India Ayushman Bharat PM-JAY
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is a Government of India health-assurance benefit that provides cashless and paperless cover of up to ₹5 lakh per family per year for secondary and tertiary hospitalization. Core eligibility is based on identified households, while Indian citizens aged 70 and above can use the senior-citizen cover regardless of income.
Ayushman Bharat PM-JAY: Ongoing Government Health Coverage in India
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, usually shortened to AB PM-JAY or PM-JAY, is a Government of India health-assurance program administered nationally by the National Health Authority (NHA). It pays for defined secondary and tertiary hospitalization packages for eligible beneficiaries at empanelled public and private hospitals. The benefit is cashless and paperless at the point of service, and the scheme is portable across India.
This page describes a live benefit rather than a grant competition. There is no annual application round or published closing date for the core entitlement in the official material reviewed for this update. The front matter therefore uses deadline = 'rolling'. A person should check eligibility and card status when care is needed, or complete the senior-citizen enrollment process if they qualify. A rolling label does not mean that every Indian household is automatically covered: eligibility depends on the route described below.
Opportunity snapshot
| Detail | Current information |
|---|---|
| Program | Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) |
| Administrator | National Health Authority, Government of India |
| Benefit | Up to ₹5 lakh per family per year |
| Eligible care | Secondary and tertiary hospitalization under approved packages |
| Beneficiary cost | No premium or enrollment fee; treatment is cashless at empanelled hospitals |
| Core household route | Identified households under SECC 2011 deprivation and occupational criteria, subject to state implementation |
| Senior-citizen route | Indian citizens aged 70 or above, regardless of income |
| Application timing | Rolling; no annual closing date is published |
| Official portal | pmjay.gov.in |
| Senior-citizen enrollment | beneficiary.nha.gov.in and the Ayushman App |
| Support | PM-JAY helpline 14555; NHA also publishes 1800 11 0770 for 70+ card information |
The amount is a family-floater ceiling, not a cash payment to the household. The scheme pays the empanelled provider for covered treatment up to the applicable package and family limit. A family should not treat the ₹5 lakh figure as a general-purpose reimbursement account or as coverage for every medical service.
What PM-JAY covers
PM-JAY is designed around hospitalization. The official NHA description says it covers secondary and tertiary care in empanelled public and private hospitals and gives beneficiaries cashless, paperless access. Covered package costs can include the hospital services, medicines, diagnostics, physician and surgeon charges, room charges, operating-theatre charges, and intensive-care charges specified by the approved package. The exact service list and package conditions can change, so the hospital and the official portal are the right places to confirm a proposed procedure.
The scheme also includes package-linked pre-hospitalization and post-hospitalization support. NHA program material describes up to three days of pre-hospitalization and up to fifteen days of post-hospitalization expenses such as diagnostics and medicines. Those periods are part of a covered package; they do not create a separate outpatient insurance benefit.
Pre-existing conditions are covered from the first day. The core scheme has no restriction based on a beneficiary’s age or gender and no cap on the number of family members in an eligible household. The ₹5 lakh limit remains shared on the family-floater basis unless a particular senior-citizen entitlement creates the separate top-up described below.
PM-JAY is portable. A beneficiary can use an empanelled hospital outside the state in which the household was identified, subject to the hospital being part of the PM-JAY network and the treatment being covered. This matters for people who work away from home or need a specialty that is not available locally. Portability does not remove the need for eligibility verification or pre-authorization rules that apply to the treatment package.
PM-JAY is not a promise that every hospital accepts every procedure, and it is not a substitute for primary care or routine outpatient insurance. It is also not a scholarship, loan, cash grant, or payment made directly to an applicant. Before admission, ask the hospital’s Ayushman Mitra desk whether the hospital is empanelled for the required specialty and which package will be used.
Who is eligible
There are two important eligibility routes.
Core PM-JAY households
The original national route identifies poor and vulnerable households using the deprivation criteria for rural households and the occupational categories for urban households in the Socio-Economic Caste Census (SECC) 2011 data. NHA material describes the target as the bottom portion of the population identified by those criteria. This is not the same as saying that every person who considers their income low is automatically enrolled, and the page should not describe the program as a universal benefit for all ages and incomes.
States and Union Territories implement the national framework through State Health Agencies. Their rules may add categories or combine PM-JAY with a state health program. That is why a household not found through the central lookup should still ask the State Health Agency, an authorized Common Service Center, or an empanelled hospital whether a state expansion applies. Do not pay an intermediary to create eligibility: the benefit is government funded and the official process does not charge a beneficiary premium.
Once a household is confirmed as eligible, all members can use the family entitlement under the scheme’s rules. There is no family-size cap for the core route. The family should still complete beneficiary identification and card generation before planned care if possible, because the hospital must verify the person and the package before treatment can be authorized.
Senior citizens aged 70 and above
The NHA’s senior-citizen FAQ states that any Indian citizen aged 70 or above is eligible regardless of income or economic status. The expansion was approved by the Union Cabinet on 11 September 2024, and the senior-citizen card rollout was announced on 29 October 2024. These are background milestones, not application deadlines. The program is still described here as rolling because eligible seniors can use the NHA enrollment route rather than wait for a new yearly call.
