Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana
AB PM-JAY is a health insurance scheme for low-income families in rural and urban areas. The scheme aims to provide affordable healthcare facilities to the Poor. It is the largest health assurance scheme in the world which aims at providing a health cover of ₹5,00,000/- per family per year.
About This Scheme
The scheme “Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana” implemented by the National Health Authority (NHA) under Ministry of Health and Family Welfare, Government of India, aims to provide cashless hospitalisation coverage of ₹5,00,000 per family per year to poor and vulnerable families for secondary and tertiary healthcare services. It was launched on 23rd September 2018 in Ranchi, Jharkhand, by the Hon’ble Prime Minister of India.
“Ayushman Bharat” is an attempt to move from a sectoral and segmented approach to health service delivery to a comprehensive need-based health care service. This scheme aims to undertake path-breaking interventions to holistically address the healthcare system (covering prevention, promotion, and ambulatory care) at the primary, secondary, and tertiary levels. Ayushman Bharat adopts a continuum of care approach, comprising two interrelated components, which are –
Health and Wellness Centres (HWCs): The scheme aims to provide comprehensive primary healthcare services, including maternal and child health, non-communicable disease care, free essential drugs, and diagnostics, close to people’s homes. The centres promote preventive healthcare and healthy behaviours to reduce the risk of chronic diseases.
Pradhan Mantri Jan Arogya Yojana (PM-JAY): The second component under Ayushman Bharat is the Pradhan Mantri Jan Arogya Yojna or PM-JAY as it is popularly known. It aims to provide cashless health insurance coverage of up to ₹5,00,000 per family per year for secondary and tertiary hospitalization to poor and vulnerable families.
Benefits
Financial Health Insurance Cover:
Annual Hospitalization Coverage: Cashless coverage up to ₹5,00,000/- per family per year.
Comprehensive Treatment Costs: Covers consultation, medicines, diagnostics, surgery, ICU, implants, accommodation, and food.
Pre and Post Hospitalization Support: Covers 3 days pre-hospitalization and 15 days post-hospitalization expenses.
Treatment Complication Coverage: Covers complications arising during treatment.
Coverage Features:
Pre-Existing Disease Coverage: Covers all pre-existing diseases from day one.
No Family Size Limit: No restriction on age, gender, or family size.
Nationwide Portability: Benefits available across India in empanelled hospitals.
Wide Procedure Coverage: Covers approximately 1,929 medical procedures.
Eligibility Criteria
Rural Beneficiaries
Out of the total seven deprivation criteria for rural areas, PM-JAY covered all such families who fall into at least one of the following six deprivation criteria and automatic inclusion(Destitute/ living on alms, manual scavenger households, primitive tribal group, legally released bonded labour) criteria:
Only one room with kucha walls and kucha roof
No adult member between ages 16 to 59
Households with no adult male member between ages 16 to 59
Disabled member and no able-bodied adult member
SC/ST households
Landless households deriving a major part of their income from manual casual labour
Automatically includedHouseholds without shelter
Destitute/ living on alms,
Manual scavenger families,
Primitive tribal groups,
Legally released bonded labour.
Urban Beneficiaries
For urban areas, the following 11 occupational categories of workers are eligible for the scheme:
Ragpicker
Beggar
Domestic worker
Street vendor/ Cobbler/hawker / other service provider working on streets
Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/ Coolie and other head-load worker
Sweeper/ Sanitation worker/ Mali
Home-based worker/ Artisan/ Handicrafts worker/ Tailor
Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/ Rickshaw puller
Shop worker/ Assistant/ Peon in small establishment/ Helper/Delivery assistant / Attendant/ Waiter
Electrician/ Mechanic/ Assembler/ Repair worker
Washer-man/ Chowkidar
Application Process
Apply Offline
The Arogya Mitra searches the available list of beneficiaries using details such as name, location, ration card number, mobile number, or the RSBY URN of the beneficiary. After this, the beneficiary is searched for in the BIS. The individual is identified and the scanned valid ID documents are then uploaded.
To get a PMJAY e-card for themselves and their family, a potential beneficiary needs to visit either a hospital or a Community Service Centre (CSC) for identification and follow the steps mentioned below:
Step 1: Potential AB-PMJAY beneficiaries are to submit the PM letter/ RSBY URN/ RC Number/ Mobile Number – The operator (commonly known as the Arogya Mitra) searches the available list of beneficiaries. The operator does this by entering details such as name, location, Ration Card number, mobile number, or even RSBY URN of the beneficiary.
