Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana is a government-led health insurance scheme providing cashless healthcare to low-income families. It offers coverage of ₹5,00,000 per family every year for secondary and tertiary hospital treatments, and in 2026 the scheme continues to run across all states, with the Union Cabinet also extending cover to every senior citizen aged 70 and above regardless of income.
Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana is a comprehensive health scheme for poor families in rural and urban areas. This scheme makes healthcare affordable and easy to access for the poor. As the largest health assurance scheme in the world, it provides a cover of ₹5,00,000 per family per year.
Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana - Introduction
The National Health Authority (NHA) runs this scheme under the Ministry of Health and Family Welfare, Government of India. It gives cashless hospitalization cover for secondary and tertiary healthcare services. The Prime Minister of India launched this scheme on 23rd September 2018 in Ranchi, Jharkhand.
Ayushman Bharat shifts the focus from separate services to a complete, needs-based healthcare delivery system. It acts as a bridge to cover prevention, promotion, and ambulatory care at primary, secondary, and tertiary levels through two main parts:
- Health and Wellness Centres (HWCs): These centres provide primary healthcare, including maternal and child health, non-communicable disease management, and basic diagnostics close to your home.
- Pradhan Mantri Jan Arogya Yojana (PM-JAY): This part provides cashless health insurance cover of up to ₹5,00,000 per family annually for secondary and tertiary hospitalization.
Key Information
| Scheme Name | Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana |
| Level | Central |
| Beneficiary | Family |
| Reach | All States |
| Category | Health & Wellness |
| Implementing Agency | National Health Authority (NHA) |
| Launched | 23rd September 2018 |
Benefits
Financial Health Insurance Cover: Eligible families receive cashless cover of up to ₹5,00,000 per family annually for secondary and tertiary care. This covers all costs related to consultations, medicines, diagnostics, surgery, ICU, and inpatient stay.
Supportive Coverage: The scheme covers major treatment costs including 3 days of pre-hospitalization and 15 days of post-hospitalization expenses. Problems that come up during treatment are also included. As of 2026, over 43.52 crore Ayushman cards have been issued and more than 36,000 hospitals are empanelled under the scheme.
| Coverage Feature | Benefit Detail |
|---|---|
| Pre-existing Diseases | Covered from day one |
| Family Size | No limit on age or gender |
| Portability | Available across India |
| Procedures | Covers 1,929 medical procedures |
Eligibility
Rural Beneficiaries: A household is eligible if it falls under the deprivation criteria defined by the Socio-Economic Caste Census (SECC). This includes families living in one-room kucha houses, those without an adult member between ages 16-59, households with a disabled member, SC/ST households, or landless families relying on manual labor. At-risk groups such as those living on alms, manual scavengers, and primitive tribal groups are automatically included.
Urban Beneficiaries: People working in one of the 11 occupational categories are eligible. Examples include:
- Ragpickers and street vendors.
- Construction workers, plumbers, masons, and welders.
- Sweepers, sanitation workers, and Mali.
- Transport workers, drivers, and conductors.
- Shop assistants, peons, and delivery attendants.
- Washer-men and security guards.
Senior Citizens (70+): Following the Union Cabinet decision of 11th September 2024, every senior citizen aged 70 and above is now eligible for health cover under Ayushman Bharat Vay Vandana, regardless of income or existing insurance. This expansion benefits around 4.5 crore families, including about 6 crore senior citizens.
Exclusions
A family is not eligible for this scheme if it meets any of the following criteria:
- It owns a motorized vehicle like a car or a boat.
- It has mechanized farming machinery.
- Its Kisan card carries a credit limit of more than ₹50,000.
- It has a government employee in the family.
- It holds a job in a government-managed non-agricultural firm.
- Its monthly income exceeds ₹10,000.
- It owns a house with solid walls and a roof, or has access to a landline and refrigerator.
- It owns more than 5 acres of agricultural land.
Application Process
OFFLINE PROCESS: Visit an empanelled hospital or a Common Service Centre (CSC) and meet an Arogya Mitra. The operator will check eligibility in the database using the Ration Card, mobile number, or RSBY URN. On confirmation, provide Aadhaar or government ID for verification. After scanning the documents, the operator submits the details for approval. Once approved by the State Health Agency, the e-card is generated.
ONLINE PROCESS:
STEP 1 - Go to the official Ayushman Bharat PM-JAY portal at beneficiary.nha.gov.in and click on the "Am I Eligible" option on the homepage.
STEP 2 - Enter the registered mobile number and verify the OTP that arrives, then search using Aadhaar, Family ID, or other available details.
STEP 3 - Check the eligibility status and complete eKYC if required on the portal.
STEP 4 - Submit the application, or visit the nearest CSC or empanelled hospital for help with the process.
STEP 5 - After verification, the Ayushman Bharat Health Card is generated and can be downloaded from the beneficiary dashboard.
Documents
When applying, keep the following ready:
- Aadhaar Card or PAN Card (Age and Identity proof).
- Proof of current residential address.
- Valid contact details including mobile number and email.
- Caste and Income Certificates.
- Relevant documents proving family status.
References
- National Health Authority Official Website
- PM-JAY Beneficiary Portal
- UMANG Portal Service
- India.gov.in Scheme Details
FAQ's
Will I have to pay for services under this scheme?
No, the scheme provides fully cashless access at public and empanelled private hospitals for all covered procedures.
Do I need to enroll to get benefits?
No, this is an entitlement-based scheme. Families identified through the SECC database are automatically eligible.
Are my existing medical conditions covered?
Yes, all pre-existing medical conditions are covered from the day of your eligibility.
Who is an Arogya Mitra?
An Arogya Mitra is a healthcare professional stationed at empanelled hospitals who helps with beneficiary identification, document processing, and the claim process.
Can I use the scheme without an Aadhaar card?
Yes, an Aadhaar card is not mandatory; other government-verified identification documents can be used.
What is the helpline number for the scheme?
Beneficiaries can call the toll-free helpline 14555 or 1800-11-4477 for support and complaints related to the scheme.
