In 2026, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) stands as one of India’s most ambitious and transformative public health initiatives. Launched on September 23, 2018, by Prime Minister Narendra Modi, this flagship scheme under the Ayushman Bharat umbrella provides cashless health insurance coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization. It targets poor and vulnerable families, aiming to reduce catastrophic out-of-pocket healthcare expenses that push millions into poverty every year.
By early 2026, the scheme has issued over 43.52 crore Ayushman cards, including 1.14 crore specialized Ayushman Vay Vandana cards for senior citizens. More than 36,000 hospitals—public and private—are empanelled nationwide, and the program has authorized over 5.77 crore hospital admissions worth approximately ₹1.15 lakh crore in private facilities alone. A landmark expansion in September 2024 extended coverage to all senior citizens aged 70 and above, irrespective of income or socio-economic status, benefiting around 4.5 crore families and 6 crore elderly individuals. This makes PM-JAY not just a welfare scheme but a cornerstone of India’s journey toward Universal Health Coverage (UHC).
The scheme operates on a “right to health” philosophy: no family size cap, no age or gender restrictions (except the new senior citizen addition), and coverage for pre-existing conditions from day one. It integrates seamlessly with the Ayushman Bharat Digital Mission (ABDM) for paperless, portable care across India. In this comprehensive guide for 2026, we break down everything you need to know—eligibility, benefits, application process, and more—to help families access this life-saving support.
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History and Evolution of Ayushman Bharat PM-JAY
Ayushman Bharat was envisioned as a two-pronged strategy: Health and Wellness Centres (HWCs) for primary care at the grassroots level and PM-JAY for secondary and tertiary hospitalization. The PM-JAY component replaced and expanded the earlier Rashtriya Swasthya Bima Yojana (RSBY).
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| Ayushman Bharat PMJAY |
The scheme draws its beneficiary database from the Socio-Economic Caste Census (SECC) 2011, ensuring targeted coverage without cumbersome income proofs for most families. Over the years, it has evolved with technology—e-cards, Aadhaar-based e-KYC, real-time pre-authorization, and the Ayushman app. The 2024 Cabinet approval for universal senior citizen coverage (effective from late 2024 onward) marked its most significant expansion yet, introducing distinct cards and top-up benefits to protect the elderly without burdening family limits.
Today, PM-JAY aligns with national goals like “Sabka Saath, Sabka Vikas” and “Atmanirbhar Bharat” by empowering citizens, reducing medical debt, and boosting private sector participation in healthcare delivery.
Key Highlights of Ayushman Bharat PM-JAY 2026
| Particulars | Details |
|---|---|
| Coverage Amount | ₹5 Lakh per family per year |
| Senior Citizens (70+) | All covered irrespective of income |
| Senior Top-up Benefit | Additional ₹5 Lakh exclusive cover |
| Ayushman Cards Issued | 43.52 Crore (including 1.14 Crore Vay Vandana) |
| Hospitals Empanelled | 36,229 (Public + Private) |
| Hospital Admissions | Over 11.69 Crore (worth ₹1.73 Lakh Crore) |
| Pre-existing Diseases | Covered from Day 1 |
| Family Size | No Cap |
| Portability | National (Anywhere in India) |
| Process | Cashless & Paperless |
| Helpline | 14555 (Toll-Free) |
| Official Website | pmjay.gov.in |
Pradhan Mantri Jan Dhan Yojana
Eligibility Criteria for PM-JAY in 2026
PM-JAY remains largely entitlement-based on SECC 2011 data. Families do not “apply” to be included; they are automatically identified if they meet the criteria. However, individuals can verify eligibility and obtain cards easily.
Rural Households
Eligibility is based on seven deprivation criteria (D1–D7). Families qualifying under any one of the following six (plus automatic inclusion categories) are covered:
- D1: One-room kucha house with kucha walls and roof.
- D2: No adult member aged 16–59 years.
- D3: No adult male member aged 16–59 years (female-headed households).
- D4: Disabled member with no able-bodied adult.
- D5: Scheduled Caste (SC) or Scheduled Tribe (ST) households.
- D7: Landless households deriving major income from manual casual labour.
Automatic inclusion applies to:
- Destitute/living on alms.
- Manual scavenger households.
- Primitive Tribal Groups.
- Legally released bonded labour.
Urban Households
Coverage targets 11 specific occupational categories of informal workers:
- Ragpickers and beggars.
- Domestic workers.
- Street vendors, hawkers, cobblers, and roadside service providers.
- Construction workers, plumbers, painters, masons, welders, porters.
- Sweepers, gardeners, sanitation workers.
- Artisans, handicraft workers, tailors, home-based workers.
- Transport workers (drivers, conductors, rickshaw pullers).
- Shop assistants, delivery helpers, waiters, peons.
- Electricians, mechanics, repair workers, assemblers.
- Watchmen (chowkidars) and washermen (dhobis).
Special 2024–2026 Expansion: Senior Citizens
All individuals aged 70+ are now eligible regardless of income, occupation, or SECC status.
- If part of an existing PM-JAY family: They get an additional top-up cover of ₹5 lakh exclusively for themselves (not shared with younger members).
