provide similar health coverage but through state-specific schemes.
Does Ayushman Bharat cover OPD (outpatient) treatment or only hospitalisation?
PM-JAY covers only inpatient hospitalisation and day-care procedures (surgeries/treatments that do not require overnight admission). Regular OPD visits, doctor consultations, routine medicines, and diagnostic tests without hospitalisation are NOT covered by PM-JAY. For OPD care, visit an Ayushman Bharat Health & Wellness Centre (HWC) in your area.
Is there a family size limit for Ayushman Bharat?
No. PM-JAY covers the entire family (all members listed in the SECC data) within the ₹5 lakh annual limit. There is no cap on family size. Even families with 8–10 members share the ₹5 lakh annual limit.
Does Ayushman Bharat cover pre-existing diseases?
Yes — all pre-existing conditions are covered from day one. Unlike private health insurance which typically excludes pre-existing conditions for 2–4 years, PM-JAY has no such exclusion. If you have diabetes, heart disease, cancer, or kidney disease and need hospitalisation, you are fully covered from the first day you use the scheme.
A hospital is asking me to pay for medicines under Ayushman Bharat. Is this correct?
No. All medicines, investigations, ICU charges, surgeon fees, and room charges within the treatment package must be provided FREE at the point of care. If the hospital is asking you to pay, it is a violation of PM-JAY rules. Immediately report to the Ayushman Mitra at the hospital, or file a complaint at cgrms.pmjay.gov.in or call 14555.
How does PM-JAY's cashless treatment work at a private hospital?
Walk into any PM-JAY empanelled private hospital → Go to the Ayushman Mitra desk → Show your Aadhaar → The Mitra authenticates you via OTP or biometric → Pre-authorisation is obtained from the insurer electronically → You are admitted and treated → The hospital submits the claim after treatment → You pay nothing. The Ayushman Mitra is your single point of contact throughout.
Can I use Ayushman Bharat outside my home state?
Yes. PM-JAY is fully portable across India — you can use your Ayushman Card at any empanelled hospital in any state. This is extremely useful for treatment in specialised hospitals in major cities like AIIMS Delhi, CMC Vellore, or Tata Memorial Cancer Centre Mumbai.