Ayushman Bharat: Pradhan Mantri Jan Arogya Yojana (PMJAY)
Ayushman Bharat (PMJAY) is India’s flagship health scheme that aims to provide insurance and in turn quality healthcare.
50 Cr Indians already have an ABHA card. Get yours today
50 Cr Indians already have an ABHA card. Get yours today
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Pradhan Mantri Jan Arogya Yojana (PMJAY) popularly known as Ayushman Bharat Yojana Scheme is the flagship scheme by the Government of India. It is essentially a health insurance scheme to cater to the poor, lower section of the society and the vulnerable population.
The scheme offers financial protection in case of hospitalisation due to medical emergencies. This article is a detailed guide about the government’s health insurance scheme’s eligibility, features, benefits and the application process.
What is PMJAY (Ayushman Bharat Yojana Scheme)?
Considered as one of the biggest healthcare schemes in the world, Ayushman Bharat Yojana aims to cover more than 50 crore Indian citizens. It is designed especially for the economically weaker sections of the country. The PMJAY was launched in September 2018 providing health insurance plans of a maximum sum insured amount of Rs.5 lakh.
The government health insurance scheme covers most of the medical treatment costs, medicines, diagnostics and pre-hospitalisation expenses. Additionally, the scheme offers cashless hospitalisation services through the Ayushman Bharat Yojana e-card which you can use to get healthcare services at any of the empanelled hospitals across the country. Beneficiaries of the scheme can avail hospitalisation for necessary treatment by showing their PMJAY e-card.
PM-JAY (Ayushman Bharat Yojana) Overview
Name of the Scheme | Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) or Ayushman Bharat National Health Protection Scheme (NHPS) |
|---|---|
Type of project | Health Insurance |
Started By | Prime Minister Shri Narendra Modi |
Country | India |
Ministry | Ministry of Health and Family Welfare |
Launched | 23 September 2018; 4 years ago |
Total Number of Ayushman Cards Issued Until Now | 21,40,17,608 (as of 21st December 2022) |
Total Number of Hospital Admissions Until Now | 4,23,59,252 (as of 21st December 2022) |
Total Number of Registered Families | Over Ten Crore |
Budget | ₹8,088 crore (US$1.0 billion) (2021–22) [1] |
Status | Active |
Website | |
Helpline Numbers | 1800-111-565 or 14555 |
Address | National Health Authority of India, 3rd, 7th and 9th Floor, Tower-L, Jeevan Bharati Building, Connaught Place, New Delhi – 110001 |
PM-JAY (Ayushman Bharat Yojana Scheme) Eligibility Criteria for Rural and Urban Population
PM-JAY scheme has been launched to cover the bottom 40% of poor and economically weaker sections of the country. The Ayushman Bharat Yojana Eligibility is designed with pre-conditions so that only the underprivileged people of the society benefit from the initiative.
PMJAY Rural
The scheme covers all beneficiaries who fall under at least one of below six deprivation categories and automatically includes destitute, manual scavenger families, living through alms, primitive tribal group, bonded labourers:
Households with only one room with Kucha walls and roof.
No adult member in the age group between 16 and 59 years.
No adult male member in the age group between 16 and 59 years.
Disabled member and no-abled bodied member in the household.
SC and ST
Landless households and major sources of income are through manual casual labour.
PMJAY Urban
Under the scheme, urban households are categorised based on occupation. Below are 11 occupational categories of workers who are eligible for the Ayushman Bharat Yojana Scheme:
Beggar
Domestic worker
Ragpicker
Cobbler/Street Vendor/Hawker/Other service providers on the street.
Plumber/Construction Worker/Mason/Painter/Labour/Welder/Security Guard/Coolie
Sweeper/Mali/Sanitation Worker
Artisan/Handicrafts Worker/Tailor/Home-based Worker
Driver/Transport Worker/Conductor/Cart or Rickshaw Pullers/Helper to Drivers or Conductors
Shop Workers/Peon in Small Establishment/Assistant/Helper/Attendant/Delivery Assistant/Waiter
Mechanic/Electrician/Repair Worker/Assembler
Chowkidar/Washer-man
What is Covered
What is Not Covered
What is Covered Under Ayushman Bharat Yojana Scheme?
