Ayushman Bharat PM-JAY: Eligibility, Coverage, and How to Apply

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the Government of India's flagship public health insurance scheme, and for eligible families, it can change a medical emergency from a financial catastrophe into a manageable one.

Coverage Amount

The scheme provides health cover of ₹5 lakh per family, per year, for secondary and tertiary care at empanelled hospitals, with cashless and paperless treatment, meaning eligible families don't pay out of pocket for covered procedures at participating hospitals.

Eligibility Criteria

Original eligibility is based on the Socio-Economic Caste Census (SECC) 2011 deprivation and occupational criteria: households living in a single-room kutcha house, households with no adult member aged 16 to 59, households with no adult male member in that age range, and families with a disabled member and no able-bodied adult, among other criteria. Since October 2024, the government extended coverage to all citizens aged 70 and above, with an additional ₹5 lakh cover per year, regardless of income or existing scheme membership.

How to Check Eligibility and Apply

To check eligibility, use the official PM-JAY portal or the Ayushman App, verify identity through Aadhaar-based e-KYC, and eligible beneficiaries receive an Ayushman Card. At an empanelled hospital, present the card (or registration details at the 'Ayushman Mitra' help desk) to access cashless treatment.

At the Hospital

If a family is mid-emergency and unsure whether they qualify, the fastest path is usually asking the hospital's billing or Ayushman Mitra desk directly, most empanelled hospitals can check eligibility on the spot rather than waiting for an online application to process.

HelpIndiaBreathe doesn't process PM-JAY applications and isn't affiliated with the scheme. We point to it because it's often the single biggest source of relief available before anyone needs to consider a fundraiser at all.