Pradhan Mantri Ayushman Bharat Yojana (PM-JAY) is a health protection scheme that provides free secondary and tertiary care hospitalization coverage of up to Rs5 lakh per family per year for economically vulnerable households. It aims to improve healthcare access, reduce out-of-pocket expenses, and strengthen the country's public health system through a network of empaneled hospitals nationwide.
Benefits Offer Under the Scheme
- Up to Rs5 lakh coverage per family per year for secondary and tertiary hospitalization care
- Cashless and paperless treatment at empaneled public and private hospitals across India
- Covers pre- and post-hospitalization expenses (typically 3 days before and 15 days after admission)
- No restriction on family size, age, or gender
- Includes a wide range of treatments (over 1,500+ medical procedures, including surgeries, diagnostics, medicines, and ICU care)
- Nationwide portability - beneficiaries can avail treatment at any empaneled hospital in India
- Covers all pre-existing diseases from day one of enrolment
- Free medicines, diagnostics, and transport allowance during hospitalization
- Focus on vulnerable populations - targeted at economically weaker sections based on SECC database
- Helpline and grievance redressal system for beneficiary support
Eligibility
- Beneficiaries are identified usingthe Socio-Economic Caste Census (SECC) database
- Rural eligibility (deprivation criteria): households meetingconditions such as
- Only one room with kutcha walls and roof
- No adult member (16-59 years)
- Female-headed household with no adult male
- Disabled member with no able-bodied adult
- SC/ST households
- Landless households derivingincome from manual labor
- Automatic inclusion (rural):
- Destitute, homeless, or livingonalms
- Manual scavenger families
- Primitive tribal groups
- Legally released bonded laborers
- Urban eligibility (occupation-based):families of workers in specific categories such as:
- Ragpickers, domestic workers, sanitation workers
- Street vendors, cobblers, hawkers
- Construction workers, plumbers, electricians, mechanics, drivers, etc.
- No income cap required - eligibility is determined by deprivation and occupational criteria rather than income level
- Must be listed in PM-JAY beneficiary database to avail benefits
- Additionally, all senior citizens aged 70 years or older can come under special health coverage. Such applicant will have to apply in specific application form.
Application Details
- Check eligibility: Visit the PM-JAY website or use the "Am I Eligible" feature, or check at a nearby Common Service Centre (CSC)
- Verification of identity: Provide required documents such as Aadhaar card, ration card, or other government ID for verification
- Visit empaneled hospital or Arogya Mitra desk: Go to a listed hospital or help desk for assistance with enrollment and validation
- No formal application form required: Eligible families are automatically identified from the SECC database
- Get Ayushman card (e-card): Once verified, a digital or physical Ayushman card is issued for availingbenefits
- Biometric authentication:Required at the hospital duringtreatmenttoconfirm identity
- Cashless treatment availed directly: After verification, beneficiaries can directly receive treatment without payingupfront costs
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