With the intention to provide accessible healthcare to the poor and needy, the Ayushman Bharat Yojana Scheme offers coverage of up to Rs.5 lakh per family per year for secondary and tertiary hospitalisation care.
The health insurance under AB-PMJAY includes hospitalisation costs of beneficiaries and includes the below components:
Medical examination, consultation and treatment.
Pre-hospitalisation.
Non-intensive and intensive care services.
Medicine and medical consumables.
Diagnostic and laboratory services.
Accommodation.
Medical implant services, wherever possible.
Food services.
Complication arising during treatment.
Post-hospitalisation expenses for up to 15 days.
COVID-19 (Coronavirus) treatment.
What is Not Covered Under Ayushman Bharat Yojana Scheme?
Similar to other types of health insurance policies, the Ayushman Bharat Yojana Scheme has some exclusions. Below components are not covered under the scheme:
Out-Patient Department (OPD) expenses.
Drug rehabilitation.
Cosmetic surgeries.
Fertility treatments.
Individual diagnostics.
Organ transplant.
Features of Ayushman Bharat Yojana Scheme
Here are the notable features & key highlights of the Ayushman Bharat Yojana (आयुष्मान भारत योजना) scheme, also known as PMJAY:
It is one of the world’s largest health insurance schemes financed by the government of India.
Coverage of Rs.5 lakh per family per annum for secondary and tertiary care across public and private hospitals.
Approximately 50 crore beneficiaries (over 10 crore poor and vulnerable entitled families) are eligible for the scheme.
Cashless hospitalisation.
Covers up to 3 days of pre-hospitalisation expenses such as medicines and diagnostics.
Covers up to 15 days of post-hospitalisation expenses which include medicines and diagnostics.
No restriction on the family size, gender or age.
Can avail services across the country at any of the empanelled public and private hospitals.
All pre-existing conditions covered from day one.
The scheme includes 1,393 medical procedures.
Includes costs for diagnostic services, drugs, room charges, physician’s fees, surgeon charges, supplies, ICU and OT charges.
Public hospitals are reimbursed at par with private hospitals.
Benefits & Advantages of Ayushman Bharat Yojana Scheme
Here are the key advantages & benefits of PMJAY:
It covers all hospitalisation expenses with cashless transactions to beneficiaries.
Accommodation during hospitalisation.
Pre and post-hospitalisation costs.
Any complications arising during the treatment.
Can be used by all family members.
No cap on family size, age or gender.
Pre-existing conditions are included from day one.
List of Critical Diseases or Illnesses Covered Under Ayushman Bharat Yojana Scheme
The medical care scheme extended coverage for more than 1300 medical packages at empanelled public and private hospitals in the country. Below are some of the critical illnesses covered under the Ayushman Bharat Yojana:
Double valve replacement.
Coronary artery bypass graft.
COVID-19.
Pulmonary valve replacement.
Skull base surgery.
Anterior spine fixation.
Laryngopharyngectomy with gastric pull-up
Tissue expander for disfigurement following burns.
Carotid angioplasty with stent.
PM-JAY Enrollment Process
The scheme is an entitlement based initiative launched by the government of India for the poor and the venerable sections of the society. Hence there is no enrolment process. Beneficiaries are selected based on the SECC 2011 and who are part of the RSBY plan. If you would like to know if you are eligible for the scheme, follow these steps:
Step 1: Visit the government website exclusive for PMJAY scheme (https://pmjay.gov.in/) and click on “Am I Eligible” icon.
Step 2: Enter your contact details and generate OTP.
Step 3: Choose your state.
Step 4: Now, search either by your name, mobile number, HHD number or your ration card number.
Step 5: The result will let you know if you are eligible for the PMJAY scheme.
Also, you can contact the Ayushman Bharat Yojana customer care at 1800-111-565 or 14555 or you can reach out to any of the Empanelled Health Care Providers (EHCP).
Documents Required to Apply For Ayushman Bharat Yojana Scheme
Below is the list of documents required to apply for PMJAY scheme:
Identity and Age Proof (Aadhaar Card/PAN Card)
Details of your mobile number, email address and residential address.
