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About PM-JAY

PM-JAY Scheme: Ayushman Bharat Yojana, Eligibility and Online Registration

A healthcare initiative of the Indian government that supports the well-being of underprivileged families with up to ₹5 lakh of health cover a year.

Check eligibility

Overview

Health Cover for Those Who Need It Most

The Ayushman Bharat Yojana is a healthcare initiative started by the Indian government to support the well-being of the underprivileged. You can sign up for it on the Pradhan Mantri Jan Arogya Yojana (PM-JAY) website. Before applying for the Ayushman Bharat scheme, or the PMJAY card, check the eligibility requirements and find out whether you fall into the rural or the urban category. The benefits include up to ₹5 lakh of health insurance cover every year for each family.

PMJAY registration promises cashless care at accredited private and public hospitals. Expensive procedures such as coronary bypass surgery and knee replacement are covered too. The scheme's main benefit is financial security in unforeseen circumstances.

  • ₹5 lakh

    Health cover per family, every year

  • ~1350

    Medical packages on offer

  • ~23300

    Hospitals empanelled (as of 20 July 2021)

  • 15 days

    Follow-up care after hospitalisation

The programme

Ayushman Bharat Yojana

The Ayushman Bharat initiative was set up in line with the Sustainable Development Goals (SDGs) and their core value of "leaving no one behind." It has adopted the Health and Wellness Centre (HWC) and the Pradhan Mantri Jan Arogya Yojana (PM-JAY).

Ayushman Bharat aims to change how health services are delivered, moving from a sectoral and segmented approach to one that is comprehensive and based on need. The programme seeks to put ground-breaking interventions in place that address the primary, secondary and tertiary healthcare system as a whole, covering prevention, promotion and ambulatory care. With two interconnected components, Ayushman Bharat follows an integrated system-of-care approach.

Two parts

The Two Types of PM-JAY

There are two types of PM-JAY: Health and Wellness Centres (HWCs) and the Pradhan Mantri Jan Arogya Yojana (PM-JAY).

Type A

Health and Wellness Centres (HWCs)

Health and Wellness Centres are designed to offer a broader range of services that meet the primary healthcare needs of the whole local population, which improves accessibility, universality and equity close to the community.

The emphasis on health promotion and prevention puts the spotlight on keeping people healthy. It does this by encouraging and empowering individuals and communities to adopt healthy behaviours and make changes that lower the risk of chronic diseases.

Type B

Pradhan Mantri Jan Arogya Yojana (PM-JAY)

PM-JAY, as it is more commonly known, is the second component of Ayushman Bharat. It offers health insurance cover of ₹5 lakh per family, which can be used for secondary and tertiary care hospitalisation at any established hospital across the country. Families covered under RSBY but not listed in the SECC 2011 database are also included in the coverage. The cost of implementing PM-JAY is shared between the Central and State Governments, with all funding coming from the government.

Through the PM-JAY portal, people can check their eligibility and find hospitals. They do not have to enrol anywhere to receive the programme's benefits, but they will need to provide their HHD Number (Household ID Number), which is given to people identified by the SECC.

The benefits are available at PMJAY-identified public and private hospitals with empanelled staff. To receive health insurance benefits at a hospital, however, people must present their PMJAY health card.

At a glance

Features of PM-JAY

  • Fully government funded

    PM-JAY, the world's most extensive health insurance and assurance programme, is entirely funded by the government.

  • Cashless access

    PM-JAY gives the beneficiary cashless access to healthcare services.

  • Before and after hospital stays

    Pre-hospitalisation expenses for up to three days and post-hospitalisation costs for up to fifteen days, including medicines and diagnostics, are both covered.

Side by side

Government Health Insurance Scheme vs Basic Health Insurance

FeatureBasic health insuranceGovernment health insurance scheme
CoverageOffers wider coverageOffers smaller coverage
Sum insuredUp to ₹1 croreUp to ₹5 lakh
PremiumFrom ₹200 per month (depending on the plan)From ₹100 per month, or fully paid by the government (depending on the plan)
EligibilityOpen to all sections of societyOnly for low-income groups
Policy purchaseThe policy can be bought immediatelyBuying a policy may take some more time
Private hospital roomAvailable (depending on the plan)May or may not be available
Network hospitalsNumerous accredited private hospitalsA sizeable network of hospitals, both public and private
Maternity benefitsAvailable as per the planAvailable (for a single child only, in a few cases)
Ambulance chargesAvailable under most plansAvailable under a few plans
Domiciliary hospitalisation coverAvailable as per the planNot available
Online renewalOnline renewal is possibleMay or may not be renewable online
Cumulative bonusAvailable if no claim was filed in the previous policy yearNot available
Health check-upSome plans include coverNot covered
Monthly premium instalment facilityAvailable under a few plansNot available
Tax benefitsAvailable under the Income Tax Act, 1961Not available

Find a hospital

Steps to Search PMJAY Hospitals

Many hospitals have been empanelled since the Ayushman Bharat Yojana began. As of 20 July 2021, the governments of various states and union territories had empanelled about 23,300 hospitals under the programme. The official PMJAY website carries a list of all PMJAY hospitals, and the steps below show how to check the Ayushman Card hospital list.

