A Vision for Universal Health Coverage
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) stands as the world’s largest public healthcare scheme, transforming the lives of millions of vulnerable Indian families . Launched on September 23, 2018, by Prime Minister Narendra Modi, this flagship initiative embodies the vision of “Sabka Saath, Sabka Vikaas” by ensuring that quality healthcare reaches the most marginalized sections of society . The scheme provides health insurance coverage of up to ₹5 lakh per eligible family annually, offering protection against catastrophic medical expenses that have historically pushed millions into poverty.
Ayushman Bharat represents a comprehensive approach to healthcare, with AB-PMJAY serving as one of its key pillars. The broader initiative also includes Ayushman Aarogya Mandirs (AAM) for accessible primary healthcare, the Ayushman Bharat Digital Mission (ABDM) for creating a digital health infrastructure, and the PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) for strengthening healthcare capacity across the country . Together, these components deliver affordable and quality healthcare to achieve universal health coverage for all Indians.
Understanding AB-PMJAY: Scheme Overview
What is AB-PMJAY?
The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana is a government-funded health assurance scheme that provides cashless healthcare coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization . The scheme was announced in the Union Budget of India on February 1, 2018, and launched on September 23, 2018, from Ranchi, Jharkhand . It is fully financed by the Government of India, with costs shared between the central and state governments .
Key Features of PM-JAY
- World’s Largest Health Assurance Scheme: PM-JAY stands as the largest health insurance/assurance initiative globally, offering comprehensive healthcare access to vulnerable populations
- Health Coverage of ₹5 Lakh: Each entitled family receives an annual health cover of ₹5 lakhs for secondary and tertiary care hospitalization across public and private empanelled hospitals
- Coverage for Over 12 Crore Families: Around 55 crore beneficiaries from 12 crore poor and vulnerable families are eligible for the scheme’s benefits
- Cashless Access to Healthcare: Beneficiaries enjoy cashless healthcare services at the point of care, eliminating the need for out-of-pocket payments during treatment
- No Family Size or Age Restrictions: PM-JAY imposes no restrictions on family size, age, or gender, ensuring inclusivity for all
- Coverage from Day One: All pre-existing medical conditions are covered from the very first day of enrolment
- Nationwide Portability: Beneficiaries can access cashless treatment at any empanelled public or private hospital across India
- Comprehensive Service Package: The scheme covers 1,961 medical procedures spanning 27 medical specialties, including General Medicine, Surgery, Oncology, and Cardiology
Financial Impact
As of July 22, 2026, a total of 44.73 crore Ayushman cards had been generated under AB-PMJAY, while over 12.69 crore hospital admissions worth ₹1.92 lakh crore have been authorized under the scheme . The scheme has saved families over ₹1.52 lakh crore in out-of-pocket healthcare expenses, according to the Economic Survey of India (2024-25) . The union government’s budget estimates have increased over the years, with a budget of ₹9,406 crore estimated for 2025-26 .
Eligibility Criteria for AB-PMJAY
Original Eligibility Framework
The scheme initially targeted the bottom 40% of India’s population based on the Socio-Economic Caste Census (SECC) 2011 . A total of 10.74 crore eligible households were identified under the scheme based on certain deprivation and occupational criteria in rural and urban areas respectively . In January 2022, the beneficiary base was revised to 12 crore families, considering the decadal population growth rate .
Eligibility for Rural Households
Rural families qualify for AB-PMJAY if they meet at least one of the following deprivation conditions :
- D1: Living in a single-room dwelling with kucha (unplastered) walls and roof
- D2: No adult household member between 16 and 59 years of age
- D3: No adult male member between 16 and 59 years of age
- D4: Presence of a differently-abled member with no able-bodied adult to support
- D5: Belonging to Scheduled Caste (SC) or Scheduled Tribe (ST) groups
- D7: Landless households earning primarily through manual labour
Eligibility for Urban Households
In urban areas, eligibility is based on occupation. The following categories of workers can register under the scheme :
- Beggars and ragpickers
- Domestic workers
- Street vendors, hawkers, cobblers, and other roadside service providers
- Construction workers, plumbers, security guards, painters, masons, welders, porters, and head-loaders
- Sweepers, gardeners, and sanitation workers
- Artisans, handicraft workers, tailors, and home-based workers
- Transport workers including drivers, conductors, helpers, rickshaw and cart pullers
- Shop assistants, delivery helpers, waiters, and peons in small businesses
- Electricians, mechanics, repair workers, and assemblers
- Watchmen (chowkidars) and washer-men
Special Inclusion: ASHA, Anganwadi Workers, and Helpers
In March 2024, approximately 37 lakh families of Accredited Social Health Activists (ASHAs), Anganwadi Workers (AWWs), and Anganwadi Helpers (AWHs) were included under the scheme . This recognition acknowledges the crucial role these community health workers play in India’s healthcare system.
Who is NOT Eligible?
