Ayushman Bharat PM-JAY — Everything You Need to Know

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the world's largest government-funded health insurance scheme — covering 50 crore people (40% of India's population) with ₹5 lakh annual health coverage at zero premium. Understanding this scheme can literally save your life and lakhs of rupees.

Who is Eligible for PM-JAY?

Eligibility is based on SECC 2011 (Socio-Economic Caste Census) data. You don't need to apply — if your family was identified in SECC 2011, you're automatically eligible.

Rural eligibility criteria (any one): Households with no permanent shelter | BPL card holders | SC/ST households | Households with disabled members | No adult member between 16–59 | Female-headed households | Manual scavenger households | Landless agricultural households.

Urban eligibility criteria (occupational categories): Ragpicker, beggar, domestic worker, street vendor, construction worker, plumber, welder, electrician, watchman, sweeper, home-based worker, artisan, tailor, driver, helper/porter, painter, conductor, vegetable/fruit seller, washer-man.

Aadhaar-based check: Go to mera.pmjay.gov.in → Enter Aadhaar or mobile number → Check family eligibility instantly. Or call 14555 (PM-JAY helpline).

What PM-JAY Covers — 1,949 Procedures

Cardiac care: PTCA (angioplasty) ₹1,60,000 package | CABG (bypass) ₹2,00,000 | Pacemaker implant ₹1,20,000

Cancer: Mastectomy ₹60,000 | Chemotherapy packages ₹10,000–50,000/cycle | Radiation ₹60,000–1,40,000 course

Orthopaedics: Total knee replacement ₹1,60,000 | Hip replacement ₹1,80,000 | Spine surgery ₹1,40,000–2,10,000

Maternity: Normal delivery ₹9,000 | C-section ₹16,000 | High-risk delivery ₹35,000

Dialysis: ₹4,750 per session (lifelong for chronic kidney disease)

Neurosurgery: Craniotomy ₹1,10,000 | Spine surgery ₹1,40,000

All packages are all-inclusive — bed charges, surgeon fees, medicines, diagnostics, and follow-up are covered.

How to Use PM-JAY for Treatment

1. Check eligibility at mera.pmjay.gov.in or call 14555.

2. Find empanelled hospitals near you on the same portal or app (Ayushman Bharat app). There are 25,000+ empanelled hospitals including major private chains (Apollo, Fortis, Max, Narayana, Manipal, Medanta).

3. At the hospital, visit the Ayushman Bharat Help Desk (mandatory in all empanelled hospitals). Show Aadhaar.

4. Hospital verifies eligibility on the portal in real-time. No physical card needed — Aadhaar is sufficient.

5. Pre-authorisation is issued by the hospital for your procedure. Treatment proceeds at zero cost — no deposit required.

6. Discharge with zero payment. All bills settled directly between hospital and NHA (National Health Authority).

PM-JAY + State Schemes

Many states top up PM-JAY with additional coverage: Andhra Pradesh/Telangana (Dr NTR Vaidya Seva/Aarogyasri — ₹10 lakh cover), Tamil Nadu (Chief Minister's Comprehensive Health Insurance — ₹5 lakh), Gujarat (MA Card — ₹5 lakh top-up), Karnataka (Arogya Karnataka — ₹5 lakh). Combined coverage can reach ₹10–15 lakh/year in these states.