A single medical emergency can push a family into devastating poverty. In India, where millions work in the informal economy without any employer-provided health coverage, one hospitalization—a surgery, a cancer diagnosis, or a cardiac event—can wipe out years of savings in days. This harsh reality is what the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) was designed to fight.
Launched on September 23, 2018, by Prime Minister Narendra Modi in Ranchi, Jharkhand, PM-JAY is the largest publicly funded health insurance scheme in the world. It offers free hospital treatment worth up to ₹500,000 per eligible family per year.
The numbers behind the scheme tell a powerful story. As of March 2025, more than 36.9 crore Ayushman cards have been created under the scheme. Its financial impact has been equally significant—the Economic Survey 2024–25 highlights that PM-JAY has helped generate recorded savings of over ₹1.25 lakh crore for beneficiary households by reducing out-of-pocket health expenditure.
This is the complete guide to Ayushman Bharat PM-JAY in 2025—who can get it, how to apply, what it covers, and the latest updates that make it more powerful than ever before.
Table of Contents
What Is Ayushman Bharat PM-JAY?
Ayushman Bharat is a two-part scheme. The first component focuses on Health and Wellness Centres (HWCs)—upgrading primary health centers across rural India to provide preventive and basic care. The second and more widely known component is PM-JAY, which provides secondary and tertiary hospitalization cover.
AB PM-JAY aims to provide health coverage of ₹5 lakh per family per year for secondary and tertiary care hospitalization to approximately 55 crore beneficiaries corresponding to 12.37 crore families constituting the bottom 40% of India’s population.
The scheme is cashless and paperless at the point of service—meaning a beneficiary can walk into an empaneled hospital anywhere in India, show their Ayushman card, and receive treatment without paying a single rupee upfront.
Key Benefits of Ayushman Bharat PM-JAY
1. ₹5 Lakh Annual Health Cover
Each eligible family receives up to ₹5 lakh of health insurance cover every year. This cover is for the entire family—not per individual—and renews annually.
2. Cashless and Paperless Treatment
Beneficiaries do not need to pay out of pocket at empaneled hospitals. Bills are settled directly between the hospital and the scheme. No upfront payment, no reimbursement hassle.
3. Covers Pre-Existing Diseases
Unlike most private health insurance policies, PM-JAY covers pre-existing diseases from Day 1. A patient with diabetes, hypertension, kidney disease, or any other chronic condition is fully eligible from the moment they enroll.
4. No Cap on Family Size
The cover of ₹5 lakh applies to the entire family regardless of size. Whether a family has 2 members or 10, the same cover applies—there is no restriction based on the number of dependants.
5. Covers 1,900+ Medical Procedures
Beneficiaries now gain access to 1,961 health benefit packages from 27 medical specialties, featuring updated procedures and better rates for hospitals. This includes surgeries for heart conditions, cancer, kidney failure, orthopedic procedures, maternity care, and much more.
6. Portability Across India
The Ayushman card is valid at any empanelled hospital anywhere in India. A beneficiary from Bihar can use their card for treatment in Mumbai, Delhi, or Chennai—making it truly national in scope.
7. Senior Citizen Top-Up
In a landmark expansion announced in October 2024, senior citizens aged 70 and above, who belong to families already covered under AB PM-JAY, now receive an additional top-up coverage of up to ₹5 lakh per year exclusively for themselves. This coverage does not need to be shared with other family members below the age of 70.
Furthermore, all eligible senior citizens are issued a separate health card to facilitate easier access to the scheme’s benefits.
Eligibility Criteria
Who Is Eligible?
The eligibility criteria for beneficiary families were initially identified from the Socio-Economic Caste Census (SECC) of 2011. The following groups are covered:
- Families identified as economically deprived in the SECC database
- Rural families—those with no permanent house, manual scavengers, primitive tribal groups, bonded labourers, and other deprived categories
- Urban families—those working as ragpickers, domestic workers, street vendors, construction workers, security guards, transport workers, and other informal sector occupations
- ASHA workers, Anganwadi workers and helpers, transgenders, and building and construction workers
- All senior citizens aged 70 and above—regardless of economic status, from October 2024 onwards
States Implementing PM-JAY
West Bengal is the only state where the scheme is not implemented after Odisha and Delhi came on board recently. Delhi became the 35th state/UT to implement AB PM-JAY, with card distribution starting from April 10, 2025.