Caste certificate
Income certificate
Documents stating your current family status.
How To Apply Online For Ayushman Bharat Yojana?
Below is the process to find out if you are eligible for the Ayushman Bharat Yojana Registration:
Step 1
Visit the exclusive website for PMJAY (https://pmjay.gov.in/) and click on the “Am I Eligible” icon.
Step 2
Input your contact details and click on “Generate OTP”.
Step 3
Now, select your state and search by your name, mobile number, HHD number or your ration card number.
Step 4
You can view if you are eligible for the government healthcare scheme.
How To Download Ayushman Bharat Yojana Card Online?
To ensure cashless, paperless and portable transactions through the PM-JAY scheme, the Ayushman Bharat Yojana Golden Card will be issued to beneficiaries.
To get this PMJAY Golden Card, follow the process below:
Step 1: Visit the PMJAY website (https://mera.pmjay.gov.in/search/login) and log in with your registered mobile number.
Step 2: Enter the ‘Captcha Code’ to generate the OTP.
Step 3: Opt for the HHD code.
Step 4: Provide the HHD code to the Common Service Centre (CSC), where they would check the HHD code and other details.
Step 5: The CSC representatives who are known as Ayushman Mitra will complete the rest of the process.
Step 6: You will have to pay Rs.30 to get the Ayushman Bharat card.
How To Check The Name in the PMJAY List 2024?
To check if your name is in the PMJAY list 2024, you can check it through different methods. They are:
Common Service Centre (CSC)
Visit the nearest CSCs or you can visit any of the empanelled hospitals to check if you are eligible for the healthcare scheme.
Helpline Numbers
PMJAY helpline numbers are available to get information about your eligibility for the scheme. You can contact 14555 or 1800-111-565.
Online
Visit the official website of the scheme (https://www.pmjay.gov.in/) and check if you are eligible for the scheme.
Medical packages under PMJAY
As a beneficiary of the scheme, families, as well as individuals, can avail nearly 25 specialities, which include:
Cardiology
Oncology
Neurology
Paediatrics
The PMJAY scheme does not take into consideration pre-existing illnesses as it comes under the massive scheme introduced by the government of India.
Hospitalisation Process in Ayushman Bharat Scheme (PMJAY)
Any of your family members or you require hospitalisation, you need not pay anything under the PMJAY scheme subject to being admitted in any of the empanelled public or private hospitals. The entire process of hospitalisation and treatment is cashless since there is a 60:40 cost-sharing between the centre and the state, respectively.
As a beneficiary, you will receive the Ayushman health card which will enable you to avail cashless treatment and hospitalisation. With the golden card, you can avail the benefits of the scheme at any of the empanelled public and private hospitals.
How to Find PMJAY Hospital List?
To find out the Ayushman Bharat hospital list, follow the below steps to find out the PMJAY hospital list:
Step 1: Visit the official website of the PMJAY – Hospitals list section
Step 2: Select your state and the district.
Step 3: Now, choose the type of hospital (public/private-for-profit/private and not for profit)
Step 4: Choose the medical speciality you are looking for.
Step 5: Enter the “Captcha Code” and click on search.
You will be redirected to the list of Ayushman Bharat Yojana hospitals along with address, website and contact information. You can also check the ‘Suspended Hospital List’ on the same link provided above.
PMJAY Toll-free Number and Address
Toll-Free Number | 14555/1800-111-565 |
|---|---|
Address | National Health Authority of India, 3rd, 7th and 9th Floor, Tower-L, Jeevan Bharati Building, Connaught Place, New Delhi – 110001 |
Grievance Portal |
What is an ABHA account?
On September 27th, 2021, the Indian Government kickstarted the Ayushman Bharat Digital Health Mission (ABDM). The aim? Handing every Indian a digital health ID called the ABHA Card. Picture it as a 14-digit superpower that unlocks your medical records anytime, anywhere in India. Now, you can effortlessly share your health info with doctors all over the country, no matter the distance.
Overview of ABHA Health Card
Here is an overview of the ABHA card scheme.
