Health

Ayushman Bharat PM-JAY – Eligibility & Benefits

3 min read

Updated: February 2024

Disclaimer: This guide is for general educational purposes only and is not legal advice. Laws may vary by state and change over time. Consult a qualified lawyer for advice specific to your situation.

Ayushman Bharat PM-JAY — Free Health Coverage Guide

What is Ayushman Bharat?

Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the world's largest government-funded health insurance scheme. It provides:

  • ₹5 lakh health coverage per family per year
  • Covers secondary and tertiary care hospitalisation
  • Available at empanelled government and private hospitals
  • Cashless and paperless treatment

Who is Eligible?

Eligibility is based on the Socio-Economic Caste Census (SECC) 2011 data. You may be eligible if:

Rural Families (any of these)

  • Families with no adult member aged 16–59 years
  • Families where the head of household is a woman with no adult male
  • Primitive tribal groups
  • Families with a disabled member and no able-bodied adult
  • Manual scavenging families
  • Families living in kutcha walls and roof
  • Landless households earning from manual casual labour

Urban Occupational Categories

  • Rag pickers
  • Beggars
  • Domestic workers
  • Street vendors / cobblers / hawkers
  • Construction workers, plumbers, masons
  • Washermen, watchmen, sanitation workers
  • Home-based artisans
  • Transport workers (drivers, conductors, porters)
  • Shop workers, helpers in small establishments

If you are on the BPL list or received benefits under RSBY (Rashtriya Swasthya Bima Yojana), you are likely eligible.

What Does It Cover?

Over 1,949 medical procedures including:

  • Surgeries (orthopaedic, cardiac, cancer, etc.)
  • Chemotherapy and radiation
  • ICU charges
  • Pre and post-hospitalisation (up to 3 days before, 15 days after)
  • Day care procedures (no overnight stay needed)
  • Diagnostics, medicines, and consultation during hospitalisation

Does NOT cover: OPD (outpatient), dental (except surgeries), cosmetic surgery, self-inflicted injuries.

How to Check if You Are Eligible

Option 1: Online

  1. Visit pmjay.gov.in
  2. Click "Am I Eligible"
  3. Enter your mobile number and OTP
  4. Enter Ration Card or name + state to search

Option 2: Common Service Centre (CSC)

Visit your nearest Jan Seva Kendra / CSC with Aadhaar card.

Option 3: Ayushman Mitra at Hospital

Visit any empanelled hospital and ask the Ayushman Mitra (help desk) to check your eligibility.

How to Get Your Ayushman Card

  1. Check eligibility (above)
  2. Go to your nearest Empanelled Hospital or CSC
  3. Carry: Aadhaar Card + Ration Card
  4. The Ayushman Mitra will verify and generate your e-card
  5. Download from beneficiary.nha.gov.in

The card is free. No one should charge you for it.

How to Use It at Hospital

  1. Visit any PM-JAY empanelled hospital
  2. Show your Ayushman card / Aadhaar at the Ayushman Mitra desk
  3. They will verify your eligibility online
  4. Treatment is completely cashless — no upfront payment needed

Find Empanelled Hospitals Near You

  • Visit hospitals.pmjay.gov.in
  • Enter your state and district
  • Filter by speciality

Helpline

Ayushman Bharat Helpline: 14555 (Toll Free, 24×7) Website: pmjay.gov.in


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About This Guide

Category

Health

Reading Time

3 min read

Language

English

Updated

Feb 2024

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