Ayushman Bharat (PMJAY): ₹5 lakh free health insurance per family per year covering 1,929 medical procedures at 35,000+ empanelled hospitals.Annual Cover: ₹5 Lakh. Beneficiaries: 55+ Crore. Hospitals: 35,000+. Procedures: 1,929+.Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is the world's largest government-funded health insurance scheme. Launched on 23 September 2018, it provides free health coverage of up to ₹5 lakh per family per year to economically vulnerable families in India. The scheme covers secondary care (hospitalization) and tertiary care (surgery, ICU) at government and empanelled private hospitals.
Active SchemeUpdated: Last reviewed: April 2026 • Source: National Health Authority
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Ayushman Bharat (PMJAY)
₹5 lakh free health insurance per family per year covering 1,929 medical procedures at 35,000+ empanelled hospitals
Annual Cover
₹5 Lakh
Beneficiaries
55+ Crore
Hospitals
35,000+
Procedures
1,929+
📖What is Ayushman Bharat (PMJAY)?
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is the world's largest government-funded health insurance scheme. Launched on 23 September 2018, it provides free health coverage of up to ₹5 lakh per family per year to economically vulnerable families in India. The scheme covers secondary care (hospitalization) and tertiary care (surgery, ICU) at government and empanelled private hospitals.
The scheme covers over 55 crore individuals (approximately 12 crore families) from the bottom 40% of the population. Eligibility is determined based on the Socio-Economic Caste Census (SECC) 2011 data — if your family was identified as deprived in that census, you are automatically eligible. There is no enrollment fee, no premium to pay, and no age limit for beneficiaries.
PMJAY covers 1,929 medical and surgical procedures including pre-hospitalization (3 days before admission), hospitalization, and post-hospitalization (15 days after discharge) expenses. This includes diagnostics, medicines, room charges, surgeon fees, OT charges, and ICU costs. The coverage is on a family floater basis — meaning the entire ₹5 lakh limit is shared by all family members.
The scheme is implemented by the National Health Authority (NHA) at the central level and State Health Agencies (SHAs) at the state level. Over 35,000 hospitals across India (both government and private) are empanelled under PMJAY. Treatments are entirely cashless at empanelled hospitals — you don't need to pay anything upfront.
✅Eligibility
Who is eligibleFamilies identified as deprived in the SECC 2011 census data (bottom 40% of population)
Income criteria (rural)Families with kucha house, no adult earning member, female-headed household, SC/ST, landless, manual scavengers, destitute, beggars
Income criteria (urban)Rag pickers, street vendors, domestic workers, construction workers, plumbers, painters, security guards, sweepers, sanitation workers, transport workers, shop workers, rickshaw/auto drivers
Family sizeNo limit on family size — all members of the family are covered
Age limitNo age limit — newborns to senior citizens all covered
Premium/fee₹0 — completely free. No enrollment fee, no premium, no copay
Documents neededAadhaar card or any government ID, ration card (for family verification). Ayushman card can be made at any empanelled hospital or CSC center
📌Who Gets It Automatically
📌Who Gets It Automatically
If your family was in the SECC 2011 deprivation list, you're automatically eligible — no application needed. Just visit the nearest CSC center or hospital and get your Ayushman card made. Over 12 crore families fall in this auto-eligibility group.
🔍How to Check If You Are Eligible
1
Visit the PMJAY eligibility portal
Go to mera.pmjay.gov.in or beneficiary.nha.gov.in. This is the official portal to check your eligibility.
2
Enter your mobile number
Enter your registered mobile number and complete the OTP verification. Your mobile should be linked to your ration card or SECC data.
3
Search by name, ration card, or RSBY ID
You can search using: your name + father's name + state, or ration card number, or RSBY (Rashtriya Swasthya Bima Yojana) URN number. The system checks if your family is in the SECC 2011 database.
4
Check result
If eligible, you'll see your family details and a message confirming eligibility. You can then generate your Ayushman card online or at an empanelled hospital.
5
Not found? Don't lose hope
If your family isn't found in the system but you believe you qualify, visit your nearest Ayushman Bharat Arogya Mandir (Health & Wellness Centre) or call the helpline at 14555. Many states have expanded eligibility beyond SECC 2011 data.
🪪How to Get Your Ayushman Card
The Ayushman Card (also called ABHA Health Card or Golden Card) is your identification document for availing cashless treatment. Without this card, you may face delays at the hospital.
Method 1 — At any empanelled hospital: Visit the Ayushman Mitra desk at any PMJAY-empanelled hospital. Carry your Aadhaar card and ration card.
The Ayushman Mitra will verify your eligibility, take your photo, and generate the card on the spot. This is the most common method and takes about 10-15 minutes.
Method 2 — At a CSC center: Visit your nearest Common Service Centre (CSC). The CSC operator can check your eligibility and generate the card.
You may need to pay a nominal fee of ₹30 for the card printing.
Method 3 — Online through the PMJAY app: Download the 'Ayushman Bharat' app from Google Play Store. Register using your mobile number, verify with Aadhaar OTP, and download your digital Ayushman card.
You can show this digital card at hospitals.
Method 4 — Through Aarogya Mandir: Visit any Ayushman Bharat Health & Wellness Centre (AB-HWC) in your area. They can verify your eligibility and issue the card.
Important: The card is free to generate. If anyone asks you to pay a large amount (₹500+), it is likely a scam.
The maximum legitimate charge is ₹30 for printing at CSC centers.
