HomeDelhi NewsAyushman Bharat PM-JAY 2026: ₹5 Lakh Free Health Coverage — Who Qualifies,...

Ayushman Bharat PM-JAY 2026: ₹5 Lakh Free Health Coverage — Who Qualifies, How to Apply & Complete Guide for Delhi

If you belong to India’s bottom 40% economically — or if you are 70 years or above — the government may already be paying for your hospitalisation. Here is the complete, actionable guide to Ayushman Bharat PM-JAY 2026 — India’s largest free health insurance scheme.

What Is Ayushman Bharat PM-JAY?

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is the world’s largest government-funded health assurance scheme. Launched on September 23, 2018, in Ranchi, Jharkhand by Prime Minister Narendra Modi, it provides:

  • ₹5 lakh health cover per family per year for secondary and tertiary hospitalisation
  • Cashless and paperless treatment at empanelled public and private hospitals
  • Pan-India coverage — valid at any empanelled hospital across all states
  • No cap on family size, age or gender — the entire family is covered under one card
  • Coverage for 1,900+ medical procedures across 27 speciality areas

The scheme targets over 12 crore poor and vulnerable families — approximately 55 crore beneficiaries — forming the bottom 40% of India’s population. As of 2026, over 27 crore Ayushman Cards have been generated and 5 crore+ hospital admissions have taken place under the scheme. A network of 28,000+ empanelled hospitals is available across India.

Who Is Eligible for Ayushman Bharat PM-JAY?

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

Rural Households — Any of These Criteria Qualifies You:

  • Families living in kuccha houses (mud/non-durable materials) with only one room
  • Households with no adult male member aged 16–59 years
  • Families with a disabled member and no able-bodied adult member
  • Households headed by a female member with no adult male aged 16–59
  • Families belonging to SC/ST categories
  • Households with no literate adult above 25 years
  • Landless households that earn primarily through manual casual labour
  • Primitive tribal communities and legally released bonded labourers

Urban Households — Any of These Occupational Categories Qualifies:

  • Rag pickers, beggars, domestic workers
  • Street vendors, cobblers, hawkers, other service providers
  • Construction workers — masons, labourers, plumbers, welders, painters, coolie workers
  • Transport workers — drivers, conductors, cart pullers, rickshaw pullers, helpers
  • Shop workers, peons, delivery assistants, waiters and helpers in small establishments
  • Sanitation workers, gardeners, sweepers, home-based workers
  • Artisans, handicraft workers, tailors
  • Security guards, coolies, other head-load workers
  • ASHA workers, Anganwadi workers and other welfare/scheme workers (added 2024)

Special Category — All Senior Citizens 70 Years and Above (Since Sep 2024):

In September 2024, the Union Cabinet approved a landmark expansion:

All senior citizens aged 70 years and above are eligible for Ayushman Bharat — regardless of their income or existing insurance.

SituationBenefit
Senior (70+) in a family already under PMJAYAdditional ₹5 lakh top-up cover exclusively for them (total family gets up to ₹10 lakh)
Senior (70+) with private health insuranceCan avail PMJAY alongside existing coverage
Senior (70+) under CGHS/ECHS/Ayushman CAPFMust choose between existing scheme OR PMJAY

This expansion benefits approximately 6 crore senior citizens across 4.5 crore families — and every eligible senior receives a separate Ayushman Card.

What Does the Scheme Cover? — Benefits in Detail

Under Ayushman Bharat PM-JAY, the ₹5 lakh annual coverage includes:

What Is Covered:

  • Pre-hospitalisation expenses — diagnostics and medicines
  • Hospitalisation costs — surgery, ICU, doctor fees, nursing
  • Post-hospitalisation — follow-up care for 15 days after discharge
  • Day-care procedures — treatments that don’t require overnight admission
  • Transportation to hospital — ambulance charges in many cases
  • 1,900+ medical procedures across 27 speciality areas

Key Specialities Covered:

  • Cardiology — heart surgeries, bypass, stent
  • Orthopaedics — knee and hip replacements, fractures
  • Neurology — brain surgeries, stroke treatment
  • Oncology — cancer treatment including chemotherapy
  • Pulmonology — lung diseases
  • Urology, Nephrology — kidney diseases, dialysis
  • Ophthalmology — eye surgeries
  • Dental (select) — oral and maxillofacial procedures

Multiple Surgery Coverage:

  • First surgery: 100% covered
  • Second surgery: 50% covered
  • Third surgery: 25% covered

What Is NOT Covered:

  • OPD (Outpatient) consultations
  • Cosmetic procedures
  • Drug de-addiction
  • Fertility treatments
  • Organ transplantation (donor side)

How to Check If You Are Eligible

Method 1 — Online (pmjay.gov.in):

Step 1 → Visit pmjay.gov.in → Click “Am I Eligible”

Step 2 → Select “Beneficiary”, enter the captcha and your registered mobile number

Step 3 → Verify with OTP

Step 4 → Select your State, scheme and district

Step 5 → Search using Aadhaar number, Family ID or PMJAY ID

Step 6 → If eligible, your family members list will appear

Method 2 — Common Service Centre (CSC): Visit any nearby Jan Seva Kendra (Common Service Centre) — staff will check your eligibility using your Aadhaar details.

Method 3 — Empanelled Hospital: Visit any PMJAY-empanelled hospital. The Pradhan Mantri Arogya Mitra (PMAM) at the hospital will check your eligibility.

Helpline: Call 14555 for eligibility check assistance.

