Medical bills can break a family’s savings in one hospital visit. The Ayushman Bharat Yojana was started by the Government of India to solve exactly this problem. It gives eligible families a health cover of Rs. 5 lakh per year, completely free, for treatment at listed hospitals.
What is Ayushman Bharat Yojana?
Ayushman Bharat Yojana, also called Pradhan Mantri Jan Arogya Yojana (PM-JAY), is the world’s largest government-funded health insurance scheme. It aims to reduce the financial burden of hospital treatment on poor and vulnerable families.
Why was it started?
- Many families avoided hospital treatment because they could not afford it.
- Medical emergencies often pushed families into debt.
- The scheme gives cashless and paperless treatment at empanelled hospitals, so families do not pay from their own pocket for covered treatments.
Who runs the scheme?
The scheme is managed by the National Health Authority (NHA) under the Ministry of Health and Family Welfare, along with State Health Agencies in each state.
Two Main Parts of Ayushman Bharat
The Ayushman Bharat mission actually has two components. People often mix them up, so here is a clear comparison.
| Feature | PM-JAY (Health Insurance) | Health and Wellness Centres (HWC / Ayushman Arogya Mandir) |
|---|---|---|
| What it gives | Free hospital treatment up to Rs. 5 lakh per family per year | Free basic health check-ups, medicines and screenings near your home |
| Where you use it | Empanelled hospitals (government and private) | Local health sub-centres and primary health centres |
| Main card | Ayushman card (PM-JAY card) | Not card-based, walk-in service |
| Best for | Hospitalisation, surgery, major treatment | Regular check-ups, early disease detection |
| Point | Details |
|---|---|
| Scheme name | Ayushman Bharat / PM-JAY |
| Launch year | 2018 |
| Cover amount | Up to Rs. 5 lakh per family per year |
| Cover type | Family floater (no cap on family size) |
| Premium cost | Free for eligible families |
| Treatment type | Cashless and paperless at empanelled hospitals |
| Pre-existing diseases | Covered from day one |
| Official portal | pmjay.gov.in |
| Health ID system | ABHA (Ayushman Bharat Health Account) |
| Helpline | 14555 or 1800-111-565 |
Ayushman Card vs ABHA Card: What’s the Difference?
This is one of the most searched confusions, so let’s clear it simply.
| Point | Ayushman Card (PM-JAY Card) | ABHA Card (Health ID) |
|---|---|---|
| Full form | Pradhan Mantri Jan Arogya Yojana card | Ayushman Bharat Health Account |
| Purpose | Proof that you are eligible for free hospital treatment cover | A 14-digit digital health ID that stores your medical records |
| Who can get it | Only eligible families as per government criteria | Any Indian citizen can create one, free |
| What it does | Lets you get cashless treatment at empanelled hospitals | Links your prescriptions, reports and health history digitally |
| Where to make it | Beneficiary portal or Common Service Centre | ABHA website or ABHA mobile app |
Simple way to remember
- Ayushman card = your insurance proof for free treatment.
- ABHA card = your digital health record ID, open to everyone.
You can have both. They work together but serve different purposes.
Eligibility Criteria
Eligibility for PM-JAY is decided using data from the Socio-Economic Caste Census (SECC) and state-specific criteria. It is not open to every citizen automatically.
Rural households: commonly included groups
- Families with only one room and kutcha walls and roof
- Households with no adult member between ages 16 and 59
- Female-headed households with no adult male member
- Households with a disabled member and no able-bodied adult
- Scheduled Caste and Scheduled Tribe households, as per listed criteria
- Manual scavenger families
- Landless households earning mainly from manual labour
Urban households: commonly included occupational categories
| Category | Examples |
|---|---|
| Waste pickers | Rag pickers, sanitation workers |
| Street-based workers | Beggars, cobblers, hawkers |
| Domestic and construction workers | House helpers, masons, labourers |
| Transport workers | Rickshaw pullers, drivers, conductors |
| Home-based workers | Tailors, artisans |
| Other informal workers | Security guards, washermen, small shop assistants |
Who is generally excluded?
- Families owning a motorised four-wheeler
- Government employees with existing health scheme coverage
- Households with a member earning a defined income threshold under state rules
- Families already covered under certain other government health schemes, depending on state overlap rules
Since criteria can be updated by states, always confirm using the official eligibility checker before assuming your status.
How to Check Eligibility Online
Step-by-step method
- Visit pmjay.gov.in.
- Click on Am I Eligible on the home page.
- Enter your mobile number and the captcha shown.
- Click Generate OTP and enter the OTP received.
- Select your state.
- Search using your name, ration card number, RSBY URN, or mobile number, depending on what your state supports.
- If your family is listed, your eligibility details will appear on screen.
