Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) is a flagship health insurance scheme. The Ayushman Bharat - PMJAY was launched in September 2018.
Deeksha Dixit19 Sept, 2025
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Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) , introduced in 2018 and expanded in September 2024, is a flagship health insurance scheme of the Government of India. It aims to provide financial protection and access to quality healthcare services to economically vulnerable families in the country. Read on to learn more about the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is aimed at providing accessible and affordable healthcare to economically vulnerable families. Under the scheme, eligible families are provided free health coverage of up to Rs 5 lakh per year for secondary and tertiary care hospitalization.| Ayushman Bharat Scheme Details | |
| Launch Date | September 23, 2018 (Expanded on September 11, 2024) |
| Coverage Amount | ₹5 lakh per family per year for secondary and tertiary care hospitalization |
| Nodal Agency | National Health Authority (NHA) |
| Target Beneficiaries | Approximately 10.74 crore poor and vulnerable families (around 50 crore individuals) |
| Components |
|
| Implementation | States can choose to implement through insurance companies, directly, or through a mixed model |
| Funding | Fully funded by the Government of India; costs shared between Central and State Governments |
| Additional Coverage | Senior citizens aged 70 years and above receive additional coverage of ₹5 lakh |
| Website | nha.gov.in/PM-JAY |
Ayushman Bharat Scheme Objective
The main objective of Ayushman Bharat is to achieve Universal Health Coverage (UHC) and improve access to quality healthcare for economically vulnerable populations. Here are some key objectives:- Universal Health Coverage: Provides comprehensive healthcare to over 50 crore individuals from economically weaker sections, ensuring necessary treatment without financial burden.
- Financial Protection: Offers ₹5 lakh per family annually for secondary and tertiary hospitalization, reducing out-of-pocket expenses.
- Comprehensive Healthcare Services: Covers preventive, curative, and rehabilitative services, with Health and Wellness Centres (HWCs) for primary care and health awareness.
- Strengthening Healthcare Infrastructure: Enhances healthcare infrastructure by promoting HWCs and improving hospital capacity for better disease prevention and management.
Image Credit: nha.gov.in
Benefits Covered Under Ayushman Bharat PM-JAY
The benefits covered under the Ayushman Bharat (PM-JAY) include the following:- Up to ₹5 lakh per family per year for secondary and tertiary hospitalization expenses.
- Pre-hospitalization
- Medical examination, treatment, and consultation
- Non-intensive and intensive care services
- Diagnostic and laboratory investigations
- Medicine and medical consumables
- Accommodation benefits
- Medical implantation services (where necessary)
- Complications arising during treatment
- Food services
- Post-hospitalization follow-up care up to 15 days
Ayushman Bharat Scheme Eligibility
The eligibility criteria for beneficiaries are primarily based on the Socio-Economic Caste Census (SECC) 2011 data and specific conditions for different demographics. This includes: Rural Households:- Families living in kucha houses (non-pucca structures).
- Families without an adult male member aged between 16 and 59 years.
- Households identified under deprivation categories, including:
- Destitute or living on alms.
- Manual scavenger households.
- Primitive tribal groups.
- Legally released bonded laborers.
- Ragpicker
- Beggar
- Domestic worker
- Street vendor/ Cobbler/hawker /other service provider working on streets
- Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/ Coolie and other head-load worker
- Sweeper/ Sanitation worker/ Mali
- Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/ Rickshaw puller
- Shop worker/ Assistant/ Peon in small establishment/ Helper/Delivery Assistant / Attendant/ Waiter
- Electrician/ Mechanic/ Assembler/ Repair worker
- Washer-man/ Chowkidar
- Home-based worker/ Artisan/ Handicrafts worker/ Tailor
ABHA Full Form
ABHA stands for Ayushman Bharat Health Account . This initiative is part of the Ayushman Bharat Digital Mission, which aims to create a digital health ecosystem in India. ABHA provides individuals with a unique 14-digit health ID, enabling them to store and access their medical records digitally. This facilitates easier management of healthcare services and enhances the efficiency of health programs across the country.ABHA Card Vs Ayushman Card
Both the ABHA Card (Ayushman Bharat Health Account) and the Ayushman Card (Pradhan Mantri Jan Arogya Yojana or PM-JAY Card) aim to enhance healthcare access, but they serve different purposes and functions. Here are the key differences:| Parameter | ABHA Card | Ayushman Card |
| Purpose | Serves as a digital health identification number that stores and manages health records. | Provides financial protection for hospitalization expenses. |
| Coverage | Does not cover medical expenses; focuses on maintaining digital health records. | Covers hospitalization costs up to ₹5 lakh per family per year. |
| Eligibility | Available to all Indian citizens, regardless of economic status. | Specifically designed for economically weaker sections identified through SECC data. |
| Benefits | Offers a unique 14-digit health ID for easy access to medical records and services. | Facilitates cashless treatment at empanelled hospitals across India. |
| Enrolment | Voluntary registration for all citizens. | Mandatory registration for eligible individuals from economically weaker sections. |
| Main Function | Focuses on creating a comprehensive digital health record for citizens. | Aims to provide affordable healthcare services and financial support during emergencies. |
| UPSC Related Articles | ||
| UJALA Scheme | PM Surya Ghar Muft Bijli Yojana | PM Vishwakarma Scheme |
| Antyodaya Diwas | PM Awas Yojana | UPS Vs NPS Vs OPS Scheme |
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana FAQs
What is Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)?
PM-JAY is a health insurance scheme that offers up to ₹5 lakh coverage per family for secondary and tertiary hospitalization, benefiting economically vulnerable families.
How to apply for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?
Eligible families can apply through state agencies or the scheme’s official website at nha.gov.in.
What is the difference between the Ayushman Card and the ABHA Card?
The Ayushman Card provides financial protection for hospitalization, while the ABHA Card stores and manages digital health records.
Who is eligible for the Ayushman Bharat scheme?
The scheme targets economically vulnerable families identified through SECC data, including senior citizens, and specific occupational groups.
What are the benefits of the ABHA Card?
The ABHA Card offers a unique 14-digit health ID that helps individuals access and manage their medical records digitally.
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