Ayushman Bharat PM-JAY — Eligibility, Benefits & How to Get Your Card

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is India's flagship government health insurance scheme covering over 55 crore people — roughly the bottom 40% of India's population. It provides ₹5 lakh per family per year for hospitalisation at any empanelled government or private hospital across India, cashless and paperless.

Quick check: Go to beneficiary.nha.gov.in → enter your mobile number or Aadhaar → see if your family is listed.

Am I Eligible? — The SECC 2011 Criteria

Eligibility is based entirely on Socio-Economic Caste Census (SECC) 2011 data — there is no income test or income ceiling. If your household is listed in the SECC 2011 database under a qualifying category, you are eligible. If not, you cannot self-declare eligibility.

Rural Households — Any One of These Qualifies

Also automatically covered (rural): Destitute persons / those living on alms · Manual scavenger households · Primitive tribal groups · Legally released bonded labourers

Urban Households — These Occupations Qualify

Workers in any of these occupations are eligible:

• Ragpickers
• Beggars
• Domestic workers
• Street vendors, cobblers, hawkers and other street service providers
• Construction workers — plumbers, masons, painters, welders, security guards, head-load workers
• Sweepers, sanitation workers, gardeners
• Home-based workers — weavers, handicraft workers, tailors
• Transport workers — drivers, conductors, helpers, cart pullers, rickshaw pullers
• Shop workers, peons in small establishments, delivery assistants, waiters
• Electricians, mechanics, assemblers, repair workers
• Washermen, watchmen (chowkidars)

Note: There is no income limit. A construction supervisor or a government employee is not covered simply because their income is low — the occupation category matters, not the salary.

What Does PM-JAY Cover?

Coverage Amount: ₹5 Lakh Per Family Per Year

• The full ₹5 lakh is shared across all family members — no cap on family size or number of members
• All pre-existing conditions are covered from Day 1 — no waiting period
• Approximately 1,929 medical procedures are covered across specialties
• Benefits are portable — usable at any empanelled hospital anywhere in India, not just your home state

What Is Included

• Hospitalisation for secondary and tertiary care
• Pre-hospitalisation: Up to 3 days before admission (medicines and diagnostics related to the illness)
• Post-hospitalisation: Up to 15 days after discharge (medicines, follow-up visits)
• Drugs and medicines during hospitalisation
• Diagnostic tests and investigations
• ICU charges, room charges, surgeon and physician fees
• Daycare procedures (treatments not requiring 24-hour admission)
• Cancer treatment (multi-stage pre-authorisation via tumor board process)

What Is NOT Covered

Ayushman Vay Vandana Card — Coverage for All Seniors 70+

The scheme was expanded to cover all Indian citizens aged 70 and above regardless of SECC status or economic condition. Unlike the core PM-JAY (which is SECC-based), this expansion covers every senior citizen in India.

What the 70+ expansion provides:

• Seniors aged 70+ who are already in a PMJAY family get an additional ₹5 lakh per year as personal cover — over and above the family's existing ₹5 lakh pool
• Seniors aged 70+ from non-PMJAY families also receive ₹5 lakh per year coverage

To enrol:

• Missed call to 1800110770 — initiates the Ayushman Vay Vandana Card process
• Or enrol via the Ayushman app or beneficiary.nha.gov.in

How to Check PM-JAY Eligibility Online

Step-by-step:

1. Go to beneficiary.nha.gov.in
2. Enter your mobile number (linked to Aadhaar) or Aadhaar number or Ration Card number
3. Enter the OTP
4. The portal will show whether your family is listed as a PMJAY beneficiary

Alternative checks:

• Call helpline 14555 (toll-free, 24 hours, multilingual)
• Visit your nearest Common Service Centre (CSC) — available at gram panchayat level in most states

Note: mera.pmjay.gov.in was previously listed for eligibility checks but may no longer be active. Use beneficiary.nha.gov.in as the primary portal.

How to Get Your Ayushman Card (Golden Card)

Option 1 — Ayushman App

1. Download the official "Ayushman" app
2. Complete e-KYC verification with Aadhaar
3. Generate your Ayushman Card digitally

Option 2 — Online at beneficiary.nha.gov.in

1. Log in with mobile or Aadhaar
2. Verify eligibility
3. Download or generate the card

Option 3 — Common Service Centres (CSCs) Walk into your nearest CSC with Aadhaar and ration card. The operator verifies eligibility and generates the card on the spot — helpful if you're not comfortable with online processes.

Option 4 — At the Hospital Every empanelled hospital has an Arogya Mitra (PMAM) — a dedicated help desk staff member. When you're admitted, the Arogya Mitra can verify your eligibility using your Aadhaar or NHPM-ID and generate the card for that admission.

How to Use PM-JAY at the Hospital

1. Go to any empanelled hospital (government or private)
2. Find the Arogya Mitra / PMJAY help desk at the hospital entrance or emergency area
3. Show your Ayushman Card or NHPM-ID or Aadhaar
4. The Arogya Mitra verifies your eligibility on the portal
5. Treatment begins — cashless and paperless. No upfront payment for covered procedures

You can use PM-JAY in any state, not just your home state. The home state bears the cost — this is called portability.

Find an Empanelled Hospital Near You

Over 25,000 hospitals across India are empanelled under PM-JAY — both government and private.

To search: Go to hospitals.pmjay.gov.in

You can filter by:

• State and district
• Hospital type (public / private non-profit / private for-profit)
• Medical speciality (cardiology, oncology, orthopaedics, etc.)
• Hospital name

Quality incentives: NABH-accredited hospitals receive higher package rates — a built-in quality signal.

Which States Have PM-JAY?

As of April 2025, 35 states and Union Territories are implementing PM-JAY. Recent additions:

• Odisha — joined January 2025
• Delhi (NCT) — joined April 2025

West Bengal runs its own "Swasthya Sathi" scheme and has historically not implemented PM-JAY — check pmjay.gov.in for the latest state list.

State top-ups: Several states co-brand and supplement the central scheme with additional coverage (e.g., Maharashtra's Mahatma Phule Jan Arogya Yojana, AP's Dr. YSR Aarogyasri). These states may cover additional families or provide higher amounts.

Cost-Sharing Between Centre and States

Helpline Numbers

Frequently Asked Questions

Is there an income limit for PM-JAY?

No. Eligibility is purely based on SECC 2011 deprivation criteria (rural) or occupational categories (urban). There is no income ceiling — a daily wage labourer in an urban occupational category qualifies; a non-listed person does not, regardless of their income.

What if my name is not in the SECC 2011 list?

You cannot self-enrol in the core PM-JAY scheme if your family is not in the SECC 2011 database. However, if you are 70 years or older, you qualify for the Ayushman Vay Vandana Card expansion regardless.

Can I use PM-JAY outside my home state?

Yes — PM-JAY benefits are fully portable. You can receive treatment at any empanelled hospital in India. Your home state government pays the hospital.

How many times can I use the ₹5 lakh cover?

As many times as needed within the year, until the ₹5 lakh limit is reached. The cover resets every year.

Does PM-JAY cover childbirth?

Yes — delivery and maternity care are covered under the scheme's health benefit packages.

What is an NHPM-ID?

The National Health Protection Mission ID — the unique identifier assigned to your family when registered under PM-JAY. You can use this number (along with Aadhaar/ration card/mobile) for hospital admissions.

Is PM-JAY the same as CGHS?

No. CGHS (Central Government Health Scheme) covers central government employees and pensioners. PM-JAY covers economically vulnerable families from the SECC 2011 database and all 70+ senior citizens.