- If not previously covered: They receive ₹5 lakh coverage on a family basis.
- A new, distinct Ayushman Vay Vandana card is issued.
Senior citizens already under CGHS, ECHS, or other schemes can choose PM-JAY. Private insurance or ESI coverage does not disqualify them.
Exclusions (applicable to non-senior categories): Families owning pucca houses, motorized vehicles (2/3/4-wheelers or fishing boats), mechanized farming equipment, Kisan Credit Cards (₹50,000+ limit), government jobs, refrigerators, landlines, or earning >₹10,000/month (urban) are generally excluded. Government employees and those with 5+ acres of land are also ineligible. No cap on family size or number of members; newborns can be added with basic documents.
Benefits and Coverage Details
PM-JAY offers cashless and paperless treatment up to ₹5 lakh per family per financial year (April–March) at empanelled hospitals. Key highlights:
- Floating cover: Shared among family members; can be used by one or multiple.
- Pre-existing diseases: Covered from day one—no waiting period.
- Pre-hospitalization: Up to 3 days (diagnostics, medicines).
- Post-hospitalization: Up to 15 days (follow-up care).
- Day-care procedures: Over 500 covered without overnight stay.
- National portability: Treatment anywhere in India.
- Transport allowance: In some cases, for inter-hospital shifts.
- Food and accommodation: Included in packages.
The scheme covers approximately 1,929 procedures and packages (Health Benefit Packages – HBP 2.2) across 25 specialties, including:
- Cardiology & cardiothoracic surgery (angioplasty, bypass).
- Oncology (cancer surgery, chemotherapy, radiation).
- Orthopaedics (joint replacements, fracture management).
- Neurology & neurosurgery (stroke, brain tumour).
- Nephrology (dialysis, kidney transplant).
- General surgery, gynaecology, paediatrics, burns management, mental health, and more.
For seniors under the 2024 expansion, the top-up ensures dedicated protection against age-related ailments like cardiac issues, cancers, and joint problems.
What is NOT covered (exclusions): Outpatient department (OPD) consultations, dental procedures (unless part of hospitalization), cosmetic surgeries, fertility treatments, drug rehabilitation, and certain high-end experimental treatments beyond package limits.
How to Check Eligibility and Apply Online for Ayushman Card in 2026
The process is simple, free, and digital-first. No paperwork is mandatory at the start.
Step-by-Step Online Process:
- Visit the Official Portals: https://pmjay.gov.in/or beneficiary.nha.gov.in (the dedicated beneficiary portal).
- Click on “Am I Eligible” or “Login as Beneficiary”.
- Enter your mobile number + CAPTCHA → Verify with OTP.
- Select State/District → Search using:Name + Father’s/Husband’s name
- Ration card number
- Aadhaar number
- SECC number
- Or mobile/ration card.
- If your family appears, complete e-KYC using Aadhaar (OTP-based).
- Download the Ayushman Card (e-card) instantly as PDF. It contains a QR code and family ID.
- You can also use the official Ayushman App (available on Google Play) for the same process.
Alternative options:
- Visit nearest Common Service Centre (CSC) or empanelled hospital (Arogya Mitra will assist).
- Dial helpline 14555 (24x7) or 1800-111-565 for verification.
- State-specific portals (e.g., ayushmanup.in for Uttar Pradesh).
Required Documents (for verification):
- Aadhaar card (primary for e-KYC).
- Ration card / Voter ID / PAN (as supporting ID).
- Proof of address.
- For seniors: Age proof if needed.
- Bank details (optional, for any transport allowance).
- The card is valid pan-India and can be updated for new family members or corrections via the portal.
How to Check Ayushman Bharat Hospital List Online?
- Here's a short guide to check Ayushman Bharat (PMJAY) hospital list online:Visit the official portal: https://hem.nha.gov.in/search
- Click on "Find Hospitals" or go to the search section.
- Select your State, District, Hospital Type (Public/Private), Speciality (optional), and Hospital Name (if known).
- Enter the Captcha and click Search.
- The list of empanelled hospitals will appear with details.
Download Ayushman Bharat Treatment Packages List
- Official Method (Recommended):Visit the National Health Authority (NHA) website: https://nha.gov.in/
- Go to Resources / Documents or PMJAY section.
- Look for HBP 2.1 or Health Benefit Package (latest version).
- Download the PDF directly (example direct link for HBP 2.1: https://nha.gov.in/img/pmjay-files/HBP-2.1.pdf).
- Hospitals Portal → https://hospitals.pmjay.gov.in/ → Check "HBP Packages" download link.
- State-specific versions (e.g., UP, MP) are available on respective Ayushman portals like ayushmanup.in or ayushmanbharat.mp.gov.in.
- The list includes package codes, procedure names, rates, specialties, and conditions (around 1,900+ procedures across 27 specialties).
How to Avail Benefits at Hospitals
- Go to any empanelled hospital (search via app, website, or helpline).
- Show Ayushman Card or provide mobile/family ID to Arogya Mitra.
- Pre-authorization request is raised online (approved within minutes for most cases).
- Receive cashless treatment—no bills at discharge (except non-covered items).
