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Ayushman Bharat PM-JAY: Eligibility, Coverage and How to Apply in 2026

NGOLists Editorial Team·5 July 2026·5 min read
Key takeaways
  • PM-JAY gives eligible families 5 lakh a year of cashless hospital cover for secondary and tertiary treatment at empanelled hospitals.
  • Poorer families qualify through the SECC 2011 database; since 2024, every citizen aged 70 or above qualifies regardless of income via the Ayushman Vay Vandana Card.
  • Pre-existing conditions are covered from day one, with no waiting period.
  • Checking eligibility and creating the card is free — use the Ayushman App or beneficiary.nha.gov.in, or visit an empanelled hospital or CSC. Helpline: 14555.
  • As of December 2025 the scheme covers about 12 crore families with over 40 crore cards created and 32,000+ empanelled hospitals — the world's largest health-assurance programme.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana — usually shortened to PM-JAY — is India's flagship health-assurance scheme, and in 2026 it is the largest programme of its kind in the world. It gives eligible families cashless hospital treatment worth up to 5 lakh a year, and a 2024 expansion now brings every citizen aged 70 and above into the fold, regardless of income. This guide explains who qualifies, what is covered, and exactly how to check your eligibility and get your card.

What PM-JAY is

Launched in September 2018, PM-JAY is run by the National Health Authority and funded jointly by the central and state governments. It is not an insurance product you pay premiums for — eligible beneficiaries pay nothing. The scheme covers the cost of hospitalisation for a very wide list of medical and surgical packages, delivered cashless at empanelled hospitals so that a family facing a medical emergency does not have to find money up front or sell assets to pay a hospital bill.

Who is eligible

There are now two routes to eligibility, and it is worth knowing both.

Poor and vulnerable families (SECC 2011)

The original beneficiary base is drawn from the Socio-Economic Caste Census (SECC) 2011, using deprivation criteria in rural areas and defined occupational categories in urban areas — households such as landless labourers, informal workers, and families in poor housing. There is no cap on the number of members in a family, and no restriction by age or gender. Eligibility is based on the household appearing in the database, not on a fresh income test.

All senior citizens aged 70+ (Ayushman Vay Vandana Card)

The big change of recent years is the Ayushman Vay Vandana Card. Since 2024, every Indian aged 70 or above is eligible regardless of income — even income-tax payers and well-off families. If the senior's household is already covered under PM-JAY, the 70+ member gets an additional dedicated cover; if not, they receive their own 5 lakh cover. Those already on CGHS or ECHS must choose between their existing scheme and this one, but people with private insurance can hold both. Pre-existing conditions are covered from day one.

What it covers

PM-JAY covers secondary and tertiary care hospitalisation — everything from a straightforward surgery to cancer care, cardiac procedures and dialysis — through defined treatment packages. Cover includes hospitalisation charges, medicines and consumables, diagnostics, and pre- and post-hospitalisation expenses within scheme limits. Crucially, there is no waiting period and no exclusion for pre-existing disease. What it does not typically cover is routine outpatient consultation outside a hospital admission, though the broader Ayushman Bharat programme also runs Health and Wellness Centres for primary care.

How to check eligibility and get your card

  1. Download the Ayushman App from the Play Store, or go to beneficiary.nha.gov.in.
  2. Select Beneficiary, enter your mobile number and verify with the OTP.
  3. Search using your Aadhaar, ration card or family details to see if you are listed.
  4. If eligible, complete a quick e-KYC (Aadhaar OTP and a live photo for the 70+ card).
  5. Download the card to your phone — approval is often within minutes.

You can also get the card made free of charge at any empanelled hospital or Common Service Centre (CSC). The official helpline is 14555. Be careful of agents who ask for money — the Ayushman card is always free.

The scale so far

The numbers explain why PM-JAY matters. According to the National Health Authority, as of December 2025 around 42 crore Ayushman cards had been created, the scheme covered roughly 12 crore families, and more than 32,000 hospitals — over 15,000 of them private — were empanelled. Close to 11 crore hospital admissions worth about 1.6 lakh crore had been authorised. Please treat these figures as of the date cited and check the latest on the official portal, since the scheme grows every month.

Common problems applicants face

  • Name not found in the database despite being poor — families sometimes need to complete a fresh e-KYC or approach a CSC or hospital Arogya Mitra for help.
  • Aadhaar mismatches — a difference in name or date of birth between Aadhaar and other records can stall enrolment.
  • Empanelled-hospital confusion — always confirm a hospital is currently empanelled before admission, using the official hospital search.
  • Package limits — some high-end treatments have defined package rates; ask the hospital's Ayushman desk what is and isn't covered.
  • Agents charging fees — the card is free; do not pay anyone to make it.

Health access is exactly the kind of cause where NGOs and CSR funders complement government schemes — helping families enrol, running awareness drives, and filling gaps in primary care and post-discharge support. If your company or foundation wants to fund health work, our guide on how CSR funding works in India is a good starting point, and you can find verified health NGOs on NGOLists. During the monsoon, also see our guide to preventing waterborne disease, a leading cause of avoidable hospitalisation.

Further reading on NGOLists

Frequently asked questions

Who is eligible for an Ayushman Bharat card in 2026?

Two groups. First, poor and vulnerable families identified from the SECC 2011 deprivation and occupational criteria — with no cap on family size, age or gender. Second, since 2024, every Indian citizen aged 70 or above is eligible regardless of income under the Ayushman Vay Vandana Card. If a 70+ person's family is already covered under PM-JAY, they receive an additional dedicated cover; if not, they get their own.

How much does PM-JAY cover?

Up to 5 lakh per eligible family per year for secondary and tertiary hospitalisation, on a cashless and paperless basis at empanelled public and private hospitals across India. It covers hospitalisation costs, medicines, diagnostics, pre- and post-hospitalisation expenses within defined limits, and pre-existing diseases from day one with no waiting period.

How do I check eligibility and get my Ayushman card?

Download the Ayushman App or visit beneficiary.nha.gov.in, select Beneficiary, enter your mobile number and verify the OTP, then search using your Aadhaar or ration details. If you are eligible, complete a quick e-KYC and download the card to your phone. You can also get it made free at any empanelled hospital or Common Service Centre. Never pay an agent — the card is free.

Does Ayushman Bharat cover pre-existing diseases?

Yes. Unlike most private health insurance, PM-JAY covers pre-existing conditions such as diabetes, heart disease and kidney ailments from the very first day of enrolment, with no waiting period. This is one of the scheme's most important features for older and chronically ill beneficiaries.

Ayushman BharatPM-JAYAyushman cardPMJAY eligibilityVay Vandana cardhealth insurance scheme Indiagovernment health scheme
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