What you might see
| Result Shown | Meaning |
|---|---|
| Approved / Eligible | Your family qualifies for PM-JAY cover |
| Not Found | Your family may not be listed under current criteria |
| Pending Verification | Your details are under review by the local officer |
How to Apply for Ayushman Card Online (Step-by-Step)
If you are found eligible, you can generate your Ayushman card yourself.
Method 1: Using the Beneficiary Portal
- Go to beneficiary.nha.gov.in.
- Click Login and choose Beneficiary.
- Enter your mobile number, select the correct captcha, and click Generate OTP.
- Enter the OTP to log in.
- Select your state and scheme (PM-JAY).
- Search your family using Aadhaar number, ration card, or name-based search.
- Once your name appears, click e-KYC.
- Choose a verification method, such as Aadhaar OTP, fingerprint, or face authentication.
- Complete the verification and upload your photo if asked.
- After approval, download your e-card in PDF format.
Method 2: Using Common Service Centres (CSC)
- Visit your nearest Common Service Centre (CSC) or Ayushman Mitra kiosk.
- Carry your Aadhaar card and ration card or other listed ID proof.
- The operator will verify your eligibility and complete e-KYC.
- Your physical or digital Ayushman card will be issued after approval.
Method 3: Using the Ayushman App
- Download the official Ayushman App from the Play Store.
- Register using your mobile number and OTP.
- Search your family details and complete e-KYC directly from the app.
- Download your card once approved.
Beneficiary Portal Login: Step-by-Step
Many users specifically search for “beneficiary login”, so here is a focused guide.
For beneficiaries (public users)
- Open beneficiary.nha.gov.in.
- Click Beneficiary Login.
- Choose login by mobile number and OTP.
- Enter the captcha and click Generate OTP.
- Enter the OTP to access your dashboard, where you can check status, download the card, or update details.
For Ayushman Mitras and operators
- Open the same portal and select Operator/Ayushman Mitra login.
- Log in using the User ID and password issued by the State Health Agency.
- Complete beneficiary verification and card issuance from the operator dashboard.
Login options comparison
| Login Type | Who Uses It | Login Method |
|---|---|---|
| Beneficiary Login | General public | Mobile number and OTP |
| Operator / Ayushman Mitra Login | CSC operators, hospital staff | User ID and password |
| Hospital Login | Empanelled hospitals | Official hospital credentials issued by NHA |
Documents Required
| Document | Purpose |
|---|---|
| Aadhaar card | Identity verification and e-KYC |
| Ration card | Family identification, in many states |
| Mobile number | OTP-based login and verification |
| Passport-size photo | For card printing, if required |
| Income or caste certificate | In some state-specific verification cases |
Treatment and Coverage Details
What is covered?
- Hospitalisation expenses, including pre and post-hospitalisation costs for a limited period
- Surgeries, medical and day-care treatments
- Diagnostic tests linked to the treatment
- Medicines and consumables during hospital stay
- Follow-up care as defined under package rates
This chart is only an illustrative example to help you understand how package costs are generally distributed. Actual coverage depends on your treatment and hospital package.
What is usually not covered?
| Category | Examples |
|---|---|
| Cosmetic procedures | Non-medical cosmetic surgery |
| OPD-only consultations | Simple outpatient visits without hospitalisation, in most cases |
| Certain high-cost organ transplants | Coverage may vary by state and package |
| Non-empanelled hospital treatment | Treatment outside the listed hospital network |
Please check the latest exclusion list on the official website, since it can be updated by the National Health Authority.
What this means for you
- You should not pay for covered treatment at an empanelled hospital.
- The Ayushman Mitra at the hospital helps you with the entire process.
- Always carry your Ayushman card or ABHA ID and Aadhaar card when visiting the hospital.
Empanelled Hospitals: How to Find One
Step-by-step method
- Visit pmjay.gov.in.
- Click on Find Hospital or Hospital Empanelment section.
- Select your state, district, and specialty needed, such as cardiology or orthopaedics.
- Enter the captcha and click Search.
- You will see a list of empanelled hospitals with addresses and contact details.