A distinct Ayushman Card is issued to an eligible senior. Aadhaar-based e-KYC is mandatory, and the NHA FAQ says Aadhaar is the only document needed for enrollment in the senior-citizen scheme. If only a birth year appears in Aadhaar, the NHA’s published FAQ explains how the recorded age is handled; applicants should resolve any identity or date-of-birth mismatch through the official support route rather than guess.
The financial treatment depends on whether the senior already belongs to a PM-JAY family. A senior aged 70 or above in an existing PM-JAY family receives an additional top-up of up to ₹5 lakh per year for the senior members and does not have to share that top-up with family members below 70. Other eligible seniors receive up to ₹5 lakh per year on a family basis. This does not mean that every member of an existing household receives a new ₹5 lakh increase.
A senior with private health insurance or Employees’ State Insurance can still be eligible under the NHA FAQ. Someone covered by another government health scheme, such as CGHS, ECHS, or Ayushman CAPF, must follow the applicable choice rule: the official FAQ says the person must choose between the existing government scheme and AB PM-JAY rather than use both government benefits at the same time. Confirm the consequence of switching before making that choice.
How to apply or get a card
The process is different for a core household and for the 70+ route, but neither is a competitive application.
Start with the official source. Visit pmjay.gov.in and use the beneficiary or eligibility links. If the online lookup does not resolve the household, contact the State Health Agency, a Common Service Center, or an Ayushman Mitra at an empanelled hospital. The PM-JAY helpline can also explain the next verification step.
Use the dedicated senior portal when applicable. A person aged 70 or above can apply through beneficiary.nha.gov.in or the official Ayushman App. The NHA FAQ specifically names both routes. Use the official app listing and portal; do not submit Aadhaar details to an unofficial card seller.
Complete Aadhaar e-KYC. For the senior-citizen route, Aadhaar-based e-KYC is required for enrollment and card issuance. The portal may send an authentication request or request the details needed to verify the beneficiary. If the first senior is enrolled for a family, the NHA FAQ says other 70+ family members can be added with the portal’s “Add Member” feature.
Generate and save the Ayushman Card. After successful verification, save the digital card and, where available, request a printed copy. The card is an access credential; it is not a separate bank payment. Keep the beneficiary’s name and identity information consistent across the card and Aadhaar records.
Find an empanelled hospital. Use the PM-JAY site, the NHA hospital-search service, the Ayushman App, or the helpline to locate a hospital that offers the needed specialty. At the hospital, go to the Ayushman Mitra or beneficiary help desk before paying for anything. Ask whether the proposed treatment is covered under a PM-JAY package.
Verify admission and treatment. The hospital verifies eligibility and identity, then follows the package’s authorization process. For covered treatment, the hospital claims payment from the scheme or its implementation partner. The patient should receive cashless treatment within the package rules and should not be asked for a beneficiary premium.
Keep records and report problems. Retain the card, identity details, admission papers, discharge summary, and any package information supplied by the hospital. If an empanelled hospital refuses eligible care or demands an improper payment, record the hospital details and report the issue through the official grievance channel or PM-JAY helpline 14555.
What to take and what to check
For a core household, take the Ayushman Card if one has already been issued, Aadhaar or another accepted government identity document, and any family-identification information requested by the official lookup or hospital. The exact verification route can vary by state and by the household record.
For a senior-citizen enrollment, Aadhaar is the key document identified by NHA. A working mobile number can help with authentication and account access, but applicants should follow the portal’s current instructions rather than assume that a particular document or phone setup is mandatory. If the Aadhaar record is wrong, correct that identity issue through the authorized channel before relying on a card.
Before admission, check four things: that the beneficiary record is found; that the hospital is empanelled; that the specialty and proposed treatment are listed under an applicable package; and whether the patient is using a government health scheme that requires a choice. These checks prevent a common misunderstanding in which the ₹5 lakh ceiling is mistaken for an unconditional payment.
Frequently asked questions
Is there a deadline?
No annual closing date is published for the core PM-JAY entitlement or for the senior-citizen enrollment route in the official material reviewed here. Use the page as a rolling opportunity, not as a dated competition. The word “rolling” describes access timing; it does not override eligibility rules.
Is the benefit free?
Eligible beneficiaries do not pay a PM-JAY premium or enrollment fee. Treatment must still fall within an approved package at an empanelled provider, and a service outside the package may follow a different payment rule. Ask the Ayushman Mitra desk before admission.
Does being poor automatically qualify a household?
No. Core eligibility is based on the official beneficiary records and the applicable state rules, not on a general self-declaration of low income. Check the record and ask about state additions if the central lookup does not show the family.
Can a person aged 70 or above qualify without being on the SECC list?
Yes. The NHA senior-citizen FAQ says Indian citizens aged 70 or above qualify regardless of income or economic status. The person still has to complete the required Aadhaar e-KYC and obtain the distinct card.
Can the card be used in another state?
PM-JAY benefits are portable across India at empanelled hospitals, subject to the hospital, beneficiary verification, and package rules. Call the helpline or check the official hospital list before traveling for planned care.
Is PM-JAY the same as ABHA?
No. PM-JAY is the health-assurance benefit for eligible hospitalization. ABHA is a digital health-account identity associated with the wider digital-health mission. An ABHA number should not be treated as proof that a household qualifies for PM-JAY.
The official references for this page are the PM-JAY portal, the NHA beneficiary portal, the NHA senior-citizen FAQ, and the NHA empanelled-hospital search. Check those sources again before making a healthcare decision because package lists, state participation, and portal instructions can change.