Central GovernmentVerified

Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana

Ministry: Ministry Of Health & Family Welfare

Department: Department of Health and Family Welfare

AB PM-JAY is a health insurance scheme for low-income families in rural and urban areas. The scheme aims to provide affordable healthcare facilities to the Poor. It is the largest health assurance scheme in the world which aims at providing a health cover of ₹5,00,000/- per family per year.

Start date23 Sept 2018
Last verifiedToday

About This Scheme

The scheme “Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana” implemented by the National Health Authority (NHA) under Ministry of Health and Family Welfare, Government of India, aims to provide cashless hospitalisation coverage of ₹5,00,000 per family per year to poor and vulnerable families for secondary and tertiary healthcare services. It was launched on 23rd September 2018 in Ranchi, Jharkhand, by the Hon’ble Prime Minister of India. "Ayushman Bharat" is an attempt to move from a sectoral and segmented approach to health service delivery to a comprehensive need-based health care service. This scheme aims to undertake path-breaking interventions to holistically address the healthcare system (covering prevention, promotion, and ambulatory care) at the primary, secondary, and tertiary levels. Ayushman Bharat adopts a continuum of care approach, comprising two interrelated components, which are - - Health and Wellness Centres (HWCs): The scheme aims to provide comprehensive primary healthcare services, including maternal and child health, non-communicable disease care, free essential drugs, and diagnostics, close to people’s homes. The centres promote preventive healthcare and healthy behaviours to reduce the risk of chronic diseases. - Pradhan Mantri Jan Arogya Yojana (PM-JAY): The second component under Ayushman Bharat is the Pradhan Mantri Jan Arogya Yojna or PM-JAY as it is popularly known. It aims to provide cashless health insurance coverage of up to ₹5,00,000 per family per year for secondary and tertiary hospitalization to poor and vulnerable families.

Benefits

₹5.0 L · annual

Financial Health Insurance Cover:
  • Annual Hospitalization Coverage: Cashless coverage up to ₹5,00,000/- per family per year.
  • Comprehensive Treatment Costs: Covers consultation, medicines, diagnostics, surgery, ICU, implants, accommodation, and food.
  • Pre and Post Hospitalization Support: Covers 3 days pre-hospitalization and 15 days post-hospitalization expenses.
  • Treatment Complication Coverage: Covers complications arising during treatment.
Coverage Features:
  • Pre-Existing Disease Coverage: Covers all pre-existing diseases from day one.
  • No Family Size Limit: No restriction on age, gender, or family size.
  • Nationwide Portability: Benefits available across India in empanelled hospitals.
  • Wide Procedure Coverage: Covers approximately 1,929 medical procedures.

Eligibility

Note: You may be eligible based on the information shown. Please verify the official eligibility requirements before applying.

Required Documents

  • Age & Identity Proof (Aadhaar Card / PAN Card).
  • Proof of Address.
  • Contact details (Mobile, e-mail).
  • Caste Certificate.
  • Income Certificate.
  • Document Proof of the Current Status of the Family (Joint or Nuclear).
  • Aadhaar Card.

✦ Required ◦ Optional

How to Apply

IIn-person

  • The Arogya Mitra searches the available list of beneficiaries using details such as name, location, ration card number, mobile number, or the RSBY URN of the beneficiary. After this, the beneficiary is searched for in the BIS. The individual is identified and the scanned valid ID documents are then uploaded.
  • To get a PMJAY e-card for themselves and their family, a potential beneficiary needs to visit either a hospital or a Community Service Centre (CSC) for identification and follow the steps mentioned below:

Step 1: Potential AB-PMJAY beneficiaries are to submit the PM letter/ RSBY URN/ RC Number/ Mobile Number - The operator (commonly known as the Arogya Mitra) searches the available list of beneficiaries. The operator does this by entering details such as name, location, Ration Card number, mobile number, or even RSBY URN of the beneficiary.

Step 2: Search in the BIS Application - The operator searches for the potential beneficiary in the entitled SECC, RSBY, State Health Scheme, Additional Data Collection Drive databases.

Step 3: Individual Identification - The identification process is carried out if the name is found in the list. For this, documents like Aadhaar or any government ID and a Ration Card or an alternative family ID are required to validate against the details available in the system. Scanned documents are then uploaded.

Step 4: Family Identification - The Arogya Mitra then identifies the family records through the ration card and the scanned documents are then uploaded. The Arogya Mitra then submits the individual and family records to the trust/insurance company for approval.

Step 5: Approval or Rejection - The Health insurance company or trust may then approve or recommend rejection for the submitted beneficiaries. The cases that are recommended for rejection will be finally verified for approval or rejection by the State Health Agency (SHA).

Step 6: E-card Issuance - On approval by SHA/insurance company/trust, an e-card will be issued to the beneficiary.

OOnline
Step 1: Register on the UMANG Portal

- Visit the official website of UMANG. In the top right corner of the landing page, click "Register." You will be taken to the Registration Page.

Step 2: Mobile Number Verification and MPIN Creation

- You will be redirected to the mobile number verification page. Enter your mobile number and get it verified via OTP. Create an MPIN to complete the registration process. You will be taken to the UMANG homepage. Login using your Mobile Number and MPIN.

Step 3: Accessing Services on UMANG

- In the tabs provided at the bottom of the page, click on the "All Services" tab. Select the service you want to apply for. You will be taken to the Online Application Form.

Step 5: Completing the Application

- In the application form, fill in all the mandatory fields and upload all the required documents in the specified format and size.

Step 6: Review and Confirmation

- Carefully review all the information provided and the documents uploaded. Make any necessary corrections, if required. Acknowledge and agree to the terms and conditions, declaration, and privacy policy, if any.

Step 7: Submitting the Application

- Click the "Submit" or "Apply" button to submit your application. You'll receive a confirmation message upon successful submission of the application.

GGovernment Portal

UMANG

Apply here ↗

Quick Info

Level
Central Government
Max benefit
₹5.0 L
Launched
23 Sept 2018