Here is how to find the list of Ayushman Card hospitals under the PMJAY programme:

Ayushman card verification is required before you receive treatment at the hospitals listed in the PMJAY hospital list PDF.

Visit the official PMJAY website
  1. 1

    Step 1: Go to the Hospitals Search page.

  2. 2

    Step 2: Choose your district and your state.

  3. 3

    Step 3: Choose whether you want a public, private, for-profit, or private non-profit hospital.

  4. 4

    Step 4: Choose the medical speciality you need, such as general, paediatric, neurosurgery, oncology or gynaecology.

  5. 5

    Step 5: Enter the captcha in the space provided.

  6. 6

    Step 6: Select "Search."

Who can apply

Ayushman Bharat Eligibility Criteria

Everyone must make sure that their name appears in the Socio-Economic Caste Census (SECC) 2011 data to receive the benefits of the Ayushman Bharat Yojana health insurance programme. This confirms whether their family qualifies for coverage. The only households eligible for PMJAY benefits are those listed in the SECC database that also hold active RSBY cards.

The Pradhan Mantri Jan Arogya Yojana lets eligible participants access healthcare services anywhere in India.

PM-JAY scheme: rural eligibility criteria

  • Households with no adult or male earner between the ages of 16 and 59
  • Families living in a single room with mud walls and a roof
  • Families with no member between the ages of 16 and 59
  • Households with one member who has a disability and no able-bodied adult
  • Families that gather manually
  • Landless families that depend heavily on manual labour for their income

PM-JAY scheme: urban domestic worker criteria

  • Beggars and ragpickers
  • Home-based artists, tailors, sweepers, craftspeople, sanitation workers and gardeners
  • Workers such as electricians, mechanics, assemblers and repairers
  • Workers in construction, labourers, painters, welders, security guards and coolies
  • Masons, plumbers and washermen

What is covered

Benefits of PM-JAY

PM-JAY covers the following services:

  • Medical examination, treatment and consultation
  • Pre-hospitalisation
  • Non-intensive and intensive care services
  • Diagnostic and laboratory investigations
  • Medical implantation services (where required)
  • Accommodation benefits
  • Medicines and medical consumables
  • Food services
  • Complications that arise during treatment
  • Follow-up care for up to 15 days after hospitalisation

Family floater of ₹5,00,000

One family member or the entire family can use the benefit of INR 5,00,000, because it is a family floater benefit. RSBY had a limit of five people per family. Based on lessons from those programmes, PM-JAY was created with no restriction on family size or the ages of members.

Pre-existing conditions covered from day one

From the day they enrol in the programme, any eligible person who has had a medical condition that PM-JAY did not previously cover can receive treatment for all of those conditions as well.

Coverage

List of Diseases Covered in PM-JAY

In all public hospitals and in any of the private network hospitals, PMJAY offers close to 1,350 medical packages. Some of the major conditions the Ayushman Yojana covers are listed below.

  • Prostate cancer
  • Carotid angioplasty with stent
  • Skull base surgery
  • Pulmonary valve surgery
  • Double valve replacement surgery
  • Coronary artery bypass grafting
  • Anterior spine fixation
  • Tissue expander for burn-related disfigurement

FAQ

Frequently Asked Questions

  • How do I find my PMJAY Household ID number?

    Families whose identities have been determined by the SECC are given a 24-digit HH ID number.

  • Does the Ayushman Bharat programme pay for orthopaedic care?

    Yes. Orthopaedic treatment is covered by the plan up to a certain amount.

  • Does PMJAY cover conditions that already exist?

    Yes. PMJAY starts covering all pre-existing conditions from day one.

  • Does the PMJAY scheme cover farmers?

    The programme provides insurance to eligible people who live in both rural and urban areas.

  • Is the health insurance cover under the Ayushman Yojana enough?

    The government set up this programme so that people living in poverty, who cannot afford an annual premium, still have access to healthcare. Treating diseases such as diabetes, cancer and heart attacks should be covered by adequate health insurance, starting at around ₹10 lakh for those who can afford the premium. You can also buy a health insurance policy worth ₹1 crore or more, according to your budget.

  • What should I do if a hospital refuses to treat an Ayushman Bharat beneficiary?

    A specialised Grievance Redressal Committee, designated at the national, state and district levels, will settle the grievance within 30 days of the complaint being filed.

Take the Next Step in Your Digital Health Journey

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