🗓️Last Updated: June 2026

Ayushman Bharat PMJAY 2026: ₹5 Lakh Health Cover — Eligibility & Card

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) is the world's largest government-funded health insurance scheme. It provides ₹5 lakh per family per year for hospitalisation at empanelled hospitals — covering 1,949 medical and surgical procedures. Learn how to check eligibility, get your Ayushman card, and use it at hospitals.

🔗pmjay.gov.in — Official Portal →

📋 Overview

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) — launched in September 2018 — is the flagship health insurance scheme of the Government of India. It provides a health cover of ₹5 lakh per family per year for secondary and tertiary hospitalisation at any empanelled public or private hospital. The scheme covers over 12 crore poor and vulnerable families (approximately 55 crore individuals) identified based on the Socio-Economic Caste Census (SECC) 2011 data. There is no application process — families are auto-enrolled based on the SECC database. You just need to check if your family is listed and then get your Ayushman card. The benefit covers pre-hospitalisation (up to 3 days) and post-hospitalisation expenses (up to 15 days), including medicines, diagnostics, and follow-up consultations. The cover is cashless and paperless at empanelled hospitals. The scheme covers 1,949 medical procedures across 27 specialties, including heart surgery, knee replacement, cancer treatment, dialysis, and ICU care.

✅ Eligibility

  • ✓Families listed in the SECC 2011 (Socio-Economic Caste Census) database — no manual application needed
  • ✓Rural families: landless households, those living in kutcha houses, manual scavengers, primitive tribal groups, legally released bonded labourers, and families with no adult male member aged 16–59
  • ✓Urban families: rag-pickers, domestic workers, street vendors, construction workers, plumbers, electricians, mechanics, security guards, beggars, and similar occupational categories
  • ✓There is no family size or age limit — the entire family is covered under one ₹5 lakh annual cover
  • ✓Some states have expanded PMJAY to additional beneficiaries (e.g., UP, MP, Rajasthan, Kerala) — check your state's list
  • ✓The benefit is portable — you can use it at any empanelled hospital across India, not just your home state

📁 Documents Required

▸Aadhaar card (primary ID for Ayushman card generation)
▸Ration card (NFSA/PHH/AAY) — helps match your family to the SECC database
▸Mobile number (for OTP verification during Ayushman card issuance)
▸No additional income or caste certificate is required — eligibility is automatic based on SECC data

💰Fees & Processing Time

Fee
Free — No premium, no co-payment. The scheme is fully funded by the central and state governments.
Processing Time
Ayushman card can be generated instantly (on-the-spot) at empanelled hospital Arogya Mitras, Common Service Centres (CSC), or at pmjay.gov.in after eligibility confirmation. Hospital treatment is cashless from day one of card issuance.

🖥️ How to Apply Online

  1. 1Go to pmjay.gov.in or beneficiary.nha.gov.in
  2. 2Click 'Am I Eligible?' on the homepage
  3. 3Enter your mobile number and complete OTP verification
  4. 4Enter your Ration Card number, Aadhaar number, or SECC data details
  5. 5Select your state and enter the required information
  6. 6If your family appears in the results, you are eligible — note down your PMJAY ID/HH ID
  7. 7To get your Ayushman card: log in to beneficiary.nha.gov.in or visit any empanelled hospital
  8. 8Enter Aadhaar number, complete face authentication or OTP verification
  9. 9Download your Ayushman card (PDF) — print or save on phone
  10. 10You can also use the Ayushman App (Android/iOS) to check eligibility and download the card

🏢 How to Apply Offline

  1. 1Visit any government empanelled hospital (look for the Ayushman Bharat board at the hospital entrance)
  2. 2Meet the Arogya Mitra (hospital facilitator) at the helpdesk
  3. 3Carry your Aadhaar card and ration card
  4. 4Arogya Mitra will check your eligibility in the SECC database and generate your Ayushman card on the spot
  5. 5Alternatively, visit the nearest Common Service Centre (CSC) — they can generate the Ayushman card
  6. 6State-level Ayushman Melas are also organised periodically — check your state health department for dates