Types of empanelled hospitals
| Type | Description |
|---|---|
| Government hospitals | Public hospitals empanelled under the scheme |
| Private hospitals | Private hospitals that meet NHA empanelment standards |
| Specialty hospitals | Hospitals focused on specific treatments, such as cancer or heart care |
Common Problems and Solutions
| Problem | Likely Reason | Solution |
|---|---|---|
| Name not found in eligibility check | Not listed in SECC or state database | Contact your local health department or CSC for verification |
| OTP not received | Network issue or wrong mobile number linked | Retry after some time or update your mobile number through proper channel |
| e-KYC failing repeatedly | Aadhaar details mismatch | Visit a CSC or Ayushman Mitra for assisted verification |
| Card not downloading | Server load or browser issue | Try a different browser or during non-peak hours |
| Hospital asking for payment | Possible misunderstanding or non-empanelled treatment | Ask for the Ayushman Mitra and confirm the treatment is package-covered |
Ayushman Bharat vs Private Health Insurance
| Feature | Ayushman Bharat (PM-JAY) | Typical Private Health Insurance |
|---|---|---|
| Premium | Free for eligible families | Paid yearly premium |
| Cover amount | Up to Rs. 5 lakh per family per year | Depends on the plan chosen |
| Pre-existing disease cover | Covered from day one | Often has a waiting period |
| Eligibility | Based on government criteria | Based on medical underwriting and payment |
| Hospital network | Empanelled government and private hospitals | Insurer’s own network hospitals |
| Best for | Low-income and vulnerable families | Anyone wanting broader or higher cover |
Tips to Avoid Fraud
- Ayushman card creation and treatment under PM-JAY are completely free.
- No hospital or agent should ask you to pay for card approval.
- Always confirm the hospital is officially empanelled before starting treatment.
- Use only the official portal pmjay.gov.in or beneficiary.nha.gov.in.
- Never share your Aadhaar OTP with unknown callers claiming to activate your card.
- Report suspicious demands for money to the PM-JAY helpline or local police.
Why This Scheme Matters (Our Analysis)
- Removes fear of medical bills: Families can seek treatment early instead of delaying due to cost worries.
- Covers the whole family: There is no cap on family size or age under the floater cover.
- Combines with ABHA for better care: Your digital health record can follow you across hospitals, reducing repeated tests and paperwork.
Simple action plan
| Step | Action |
|---|---|
| 1 | Check your eligibility on pmjay.gov.in |
| 2 | Complete e-KYC and download your Ayushman card |
| 3 | Create your ABHA ID for digital health records |
| 4 | Save the nearest empanelled hospital details |
| 5 | Keep your Aadhaar and Ayushman card together for emergencies |
Frequently Asked Questions
Q1. What is Ayushman Bharat Yojana?
It is a government health insurance scheme, also called PM-JAY, that gives eligible families free hospital treatment cover of up to Rs. 5 lakh per year at empanelled hospitals.
Q2. How do I check if I am eligible for Ayushman Bharat?
Visit pmjay.gov.in, click on Am I Eligible, verify your mobile number with OTP, select your state, and search using your name, ration card, or mobile number.
Q3. How can I apply for the Ayushman card online?
Log in to beneficiary.nha.gov.in using your mobile number and OTP, search your family details, complete e-KYC using Aadhaar verification, and download your e-card once approved.
Q4. What is the difference between the Ayushman card and the ABHA card?
The Ayushman card is proof of your free treatment cover under PM-JAY and is only for eligible families. The ABHA card is a free digital health ID available to any citizen for storing medical records.
Q5. Is there any fee for the Ayushman card or treatment?
No. Both the card and covered treatment at empanelled hospitals are free for eligible beneficiaries.
Q6. How do I log in to the beneficiary portal?
Go to beneficiary.nha.gov.in, click Beneficiary Login, enter your mobile number and captcha, generate the OTP, and enter it to access your dashboard.
Q7. What documents do I need to apply?
You generally need your Aadhaar card, ration card, mobile number, and a passport-size photo. Some states may ask for additional documents.
Q8. How do I find an empanelled hospital near me?
Visit pmjay.gov.in, click Find Hospital, select your state, district and required specialty, and view the list of empanelled hospitals with contact details.
Q9. What if my name is not found during the eligibility check?
Visit your nearest Common Service Centre or local health department to verify whether your household is listed under the relevant government database, and ask about inclusion options.
Q10. Can I create an ABHA ID even if I am not eligible for PM-JAY?
Yes. Any Indian citizen can create a free ABHA ID through the official ABHA website or app, regardless of PM-JAY eligibility.
Q11. Is pre-existing disease covered under this scheme?
Yes. PM-JAY covers pre-existing diseases from the very first day of enrolment, unlike many private insurance plans that apply a waiting period.
Q12. Who can I contact for help or complaints?
You can call the PM-JAY helpline at 14555 or 1800-111-565, or visit the nearest Common Service Centre or empanelled hospital’s Ayushman Mitra desk.
Important Links
| Purpose | Link |
|---|---|
| Application Form Link (Beneficiary Portal) | Click Here |
| Official Site (PM-JAY) | Click Here |
| Check Eligibility (“Am I Eligible”) | Click Here |
| Create ABHA Health ID | Click Here |
| Find Empanelled Hospital | Click Here |
| PM Awas Yojana Info | Click Here |
| PM Kisan Yojana Info | Click Here |
| Latest Government Schemes | Click Here |
| Home Page | Click Here |