Individuals who work in the organized sector or pay taxes on time are not eligible for the Ayushman Card . Those who run businesses, are in government service, work in the organized sector, have PF deductions, receive ESIC benefits, or pay taxes are not eligible . Additionally, Delhi and West Bengal are currently not implementing AB-PMJAY, though the scheme is being onboarded in Odisha .
Landmark Expansion: Senior Citizens Aged 70 and Above
In a historic decision, the Union Cabinet approved an expansion of AB-PMJAY on September 11, 2024, offering comprehensive health insurance to senior citizens aged 70 and above . This move provides free health coverage of up to ₹5 lakh per family, regardless of income, benefiting around 6 crore senior citizens across 4.5 crore families .
Key Features for Senior Citizens
- No Income Criteria: All senior citizens aged 70 or above are eligible for free medical treatment up to ₹5 lakh under this scheme, regardless of economic status
- Aadhaar-Based Enrollment: The only eligibility criterion is that the individual must be aged 70 years or above, as determined by the age recorded in their Aadhaar card
- Additional Top-Up Benefit: For senior citizens aged 70 and above who already belong to families covered by AB-PMJAY, an additional top-up cover of ₹5 lakh per year is provided exclusively for their use, separate from the rest of the family
- New Beneficiaries: Those who are not part of the existing scheme receive ₹5 lakh of annual coverage on a family basis
- Option to Switch: Senior citizens already covered under public health insurance schemes like CGHS or ECHS can either continue with their existing scheme or opt for AB-PMJAY
Senior Citizen Enrollment Progress
As of March 2026, 1.14 crore Ayushman Vay Vandana cards have been created for senior citizens aged 70 years and above . More than 86.51 lakh senior citizens over 70 years have been provided Ayushman Vay Vandana (VVS) Cards . Enrollment is an application-based process that can be completed through the mobile app (AyushmanApp), web portal (beneficiary.nha.gov.in), or at nearby empanelled hospitals or Common Service Centres .
How to Apply for Ayushman Bharat Card Online
Application Portal and Process
The official portals for Ayushman Bharat application are:
- beneficiary.nha.gov.in – For new applications and card generation
- pmjay.gov.in – For scheme information and registration
Step-by-Step Online Application Process
- Visit the official portal: Go to https://beneficiary.nha.gov.in or https://pmjay.gov.in
- Check eligibility: Click on “Am I Eligible?” and provide your mobile number or ration card number to check eligibility based on SECC data
- Provide Aadhaar details: Enter your Aadhaar number and personal details
- Validate through OTP: Enter the OTP received on your registered mobile number for authentication
- Complete e-KYC: The portal will display the list of all family members. Choose the member for whom you want to apply and complete Aadhaar authentication
- Upload documents: Upload scanned copies of identity proof (Aadhaar/Address proof) and family documents if prompted
- Download Ayushman Card: After registration, download your digital Ayushman card or take a print of the physical card. The card has your name, unique ID, and QR code for hospital validation
Offline Application Options
Eligible individuals can also apply offline through :
- Visit a nearby Common Service Centre (CSC) where officials can verify details and complete e-KYC
- Visit an empanelled hospital where Ayushman Mitras can help with eligibility verification and enrollment
- Call the helpline number 1800-110-770 for assistance
Required Documents
The following documents are required for PM-JAY registration :
- Aadhaar card (primary and mandatory document)
- Proof of identity (voter ID, passport, or driver’s license)
- Proof of residence (utility bill, voter ID, or passport)
- Family details (names and Aadhaar numbers of family members)
- Income certificate (depending on state guidelines)
- Caste certificate (for certain categories)
- Bank account details
Healthcare Coverage and Benefits
Comprehensive Coverage
AB-PMJAY offers comprehensive coverage across 1,961 medical procedures spanning 27 medical specialties . The Health Benefit Package includes services such as :
- General Medicine
- Surgery
- Oncology
- Cardiology
- Ophthalmology
- Orthopaedics
- Urology
- Obstetrics & Gynaecology
- Neonatal Care
- Emergency Room Packages
Coverage Components
The scheme covers all expenses incurred on the following components of treatment :
- Up to 3 days of pre-hospitalization expenses
- 15 days of post-hospitalization expenses
- Free drugs (including 15 days of post-discharge medication)
- Diagnostics (up to 3 days before admission)
- Food and lodging at no cost
Hospital Network
As of March 2026, a total of 36,229 hospitals have been empanelled under AB-PMJAY across the country, out of which 19,483 are public and 16,746 are private hospitals . The number of beds in these hospitals is 13 lakh 27 thousand, averaging 49 beds per hospital . Treatments span across around 2,000 procedures under 27 different specialties including oncology, ophthalmology, nephrology and cardiology .
Implementation Structure
National Health Authority (NHA)
National Health Authority (NHA) has been constituted as the apex body tasked with the implementation of AB PM-JAY. NHA is governed by a Governing Board chaired by the Hon’ble Union Minister of Health and Family Welfare. A full-time CEO in the rank of Secretary, appointed by Government of India, oversees the functioning of NHA under the guidance of the Governing Board .