📊Visual: What PMJAY Covers
₹5 lakh annual cover per family — one of the world's largest health schemes
Coverage is per family per year, resets annually on April 1st. Spouse + children + parents all share the same ₹5 lakh pool.
✅What is Covered Under PMJAY — Major Procedures
PMJAY covers 1,929 treatment packages across 27 medical specialties. Major treatments covered include:
Cardiac: Bypass surgery (CABG), angioplasty with stent, heart valve replacement, pacemaker implantation. These alone can save ₹2-5 lakh per procedure.
Cancer: Chemotherapy, radiation therapy, surgical removal of tumors (various organs), bone marrow transplant. Cancer treatment packages range from ₹15,000 to ₹4 lakh.
Orthopedic: Knee replacement (₹80,000-1.2 lakh package), hip replacement, spine surgery, fracture treatment with implants.
Eye: Cataract surgery, glaucoma treatment, corneal transplant, vitreo-retinal surgery.
Kidney: Dialysis (₹2,000 per session, covered for up to 12 sessions/month), kidney transplant (up to ₹3 lakh).
Maternity: Normal delivery, C-section delivery, treatment of pregnancy complications. Newborn care up to 30 days is also covered.
Others: Brain surgery, lung surgery, burns treatment, polytrauma management, neonatal ICU care, cleft lip/palate surgery.
Also covered: 3 days of pre-hospitalization expenses (tests, consultations) and 15 days of post-hospitalization expenses (medicines, follow-up visits).
NOT covered: Outpatient consultations (OPD), cosmetic surgery, fertility treatment (IVF), organ transplant (except kidney/cornea), dental treatment unless hospitalized.
🏥Visual: Hospital Process
The 4-step process is the same at every empanelled hospital
Every empanelled hospital has an Arogya Mitra — a PMJAY coordinator who handles verification, pre-authorization, and billing on your behalf.
🏥How to Use PMJAY at a Hospital — Step by Step
1
Go to any empanelled hospital
Find empanelled hospitals at hospitals.pmjay.gov.in or call 14555. Both government and private hospitals are included. You can also use the Ayushman Bharat app to search nearby hospitals.
2
Visit the Ayushman Mitra desk
Every empanelled hospital has a dedicated 'Ayushman Mitra' or 'PMJAY Help Desk' near the entrance or registration counter. Show your Ayushman card and Aadhaar.
3
Get pre-authorization
The hospital submits a 'pre-authorization request' to PMJAY system describing your treatment. This is approved within 30 minutes for most procedures (emergency cases get instant approval). You don't need to do anything — the hospital handles this.
4
Receive cashless treatment
Once approved, your treatment proceeds at zero cost. Room charges, medicines, surgeon fees, diagnostics, food during stay — everything is covered by PMJAY. You do NOT need to pay anything upfront.
5
Discharge and post-care
At discharge, verify the treatment summary. Post-hospitalization medicines and follow-up visits for 15 days are covered. If the hospital tries to charge you for covered services, complain immediately.
📍States with Additional Coverage Beyond ₹5 Lakh
Several states have expanded PMJAY coverage beyond the central ₹5 lakh limit or included more families:
Rajasthan — Chiranjeevi Yojana: Extends coverage to all families in the state. Additional coverage up to ₹25 lakh for serious illnesses.
Tamil Nadu — Chief Minister's Comprehensive Health Insurance Scheme: Covers all families with income below ₹72,000/year. Additional coverage up to ₹5 lakh.
Chhattisgarh — Dr. Khubchand Baghel Swasthya Sahayata Yojana: Covers all ration card holders, expanding beyond SECC data.
Kerala — Karunya Arogya Suraksha Padhathi (KASP): State-level scheme integrated with PMJAY, covering additional procedures.
Maharashtra — Mahatma Jyotiba Phule Jan Arogya Yojana: Integrated with PMJAY, covers families below ₹1.5 lakh income with additional procedures.
Check with your State Health Agency or call 14555 to know the exact coverage available in your state.
⚠️Important Limitation
⚠️Important Limitation
PMJAY covers hospitalization only — not OPD (outpatient visits). Doctor consultations, diagnostic tests without admission, and medicines for minor illness are not covered. You need to be admitted for at least 24 hours for coverage to kick in.
📝How to Apply
1
Check your eligibility first
Visit mera.pmjay.gov.in or call 14555. Enter your details to check if your family is in the SECC 2011 database. You don't need to 'apply' — if you're in the database, you're automatically eligible.
2
Get your Ayushman card made
Visit any empanelled hospital's Ayushman Mitra desk, a CSC center, or download the Ayushman Bharat app. Carry Aadhaar card and ration card. Card generation takes 10-15 minutes.
3
Verify your card details
Make sure your name, photo, and family details on the card are correct. If there's any error, get it corrected at the same center immediately.
4
Keep the card safe
Store the physical card safely and also save the digital version on your phone. You'll need it whenever you visit an empanelled hospital for treatment. Family members can generate their individual cards as well.
⚠️PMJAY is completely free. If anyone asks you to pay money for Ayushman card or enrollment, it is likely a fraud. The maximum legitimate charge is ₹30 for card printing at CSC centers. Report fraud to helpline 14555.
📅Important Dates & Schedule
Coverage period₹5 lakh limit resets every April 1
Card validityLifetime (as long as you remain eligible)
Helpline14555 (toll-free, 24x7)
Grievance portalgrievance.pmjay.gov.in
❓Frequently Asked Questions
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PMJAY Official Website
pmjay.gov.in
AK
Researched & verified from official sources
Updated
March 2026
March 2026