How to Get Your Ayushman Card
Visit the official website pmjay.gov.in, enter your Aadhaar number or ration card details, check your eligibility status, and, if eligible, download your Ayushman Card (Ayushman Bharat Golden Card).
You can also get your card made at:
- Common Service Centres (CSCs)—bring your Aadhaar card
- Empaneled hospitals—they have Ayushman Mitra help desks
- Government health camps and Gram Panchayat offices
How to Use the Ayushman Card at a Hospital
Show your Ayushman card at the hospital help desk. The hospital verifies eligibility on the PMJAY portal. Pre-authorization is given by the insurer or TPA. Treatment is then done cashlessly; no upfront payment is needed. The hospital then settles bills directly with the scheme.
It is important to remember that the card can only be used at empaneled hospitals—both public and private hospitals that are registered under the PM-JAY network.
Empaneled Hospitals
As of September 2024, a total of 29,648 hospitals, including 12,696 private hospitals, are empaneled under the scheme. This number has continued to grow in 2025, with Bihar seeing a twofold increase in empaneled hospitals in the current financial year.
To find an empaneled hospital near you, visit pmjay.gov.in and use the “Find Hospital” feature.
Impact and Achievements
The scale of PM-JAY’s impact is extraordinary:
- Government health expenditure increased from 29% to 48% between FY2015 and FY2022, while out-of-pocket expenditure declined from 62.6% to 39.4% over the same period.
- Out of 7.79 crore hospital admissions, around 3.61 crore were utilized by women—and 49% of Ayushman Cards are issued to women.
- Tamil Nadu, Karnataka, and Rajasthan are the top three states in terms of authorized hospital admissions, with 9.04 million, 6.6 million, and 5.74 million admissions, respectively.
- In Uttar Pradesh, out of 9 crore targeted beneficiaries, 5.38 crore Ayushman Cards have already been issued—making UP the top state in the country for card distribution.
- Cancer treatment access has improved dramatically—a recent Lancet study found that patients enrolled under AB-PMJAY saw a 90% rise in access to cancer treatment within 30 days.
Recent Updates in 2025
- Delhi joins PM-JAY (April 2025): Around 6.54 lakh families in Delhi will benefit under the scheme, with the Delhi government giving an additional top-up of ₹5 lakh over and above the central government’s cover—bringing the total to ₹10 lakh per family per year.
- Telemedicine integration: Rural beneficiaries can now access specialist consultations via telemedicine linked to the Ayushman Bharat Digital Mission (ABDM).
- Focus on critical illnesses: Enhanced packages for cancer, dialysis, and cardiac surgeries have been added to the benefits list.
- More super-specialty private hospitals have been added to the PMJAY network across all states.
Frequently Asked Questions (FAQs)
Q1. Can I get treatment in a private hospital under PM-JAY? Yes, as long as the private hospital is empanelled under PM-JAY. You can check the list at pmjay.gov.in.
Q2. What if my name is not in the SECC list? From October 2024, all senior citizens aged 70+ are eligible regardless of SECC status. For others, check with your local health authority or Common Service Centre about state-specific additions to the beneficiary list.
Q3. Does PM-JAY cover medicines and diagnostics? Yes—medicines, diagnostics, and pre- and post-hospitalization expenses (up to 3 days before and 15 days after hospitalization) are all covered.
Q4. What is the official website for PM-JAY? pmjay.gov.in
Q5. Is PM-JAY available for someone who already has private health insurance? Yes. Senior citizens with private health insurance can benefit from the scheme alongside their existing coverage.
Conclusion
Ayushman Bharat PM-JAY has redefined what healthcare access looks like for India’s most vulnerable citizens. By delivering ₹5 lakh of cashless, portable, pre-existing-disease-inclusive health cover to over 55 crore people, it has built a safety net that protects families from the catastrophic financial consequences of serious illness. With the 2024 expansion covering all senior citizens aged 70 and above—regardless of income—PM-JAY has moved one step closer to true universal health coverage. If you belong to an economically weaker household or are above the age of 70, check your eligibility at pmjay.gov.in and get your Ayushman card today. Your health is too important to leave to chance.
Rohanshi Mhatre aims to bridge the gap between government initiatives and citizens by delivering clear, reliable, and easy-to-follow information so that everyone can take advantage of available schemes.