Category | Details |
App | NDHM Health Records, ACKO |
Launched On | September 27th, 2021 |
Launched by | Ministry of Health and Family Welfare |
Website | |
Documents Necessary | Aadhaar card / Driving licence / PAN card |
Scheme | Digital Health Card |
Application Fee | Free of cost |
What are the benefits of creating your ABHA ID?
Following are the benefits of creating an ABHA ID for yourself and your family.
Store with Confidence
You don’t have to worry about managing a lot of paper documents anymore. ABHA, however, will enable you to keep all your health records, including hospital records, lab diagnostics and medical insurance claims information in one safe digital personal health locker. Bear in mind that this is particular and only accessible to yourself which means there is no third party involved in the process.
Seamless Document Sharing
Do you need to have your health records exchanged with a healthcare provider or insurer? ABHA makes it easy! Just enter your ABHA ID, and policyholders approved members can have access to all your documents, thus saving you time and effort.
Cashless Claims Approval
The ABHA ID connects to your insurance policy, making the procedure much easier. Hospitals are able to avail of your policy details in the shortest possible time frame thus, speeding up the process of cashless claims and ultimately making healthcare experiences better.
Unified Health Interface (UHI)
UHI is one of the many schemes which are being implemented by the government to make use of technologies in addition to the healthcare system in India. It is the objective to overcome issues like ensuring healthcare is available to everyone, affordable and of high quality. Making all the services accessible through one platform, like ABHA, is what the UHI has in mind to fill in the current gaps in the healthcare system so that the patients can be at the centre of their care.
Why choose ACKO for creating your ABHA account?
It is fairly simple to generate your health ID with ACKO. Just follow the steps within the ACKO app and in just a few taps you will have your ABHA ID ready. However, what makes this process really easy? This is why ACKO comes in.
At ACKO, we aren’t any insurance company; we are your reliable friend who understands your needs and puts them first. We comprehend that your time is precious and this is why we have simplified the creation of ABHA ID on our app. Quick, intuitive, and secure – that's the ACKO way.
ACKO is dedicated to offer the easiest and most powerful digital environment in healthcare. We will ease your way through claims processing, assist you with any healthcare-related matters and will be there for you whenever you need us.
Steps to create ABHA ID from the ACKO App
Take a look at the following steps that will help you create your ABHA ID within minutes.
Using the ACKO app
Here are the steps to create ABHA ID from the ACKO App
Step 1
Step 2
Step 3
Access your ACKO profile from the ACKO app and tap on “Your ABHA Cards”
Next, you need to verify your Aadhaar number with a One Time Password (OTP).
Now you can view or download your existing ABHA card. Continue following the steps given below for creating ABHA cards.
You can select from the list of members or add new ones. Then verify their Aadhaar numbers and tap ‘Get ABHA card’
You can also invite your family members or friends to create their ABHA account. Just add a few details as shown below, and we will invite them.
Now your ABHA card will be ready for download. You can repeat the process for other members.
Through the ACKO website
Following are the steps to create your ABHA account via the ACKO website.
Step 1: You will find a widget or a form similar to the following image.
Please scroll up to Step 2 (app process) for completing the registration process through the app. The app process is faster!
Frequently Asked Questions (FAQs)
Below are some of the FAQs about the Ayushman Bharat Yojana (PMJAY) Scheme:
What services are offered under the Ayushman Bharat Scheme?
Under the scheme, medical care services such as pre and post hospitalisation, daycare surgeries, newborn child services, etc.
Will an ID card be given to beneficiaries of the Ayushman Bharat scheme (PMJAY)?
A dedicated ID card will be given to eligible family and a PMJAY ecard will be given at the time of hospitalisation.
What is the HHD number in PMJY?
The HHD number in PMJAY, which stands for Household Identification number, it is a unique 25-character code that identifies households.
How do I find my HHD number?
The HH ID or Household ID number is provided to families who are identified under the SECC and contains 24 digits.
What is the process to get an Ayushman card?
The initiative was launched by the government of India which is basically an entitlement based mission. Families identified by the government through the deprivation and occupational eligibility criteria based on the socio-economic status in both urban and rural areas are identified as beneficiaries of the scheme.
