Ayushman Bharat PM-JAY

A single hospitalisation can wipe out years of savings for a poor Indian family. A bypass surgery costs ₹2–4 lakh. Cancer treatment, ₹5–20 lakh. Ayushman Bharat PM-JAY was designed to end this financial catastrophe — giving over 55 crore Indians access to free, cashless treatment at empanelled hospitals without paying a single rupee from their own pocket.

Launched on September 23, 2018, PM-JAY is now the world's largest government-funded health insurance programme. This guide covers everything you need to know in 2025 — who is eligible, how to apply, how to use it at a hospital, and what is actually covered.

What Is Ayushman Bharat PM-JAY? Key Facts at a Glance

Who Is Eligible for Ayushman Bharat PM-JAY in 2025?

PM-JAY eligibility is based on the Socio-Economic Caste Census (SECC) 2011 data — not income certificates or BPL cards. Eligibility is pre-determined. You either are on the list or you are not — you cannot apply fresh unless you qualify under specific new categories added in 2023–24.

Eligible Categories — Rural Households

• Families with no adult male member aged 16–59 years
• Families where the main earning member is a daily wage laborer, domestic worker, ragpicker, construction worker, or similar occupation
• SC/ST households
• Families living in kutcha (temporary) houses with only one room
• Landless households earning primarily from manual casual labour
• Primitive tribal groups, legally released bonded labourers

Eligible Categories — Urban Households

• Ragpickers, beggars, domestic workers, street vendors
• Construction workers, plumbers, masons, painters, electricians
• Home-based workers, artisans, handicraft workers, tailors
• Transport workers (drivers, conductors, helpers)
• Sweepers, sanitation workers, gardeners, security guards
• Cobbler, hawkers, other service providers working on streets

🆕 New in 2024 — Senior Citizens Above 70

How to Check If You Are Eligible for Ayushman Bharat — 3 Ways

How to Get Ayushman Bharat Card Online — Step by Step (2025)

The Ayushman card (also called Golden Card or ABHA-linked PM-JAY card) is your proof of eligibility at hospitals. Getting it is free. Here's how:

1. Go to beneficiary.nha.gov.in on your phone or computer.
2. Click "Login" → Enter your mobile number → Enter OTP.
3. After login, click "Am I Eligible?" — confirm your name appears in the database.
4. Click "Get Ayushman Card" → Select your state and district.
5. Aadhaar e-KYC: Enter your Aadhaar number → OTP or face authentication via the NHA app.
6. Your Ayushman card will be generated. Download PDF — it shows your unique PMJAY ID, family details, and QR code.
7. You can also download the Ayushman App (available on Play Store) and generate the card directly from the app.

⚠️ Important: You do NOT need to print the Ayushman card. Show the digital card on your phone at the hospital's Ayushman Mitra desk — they will verify via QR code scan or portal lookup. Never pay anyone to make your Ayushman card — the process is 100% free.

What Is Covered Under PM-JAY — 1,949 Medical Packages Across 27 Specialties

PM-JAY covers secondary and tertiary hospitalisation — meaning conditions serious enough to require admission (not outpatient consultations). The ₹5 lakh covers all costs: room, surgery, doctor fees, medicines, diagnostics, and 15 days post-hospitalisation follow-up.

What Is NOT Covered Under PM-JAY

• OPD (outpatient) consultations and regular doctor visits
• Medicines purchased outside of hospitalisation period
• Dental treatments (except surgery requiring hospitalisation)
• Cosmetic procedures, fertility treatments, organ transplant drugs
• Drug rehabilitation and mental health outpatient treatment
• Self-inflicted injuries

How to Use Ayushman Bharat Card at a Hospital — Step by Step

1. Find an empanelled hospital: Search at hospitals.pmjay.gov.in — filter by your state, district, and type of treatment needed. Always confirm empanelment before going.
2. Go to the hospital's Ayushman Mitra desk (usually near the OPD or admission counter). Every empanelled hospital must have one.
3. Show your Ayushman card (digital on phone or printed) and your Aadhaar card.
4. Biometric verification: The Ayushman Mitra will scan your fingerprint or take your photo to verify identity through the PM-JAY portal.
5. Pre-authorisation: For planned surgeries, the hospital sends a pre-authorisation request to the State Health Agency. This is approved within 1–3 hours for most standard procedures. Emergency cases are treated immediately.
6. Treatment begins — you pay nothing. Room charges, surgery, medicines, ICU — all covered up to ₹5 lakh. The hospital bills the government directly.
7. Post-discharge: You receive a discharge summary with the PM-JAY claim number. Keep this for records. 15 days of follow-up care is also covered.

How to Find Ayushman Bharat Empanelled Hospitals Near You

India has 29,000+ hospitals empanelled under PM-JAY — both government and private. To find one near you:

• Online: Visit hospitals.pmjay.gov.in → Select your state, district, and specialty (e.g., Cardiology, Orthopaedics) → Get a list with hospital names, addresses, and contact numbers.
• Helpline: Call 14555 and ask for empanelled hospitals near your pincode for a specific treatment.
• Ayushman App: Download from Play Store → Hospital Locator section → GPS-based search for nearest empanelled hospitals.

Major hospital chains empanelled under PM-JAY include Apollo Hospitals, Fortis, Narayana Health, Manipal, AIIMS (all), government district hospitals, and most state medical college hospitals. Coverage varies by state — some states have added more private hospitals through their state health schemes.

PM-JAY + State Health Schemes — Double Benefit in Some States

Several states have integrated their own health insurance schemes with PM-JAY — increasing the total cover beyond ₹5 lakh or expanding eligibility:

Frequently Asked Questions — Ayushman Bharat PM-JAY 2025

Important PM-JAY Official Links & Helplines