Ayushman Bharat, a flagship initiative of the Government of India, was introduced following the recommendations of the National Health Policy 2017 to realize the goal of Universal Health Coverage (UHC). This program aligns with the Sustainable Development Goals (SDGs) and upholds the principle of "leaving no one behind."

The program is organised around two interrelated elements and adheres to a continuum-of-care model:

  • Health and Wellness Centres (HWCs)
  • Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Features and benefits

  • It provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India.
  • A cover of up to Rs. 5 lakh is available for the beneficiary family every year.
  • Over 12 crore poor and vulnerable entitled families (approximately 55 crore beneficiaries) are eligible for these benefits.
  • PM-JAY provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital.
  • PM-JAY envisions helping mitigate catastrophic expenditure on medical treatment, which pushes nearly 6 crore Indians into poverty each year.
  • It covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines.
  • There is no restriction on the family size, age, or gender.
  • All pre-existing conditions are covered from day one.
  • Benefits of the scheme are portable across the country, i.e., a beneficiary can visit any empaneled public or private hospital in India to avail cashless treatment.
  • Services include approximately 1,929 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician's fees, room charges, surgeon charges, OT and ICU charges, etc.
  • Public hospitals are reimbursed for the healthcare services at par with the private hospitals.

Who is eligible?

Eligibility is determined based on the Socio-Economic Caste Census (SECC) 2011 data.

Rural Households:

  • Families living in one-room houses with ‘kuchha’ walls and roofs
  • Households without an adult male (16-59 years)
  • Families with a disabled member and no able-bodied adult
  • SC/ST households
  • Landless families dependent on daily wage labor

Urban Households (Occupational categories covered):

  • Domestic workers, street vendors, construction workers
  • Plumbers, painters, welders, mechanics
  • Rag pickers, beggars, and sanitation workers

Special Category:

  • All senior citizens aged 70 and above are eligible for free health coverage under PM-JAY, regardless of their income

Documents required for registration

To register, applicants need the following documents:

  • Aadhaar Card (for identification)
  • Proof of domicile/residence
  • Income certificate
  • Recent passport-sized photograph
  • Family documents (Ration Card, PM Letter, CM Letter)
  • Parivar Pehchan Patra (PPP ID) (if applicable)
  • Contact details (mobile number, email)

How to apply for Ayushman Bharat health insurance?

You can apply online or offline through designated centres.

Online registration process:

  1. Visit the official PM-JAY website: https://pmjay.gov.in/
  2. Click on “Am I Eligible?”
  3. Enter your mobile number and captcha code, then click “Generate OTP”
  4. Enter the OTP received on your mobile and click “Verify OTP”
  5. Provide your KYC details (name, state, age, family members, income details)
  6. Click Submit and complete the process

Offline Registration Process:

  • Visit a Common Service Center (CSC) or empaneled hospital
  • Provide required documents for verification
  • Officials will assist in generating your Ayushman Bharat card

For further assistance, visit the official PM-JAY website or contact the National Health Authority (NHA).

(PS: This information is general and may be updated over time by authorities. Audience members are advised to check official statements for the latest updates.)