⚠️Common Problems & Solutions

✗Name not found in PMJAY eligibility check
→Try alternate spellings of your name, try with another family member's name, or use your ration card number instead of Aadhaar. SECC data was collected in 2011, so names may be as they were recorded then. If still not found, contact your district PMJAY office — some states have extended coverage beyond SECC.
✗Hospital refusing to provide cashless treatment
→Call the Ayushman helpline 14555 immediately. Empanelled hospitals are legally required to provide cashless treatment for covered procedures. Ask to speak to the Arogya Mitra. If the hospital continues to refuse, file a grievance at grievance.pmjay.gov.in — the hospital can be de-empanelled.
✗Ayushman card face authentication failing
→Face authentication requires good lighting and a clear, still face. If it repeatedly fails, switch to OTP authentication (OTP sent to Aadhaar-linked mobile). Alternatively, the Arogya Mitra at the hospital can use a biometric device (fingerprint) for authentication.
✗Treatment not covered under PMJAY
→PMJAY covers 1,949 procedures. OPD (outpatient) consultations, medicines for chronic conditions without hospitalisation, and cosmetic surgeries are not covered. Check the full list at pmjay.gov.in → Health Benefit Packages. For non-covered conditions, enquire about your state's additional health scheme (e.g., CGHS, ESI, state insurance).
✗Card issued but wrong name or details
→Visit the empanelled hospital Arogya Mitra or CSC with your Aadhaar card. Request a correction through the PMJAY beneficiary management system. The Aadhaar name is used as the authoritative name, so ensure Aadhaar is updated if there is an error.

❓ Frequently Asked Questions

Q.How do I check if I am eligible for Ayushman Bharat PMJAY?

Go to pmjay.gov.in and click 'Am I Eligible?'. Enter your mobile number, then provide your ration card number or SECC data. You can also call 14555 and provide your ration card number for eligibility verification. The Arogya Mitra at any empanelled hospital can also check on the spot.

Q.What is the ₹5 lakh limit — is it per person or per family?

The ₹5 lakh limit is per family per year, not per person. All members of the family (as listed in the SECC database) share this annual limit. Some states have increased this limit — for example, several states provide ₹10 lakh coverage under expanded state schemes.

Q.What treatments and procedures does Ayushman Bharat cover?

Ayushman Bharat covers 1,949 medical and surgical procedures across 27 specialties. This includes heart surgeries (bypass, valve replacement), cancer treatment (chemotherapy, radiotherapy, surgery), orthopaedic surgeries (knee/hip replacement), dialysis, ICU care, neonatal care, psychiatric treatments, and many more. The full list of Health Benefit Packages (HBPs) is available at pmjay.gov.in.

Q.Can I use Ayushman Bharat at private hospitals?

Yes. PMJAY is valid at all empanelled hospitals — both government and private. You can find empanelled hospitals in your area at pmjay.gov.in → Find Hospital. There are over 29,000 empanelled hospitals across India. Always verify a hospital is empanelled before admission.

Q.What is the difference between Ayushman Bharat PMJAY and the state health scheme?

Many states have co-branded or extended PMJAY with their own state schemes — for example, Ayushman Bharat Mukhyamantri Jan Arogya Yojana (AB-MMJAY) in Maharashtra, Dr. YSR Aarogyasri in Andhra Pradesh, and Biju Swasthya Kalyan Yojana in Odisha. These state extensions may cover additional beneficiaries (beyond SECC 2011) and may offer higher coverage amounts. Check your state health department for details.

Q.Does the Ayushman card have an expiry date?

The Ayushman card itself does not expire. However, the annual ₹5 lakh coverage resets every year (typically April 1 to March 31). You can use the card year after year at any empanelled hospital. If you change your mobile number or Aadhaar details, update them through the PMJAY portal or CSC.

Q.Can a senior citizen (above 70) get Ayushman Bharat?

Yes. From September 2024, all senior citizens aged 70 and above are eligible for Ayushman Bharat regardless of income or SECC status — this is the 'Ayushman Vaya Vandana' expansion. They can register at pmjay.gov.in or any CSC with their Aadhaar card. This is separate from the standard SECC-based eligibility.

Q.What if I am admitted to a hospital in a different state?

PMJAY is completely portable across India. You can use your Ayushman card at any empanelled hospital anywhere in the country, regardless of which state you are a resident of. This is especially useful for patients seeking specialised treatment in larger cities.

📞Helpline & Support

  • ▸Ayushman Bharat Helpline: 14555 (toll-free, 24×7)
  • ▸Alternative number: 1800-111-565
  • ▸Email: pmjay@nha.gov.in
  • ▸State helplines: Each state has a dedicated PMJAY helpline — listed at pmjay.gov.in → Contact
  • ▸Grievance portal: grievance.pmjay.gov.in
  • ▸Arogya Mitra at hospital: Present at all empanelled hospitals to assist beneficiaries
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Disclaimer: NagrikIQ is an informational platform and is not affiliated with any government department. Information provided is for guidance only. Always verify details on the official government portal before taking action.