State Health Agency (SHA)
For effective implementation, State Governments have set up State Health Agencies (SHA) or delegated the function to an existing agency, trust or society. This entity is the nodal agency responsible for the implementation of AB PM-JAY in the State .
Implementation Modes
States/UTs can implement the scheme through different models :
- Trust Model: Claims paid directly by the SHAs (24 states/UTs)
- Insurance Model: Claims paid by insurance company; SHA pays premium to insurance company (7 states/UTs)
- Hybrid Model: Claims up to certain amount paid by insurance company and claims over and above paid by the SHAs directly (2 states/UTs)
Funding Pattern
AB PM-JAY is completely funded by the Government with costs shared between Central and State Governments :
- For all States (except North-Eastern States and three Himalayan States): 60:40 ratio (Centre:State)
- For North-Eastern States and 3 Himalayan States/UTs: 90:10 ratio
- For Union Territories without legislatures: Central Government may provide up to 100%
Frequently Asked Questions (FAQs)
1. What is Ayushman Bharat PM-JAY?
AB-PMJAY is the central government’s flagship health assurance scheme that provides health insurance of up to ₹5 lakh per eligible family annually for secondary and tertiary care hospitalization .
2. Who is eligible for Ayushman Bharat PM-JAY?
Eligible beneficiaries include families listed in the SECC 2011 database, ASHA/Anganwadi workers and helpers, and all senior citizens aged 70 years and above, regardless of income .
3. Is Ayushman Bharat free for senior citizens?
Yes, all senior citizens aged 70 or above receive free health coverage up to ₹5 lakh annually, irrespective of their economic status or income .
4. What is the Ayushman Vay Vandana Card?
The Ayushman Vay Vandana Card is a distinct card issued to senior citizens aged 70 and above under AB-PMJAY to access the scheme’s benefits .
5. How can I apply for an Ayushman card online?
Visit the official portal beneficiary.nha.gov.in or pmjay.gov.in, check eligibility, provide Aadhaar details, complete e-KYC, upload documents, and download your card .
6. What documents are required for PM-JAY registration?
Aadhaar card, proof of identity, proof of residence, family details, and bank account details are required .
7. Is Aadhaar mandatory for enrollment?
Yes, Aadhaar-based e-KYC is mandatory for enrollment and issuance of Ayushman cards .
8. What is the coverage amount under PM-JAY?
Each eligible family receives an annual health cover of ₹5 lakhs for secondary and tertiary care hospitalization .
9. How many hospitals are empanelled under AB-PMJAY?
As of March 2026, 36,229 hospitals have been empanelled, including 19,483 public and 16,746 private hospitals .
10. Is there a cap on family size under PM-JAY?
No, PM-JAY imposes no restrictions on family size, age, or gender .
11. Are pre-existing diseases covered?
Yes, all pre-existing medical conditions are covered from the very first day of enrolment .
12. Can I avail treatment anywhere in India?
Yes, the benefits under the scheme are portable across the country and can be availed at any empanelled healthcare provider .
13. How can I check my eligibility for PM-JAY?
You can check eligibility through the “Am I Eligible” option on the official PMJAY website, by visiting a Common Service Centre, or at an empanelled hospital .
14. What if my 70+ family member is already covered under PM-JAY?
Senior citizens aged 70 and above who already belong to families covered by AB-PMJAY receive an additional top-up cover of ₹5 lakh per year exclusively for their use .
15. Which states are not implementing AB-PMJAY?
Delhi and West Bengal are currently not implementing AB-PMJAY, though Odisha is being onboarded .
Conclusion
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana represents a paradigm shift in India’s approach to healthcare delivery. As the world’s largest public healthcare scheme, it has transformed the lives of millions of vulnerable families by providing access to quality healthcare without the burden of catastrophic medical expenses .
With over 44.73 crore Ayushman cards generated and 12.69 crore hospital admissions authorized, the scheme has demonstrated its immense impact on the lives of India’s most vulnerable populations . The landmark decision to extend coverage to all senior citizens aged 70 and above, regardless of income, further underscores the government’s commitment to ensuring that no one is left behind in the journey towards universal health coverage .
The digitization of the application process through beneficiary.nha.gov.in and pmjay.gov.in, along with the availability of offline enrollment through Common Service Centres and empanelled hospitals, ensures that the benefits of the scheme reach the intended beneficiaries efficiently . The comprehensive health benefit package covering 1,961 procedures across 27 specialties ensures that beneficiaries have access to a wide range of healthcare services .
Official Links for Ayushman Bharat PM-JAY:
- PM-JAY Official Portal: https://pmjay.gov.in
- Beneficiary Portal: https://beneficiary.nha.gov.in
- National Health Authority: https://nha.gov.in
- Ministry of Health and Family Welfare: https://mohfw.gov.in
Ayushman Bharat PM-JAY is more than just a health insurance scheme – it is a promise of dignity, security, and a healthier future for every Indian family. By ensuring that every citizen has access to quality healthcare without financial hardship, the scheme is helping build a stronger, more equitable India. As the scheme continues to evolve and expand, it remains a shining example of how targeted government interventions can address fundamental challenges and create lasting positive change in society.