Can I avail treatment for coronavirus through the Ayushman Bharat Yojana scheme?
You can avail free treatment for the novel coronavirus or COVID-19 at an empanelled public or private hospitals under this scheme by submitting the Ayushman Bharat card and HHD number.
Does the Ayushman Bharat scheme cover coronavirus test expenses?
Under the scheme, you can avail both treatment and test for coronavirus.
Does PMJAY cover pre-existing diseases?
Yes, the scheme covers pre-existing diseases.
What is not covered under the PMJAY scheme?
Healthcare services such as cosmetic surgeries, drug rehabilitation, fertility treatment and organ transplant are excluded from the Ayushman Bharat Yojana scheme.
Who should the beneficiaries contact at the time of hospitalisation?
Beneficiaries should contact Ayushman Mitra at the empanelled hospital to avail cashless treatment at the hospital.
Will beneficiaries of the scheme have to pay to get the healthcare coverage under the scheme?
All beneficiaries can avail free treatment for tertiary and secondary hospital treatment for packages identified under the scheme at empanelled public and private hospitals.
What is the death benefit for Ayushman card holders?
There is no death benefit to the beneficiary of Ayushman car holders.
Is cold Orthopedics covered under Ayushman Bharat scheme?
Under the scheme, medical procedures including Orthopedics are available for treatment.
How can Kashmir migrants get an Ayushman card?
Beneficiaries of the PMJAY is based on eligibility families as per SECC/RSBY data. Those families who have HHID, which is provided under the SECC are eligible for the scheme.
Is Ayushman Bharat Yojana applicable for farmers?
The primary objective of the scheme is to provide accessible and free healthcare to the poor and vulnerable sections of the society. For detailed information about the eligibility criteria can refer to the above mentioned details in the article.
How to change mobile number in PMJAY?
Contact your State Health Agency (SHA) to change your mobile number in the scheme.
Does Ayushman insurance cover people above the age of 80?
Under the scheme, there is no cap on the family size and age.
How to update data in PMJAY?
If you are a beneficiary of the scheme, then to update your data you need to visit the Common Service Centre (CSC) or you can call the Ayushman Bharat helpline number 14555 or 1800-111-565.
News Related to Ayushman Bharat Yojana Scheme
Here Are Some Latest News Related to Ayushman Bharat Yojana Scheme
Age-limit to Access Free Treatment Under Ayushman Bharat Health Insurance Scheme Increased
President Droupadi Murmu said that the Ayushman Bharat health insurance scheme will provide free treatment to all citizens above 70 years of age. The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is already operational with 55 crore beneficiaries. Now, the elderly people will also be able to avail free treatment under this scheme.
President Murmu also talked about India’s fast pace of development in opening 25,000 Jan Aushadhi Kendras for affordable medicines. She also underlined India’s role as a pioneer in the ancient system of healing such as Ayurveda and Yoga.
Ayushman Bharat Healthcare Coverage to Include ASHA and Anganwadi Workers
The Indian government has broadened health insurance benefits to include ASHA and anganwadi workers nationwide. Under the Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana (AB-PMJAY), these workers will now receive health insurance coverage of up to Rs. 5 lakh annually for hospitalisation expenses, aligning them with other beneficiaries.
This decision underscores the government's commitment to equitable healthcare access and recognises frontline workers' crucial role in community health services. It represents a significant step towards strengthening healthcare provisions across the country.
Ayushman Bharat Yojana Scheme completes 4 years since its inception
-September 27, 2022
The world’s largest government-sponsored health insurance scheme, Ayushman Bharat Yojana Scheme, otherwise known as Pradhan Mantri Jan Arogya Yojana (PMJAY), completes 4 years today. The health scheme offers health insurance coverage of up to Rs. 5 lakh per year for underprivileged and low-income families. Through this scheme, the Centre seeks to prevent financial challenges due to medical expenses incurred by the deprived section of society. It offers cashless hospitalisation along with other features such as no cap on family size or age, coverage for pre and post-hospitalisation, no restrictions on pre-existing conditions, access to empanelled private or public hospitals and coverage for more than 1500 treatments, including organ transplant and cancer care.