Step 2: Search in the BIS Application – The operator searches for the potential beneficiary in the entitled SECC, RSBY, State Health Scheme, Additional Data Collection Drive databases.
Step 3: Individual Identification – The identification process is carried out if the name is found in the list. For this, documents like Aadhaar or any government ID and a Ration Card or an alternative family ID are required to validate against the details available in the system. Scanned documents are then uploaded.
Step 4: Family Identification – The Arogya Mitra then identifies the family records through the ration card and the scanned documents are then uploaded. The Arogya Mitra then submits the individual and family records to the trust/insurance company for approval.
Step 5: Approval or Rejection – The Health insurance company or trust may then approve or recommend rejection for the submitted beneficiaries. The cases that are recommended for rejection will be finally verified for approval or rejection by the State Health Agency (SHA).
Step 6: E-card Issuance – On approval by SHA/insurance company/trust, an e-card will be issued to the beneficiary.
Official Source: View on myScheme.gov.in
Benefits
Financial Health Insurance Cover:
Annual Hospitalization Coverage: Cashless coverage up to ₹5,00,000/- per family per year.
Comprehensive Treatment Costs: Covers consultation, medicines, diagnostics, surgery, ICU, implants, accommodation, and food.
Pre and Post Hospitalization Support: Covers 3 days pre-hospitalization and 15 days post-hospitalization expenses.
Treatment Complication Coverage: Covers complications arising during treatment.
Coverage Features:
Pre-Existing Disease Coverage: Covers all pre-existing diseases from day one.
No Family Size Limit: No restriction on age, gender, or family size.
Nationwide Portability: Benefits available across India in empanelled hospitals.
Wide Procedure Coverage: Covers approximately 1,929 medical procedures.
Application Process
Apply Offline
The Arogya Mitra searches the available list of beneficiaries using details such as name, location, ration card number, mobile number, or the RSBY URN of the beneficiary. After this, the beneficiary is searched for in the BIS. The individual is identified and the scanned valid ID documents are then uploaded.
To get a PMJAY e-card for themselves and their family, a potential beneficiary needs to visit either a hospital or a Community Service Centre (CSC) for identification and follow the steps mentioned below:
Step 1: Potential AB-PMJAY beneficiaries are to submit the PM letter/ RSBY URN/ RC Number/ Mobile Number - The operator (commonly known as the Arogya Mitra) searches the available list of beneficiaries. The operator does this by entering details such as name, location, Ration Card number, mobile number, or even RSBY URN of the beneficiary.
Step 2: Search in the BIS Application - The operator searches for the potential beneficiary in the entitled SECC, RSBY, State Health Scheme, Additional Data Collection Drive databases.
Step 3: Individual Identification - The identification process is carried out if the name is found in the list. For this, documents like Aadhaar or any government ID and a Ration Card or an alternative family ID are required to validate against the details available in the system. Scanned documents are then uploaded.
Step 4: Family Identification - The Arogya Mitra then identifies the family records through the ration card and the scanned documents are then uploaded. The Arogya Mitra then submits the individual and family records to the trust/insurance company for approval.
Step 5: Approval or Rejection - The Health insurance company or trust may then approve or recommend rejection for the submitted beneficiaries. The cases that are recommended for rejection will be finally verified for approval or rejection by the State Health Agency (SHA).
Step 6: E-card Issuance - On approval by SHA/insurance company/trust, an e-card will be issued to the beneficiary.
References & Official Links
Scheme Details
| Full Name | Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana |
| Short Title | AB-PMJAY |
| Level | Central |
| Scheme For | Family |
| Ministry | Ministry Of Health & Family Welfare |
| Categories | Health & Wellness |
| States | All India |
| Gender | All |
| Age Range | Any — 18 years |
| Caste/Category | SC, ST, PwD |
| Area | Both |
| Income Limit | ₹500,000/year |
| Source | www.myscheme.gov.in ↗ |
Deepika Raikwar · 📅 23 May 2026
Deepika Raikwar is an Education Analyst and scholarship researcher who focuses on public welfare and merit-based scholarships. She simplifies complex eligibility rules, deadlines, and application processes to help common people access reliable funding opportunities worldwide.
View all posts by Deepika Raikwar →