How to Apply for Ayushman Card — Step by Step

Online Guide

Step 1 → Visit beneficiary.nha.gov.in or download the Ayushman Bharat App from Google Play Store

Step 2 → Login using your mobile number — enter the OTP received

Step 3 → Select your State and Scheme from the dropdown

Step 4 → Search for your name using Aadhaar number, Family ID or PMJAY ID

Step 5 → Complete eKYC verification — OTP on Aadhaar-linked mobile or biometric at a centre

Step 6 → Upload your photograph and fill in required details

Step 7 → Submit — check application status after 24 hours

Step 8 → Once approved, click “Download Card” — your Ayushman Card PDF is ready

If you have a ration card: If your name is on the ration card, the application process is faster, and the card can be available within 24 hours.

Offline Guide

Step 1: Visit a nearby centre

Go to any of these:

  • Common Service Centre (CSC)
  • Empanelled government/private hospital (Ayushman Mitra desk)

Step 2: Tell them you want Ayushman Card

  • Ask for Ayushman Bharat (PM-JAY) registration
  • Provide your mobile number for OTP verification

Step 3: Submit required documents

Carry originals + photocopies:

  • Aadhaar card (mandatory)
  • Ration card / family ID
  • Address proof (voter ID, electricity bill, etc.)
  • Income certificate (if applicable)
  • Caste certificate (if applicable)

Step 4: Eligibility check + biometric verification

  • Operator checks your name in PM-JAY database (SECC list)
  • You’ll give fingerprint / iris scan for e-KYC

Step 5: Application submission

  • Staff uploads your details and documents
  • If everything matches → application is approved

Step 6: Get your Ayushman Card

  • Either:
    • Printed on the spot (sometimes), OR
    • Collect later from CSC / download online

Usually takes a few minutes to a few days depending on verification.

Pro Tips

  • Take all family members’ Aadhaar + ration card
  • Ensure mobile number is linked to Aadhaar
  • Visit CSC in morning to avoid long queues
  • If rejected, ask reason—often due to data mismatch

How to Use the Ayushman Card at a Hospital

Once you have your Ayushman Card, here is how to use it:

Step 1 → Find a PMJAY-empanelled hospital near you at hospitals.pmjay.gov.in or by calling 14555

Step 2 → Carry your Ayushman Card + Aadhaar Card to the hospital

Step 3 → Present both at the hospital reception or PMAM counter

Step 4 → Hospital scans the QR code on your Ayushman Card for verification

Step 5 → Once verified, the hospital initiates the admission process

Step 6 → Receive cashless treatment — you pay nothing for covered procedures

Step 7 → After discharge, treatment continues to be covered for 15 days (post-hospitalisation follow-up)

Scheme at a Glance — Key Numbers (2026)

MetricFigure
Annual Health Cover₹5 lakh per family
Senior Citizen (70+) Top-UpAdditional ₹5 lakh exclusively for them
Total Beneficiaries~55 crore (12 crore families)
Ayushman Cards Generated27 crore+
Hospital Admissions5 crore+
Empanelled Hospitals28,000+ (public + private)
Procedures Covered1,900+
Speciality Areas27
LaunchedSeptember 23, 2018
Helpline14555
Portalpmjay.gov.in

Ayushman Bharat in Delhi — What You Need to Know

Delhi residents should note one important fact: Delhi government has its own health scheme (previously Mukhyamantri Arogya Yojana) and the integration with PM-JAY has had a complex history in the capital.

However, central government employees, CAPF/CGHS beneficiaries and senior citizens 70+ in Delhi can now access Ayushman Bharat benefits. Private and public hospitals in Delhi that are empanelled under PM-JAY accept the Ayushman Card for cashless treatment.

To find empanelled hospitals in Delhi: Visit hospitals.pmjay.gov.in → Select State: Delhi → Search by location, speciality or hospital name.

Delhi residents can also:

  • Apply for their Ayushman Card at any Common Service Centre in their area
  • Visit a Jan Arogya Kendra or government hospital to apply
  • Call 14555 for assistance and nearest empanelled hospital details

Ayushman Bharat PM-JAY 2026 — FAQs

Q. What is the health cover under Ayushman Bharat PM-JAY?

₹5 lakh per family per year for secondary and tertiary hospitalisation. Senior citizens aged 70+ get an additional ₹5 lakh top-up — taking total family coverage up to ₹10 lakh.

Q. Who is eligible for Ayushman Bharat?

Families identified under SECC 2011 data as economically deprived (rural) or working in specific occupations (urban). Since September 2024, ALL senior citizens aged 70 and above are eligible regardless of income.

Q. How do I check my PM-JAY eligibility?

Visit pmjay.gov.in → click “Am I Eligible” → login with mobile OTP → search using Aadhaar, Family ID or PMJAY ID. Or call helpline 14555.

Q. How do I get my Ayushman Card?

Apply online at beneficiary.nha.gov.in or download the Ayushman Bharat App. Verify via Aadhaar OTP or biometric, upload your photo and download the card PDF once approved.

Q. Is the Ayushman Card valid across India?

Yes — it can be used at any of the 28,000+ PMJAY-empanelled hospitals across all states.

Q. Is there a limit on the number of family members covered?

No — there is no cap on family size, age or gender. All family members are covered under one card.

Q. Are senior citizens with CGHS eligible for Ayushman Bharat?

Senior citizens (70+) currently under CGHS, ECHS or Ayushman CAPF must choose between their existing scheme OR Ayushman Bharat.

Q. What is the helpline number for PM-JAY?

14555 — available for eligibility checks, card assistance and hospital locator.

Q. How many hospitals accept the Ayushman Card?

28,000+ empanelled public and private hospitals across India. Check the full list at hospitals.pmjay.gov.in.

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