PMJAY: Ayushman Bharat Yojana Scheme to include informal sanitation workers
-September 27, 2022
The Central Government has decided to include informal sanitation workers under its Pradhan Mantri Jan Arogya Yojana (PMJAY) health insurance scheme. The initiative by the Centre is to increase its outreach to the grass root level workers through its government schemes. Sanitation workers involved in the casual sanitation works and septic tank cleaning shall be covered under the scheme. Under this health plan, the beneficiaries shall receive health insurance coverage of Rs. 5 lakh per family per year. The Centre said that if an informal sanitation worker is not listed under the beneficiaries list, then the government will include the worker and their family members under the scheme.
Central Government to provide health insurance coverage for transgender persons
-August 25, 2022
The Central Government shall provide health insurance coverage for transgender persons under its Ayushman Bharat health insurance scheme, also known as Pradhan Mantri Jan Arogya Yojana (PM-JAY). Those holding a transgender certificate issued by the National Portal for transgender people shall be eligible for coverage under the scheme. With this initiative, transgender people can avail of Rs. 5 lakh coverage per annum. They can benefit from the healthcare services at PM-JAY-empanelled hospitals.
COVID-19: Ayushman Bharat-PMJAY Will Provide Health Insurance To Migrant Workers
– June 11, 2020
A large number of workers that were dependent on daily wages for livelihood lost their jobs due to the Coronavirus pandemic. Getting hit by a medical emergency in this situation is even worse. To mitigate the sufferings, such workers will be included as beneficiaries under the Central Government’s flagship health insurance scheme – Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. The National Health Authority (NHA) is responsible for identifying and enrolling the beneficiaries of AB-PMJAY scheme. The agency is actively coordinating with various state governments to find migrant workers and get them enrolled under this scheme. The AB-PMJAY program provides coverage for diagnostics, hospitalizations, patient’s food, post-hospitalization charges, etc. for various health-related contingencies including COVID-19. The sum insured of this health insurance plan is Rs. 5 Lakh per eligible family per year. Since this is a card-based health insurance programme, the migrant workers may not have to worry about extensive documentation or complex claim procedures.
PMSBY: Premium To Be Paid By Due Date 31 May 2020
– June 4, 2020
The Central Government launched two ambitious schemes: Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) and Pradhan Mantri Suraksha Bima Yojana (PMSBY). While the former provides life insurance, the latter provides health coverage on payment of a nominal premium. The PMSBY scheme is for a period of one year beginning from 1 June to 31 May. The scheme has to be renewed by the 31st of May every year to continue enjoying the benefits. The premium will be auto-debited from their bank account. The PMSBY offers insurance against accidental death and disability with an annual premium of Rs.12 and coverage of Rs.2 lakh.
PM Thanks Taxpayers As Beneficiaries of Ayushman Bharat Cross 1-Crore
– June 1, 2020
During his ‘Mann ki Baat’ radio address, the Prime Minister thanked taxpayers for paying their taxes and they deserve credit for enabling the poor to get free medical treatment through the Ayushman Bharat health insurance scheme. The number of beneficiaries has crossed the 1-crore mark since it was launched back in September 2018. The scheme has been dubbed as the world’s biggest government-sponsored health insurance scheme. He added during his address that the one core beneficiary translates to the cumulative population of two Singapores and two Norways. He said honest taxpayers deserve the “punya” for paying taxes regularly, which has helped fund the scheme and provide free healthcare.
Govt. Confirms The Correct Ayushman Bharat Yojana’s Official Website
– May 14, 2020
The Government of India has debunked a piece of fake news which has been circulating on social media which claims that the official website of Ayushman Bharat Yojana is ‘https://ayushman-yojana.org’. However, the Centre has confirmed the correct URL is pmjay.gov.in. The Press Information Bureau Fact Check tweeted that the claim through a WhatsApp forward that https://ayushman-yojana.org is the official website of the scheme; however, the National Health Authority has confirmed that the only official website of Ayushman Bharat Yojana is https://pmjay.gov.in. The tweet was confirmed by the National Health Authority.
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