- Post-discharge, follow-up is covered for 15 days.
- Grievance redressal is three-tiered: District → State → National levels.
Impact, Challenges, and the Road Ahead
PM-JAY has dramatically reduced financial barriers. Millions have accessed life-saving surgeries, cancer care, and cardiac procedures without selling assets. It has particularly empowered women, children, and rural populations. Integration with ABDM enables digital health records, teleconsultations, and better continuity of care.
Challenges remain: uneven awareness in remote areas, occasional delays in claim settlements, quality variations across hospitals, and the need for more empanelment in Tier-2/3 cities. Fraud prevention through AI monitoring and regular audits is ongoing.
In 2026, with senior citizen inclusion and digital advancements, PM-JAY is poised to cover even more ground. Future plans may include further expansions and deeper ABDM linkage.
Conclusion
Ayushman Bharat PM-JAY 2026 is more than insurance—it is a promise of dignity and security in times of medical crisis. Whether you are a rural labourer, an urban street vendor, or a senior citizen navigating retirement, this ₹5 lakh shield ensures healthcare is a right, not a privilege. Verify your eligibility today on pmjay.gov.in or beneficiary.nha.gov.in, download your Ayushman Card, and share this information within your community. One card can save an entire family from financial ruin. For queries, call 14555 or visit your nearest empanelled hospital. Health for all is no longer a distant dream—it is here, powered by Ayushman Bharat.
| Official Website | Click Here |
|---|---|
| Apply Online | Click Here |
| Ayushman Bharat Hospital List | Click Here |
| Ayushman Bharat Treatment Packages List | Download |
| Master Health Benefit (NHB) Package 2.2 | Download |
| Central Govt Schemes | Click Here |
| Dial helpline | 14555 (24x7) |
FAQs on Ayushman Bharat PM-JAY 2026
Q. What is Ayushman Bharat PM-JAY?
PM-JAY provides up to ₹5 lakh free health insurance per family per year for secondary and tertiary hospitalization. It is completely cashless and paperless at empanelled hospitals.
Q. Who is eligible under the main scheme?
Eligibility is based on Socio-Economic Caste Census (SECC) 2011. Rural families meeting any of 6 deprivation criteria (poor housing, no adult male, SC/ST, landless labourers, etc.) and specific urban occupational groups (street vendors, domestic workers, construction labourers, etc.) are covered. No family size limit.
Q. Are all senior citizens above 70 years covered?
Yes. Since September 2024, all citizens aged 70 and above are eligible irrespective of income or family status. They get a separate Ayushman Vay Vandana Card.
Q. What extra benefit do senior citizens in already covered families get?
They receive an additional ₹5 lakh top-up cover exclusively for themselves (not shared with other family members).
Q. Is the scheme free? Do I need to pay any premium?
Yes, it is 100% free for eligible beneficiaries. No premium or registration fee is charged.
Q. Does it cover pre-existing diseases?
Yes. All pre-existing conditions are covered from day one with no waiting period.
Q. How can I check if I am eligible?
Visit pmjay.gov.in or beneficiary.nha.gov.in. Click “Am I Eligible”, enter mobile number, verify OTP, and search by name, Aadhaar, or ration card.
Q. How do I apply for Ayushman Card online? Go to pmjay.gov.in
- Click “Am I Eligible”
- Enter mobile → OTP
- Search your family
- Complete Aadhaar e-KYC
- Download the Ayushman Card instantly (PDF with QR code).
Q. What documents are needed?
Mainly Aadhaar card for e-KYC. Ration card, Voter ID, or mobile number can be used for search. No documents needed for initial eligibility check.
Q. Can I get treatment anywhere in India?
Yes. The scheme offers national portability. You can avail cashless treatment at any empanelled hospital across India.
Q. What treatments are covered?
Over 1,900 procedures in 25 specialties including heart surgery, cancer treatment, knee replacement, dialysis, brain surgery, deliveries, and many day-care procedures. Pre-hospitalization (3 days) and post-hospitalization (15 days) are also covered.
Q. Is OPD (outpatient) treatment covered?
No. Only hospitalization and related packages are covered. OPD consultations, medicines outside hospital, and dental treatments (unless part of surgery) are not covered.
Q. How do I avail benefits at the hospital?
Go to any empanelled hospital, show your Ayushman Card or mobile/family ID to the Arogya Mitra. Pre-authorization is done online and treatment is cashless.
Q. Can a newborn baby be added?
Yes. There is no cap on family size. Newborns can be added easily with basic documents.
Q. What is the helpline number?
Call 14555 (toll-free) or 1800-111-565 for any query, eligibility check, or grievance.
Q. Can senior citizens with private insurance or other schemes use PM-JAY?
Yes. They can still avail PM-JAY benefits. They have the choice to use PM-JAY or their existing scheme.
Q. Is the Ayushman Card valid for the whole year?
The coverage is renewed every financial year (April–March). The card remains valid, but benefits are available up to ₹5 lakh (or ₹10 lakh for seniors with top-up) per year.
Q. Where can I download the Ayushman App?
Available on Google Play Store. You can check eligibility, download card, and find nearby hospitals through the app.