ℹ️ Overviewపథకం వివరాలు
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) provides eligible families with health cover of up to ₹5,00,000 per family per year for specified secondary and tertiary hospital care. The benefit is shared on a family-floater basis and is delivered through empanelled public and private hospitals.
ఆయుష్మాన్ భారత్ ప్రధానమంత్రి జన ఆరోగ్య యోజన (AB PM-JAY) అర్హులైన కుటుంబాలకు సంవత్సరానికి కుటుంబానికి గరిష్ఠంగా ₹5,00,000 వరకు నిర్దిష్ట ద్వితీయ, తృతీయ స్థాయి ఆసుపత్రి చికిత్సలకు ఆరోగ్య కవరేజీ అందిస్తుంది. ఇది కుటుంబ ఫ్లోటర్ విధానంలో ఎంప్యానెల్ చేసిన ప్రభుత్వ, ప్రైవేట్ ఆసుపత్రుల ద్వారా అందుతుంది.
Coverage amounts, package lists and state implementation rules may be updated. This page is an information guide, not an eligibility approval.
🎁 Benefits / ప్రయోజనాలు
💰 Hospital cover
Up to ₹5 lakh per eligible family per year for covered hospitalization packages.
🧾 Cashless & paperless
Covered package services are intended to be cashless at empanelled hospitals after verification and authorization.
🩺 Included care costs
As permitted by package rules: treatment, medicines, diagnostics, ICU/OT, doctor/surgeon charges and room-related expenses.
🔁 Pre-existing conditions
Pre-existing diseases are covered from day one for eligible beneficiaries, subject to applicable package rules.
Package rules generally include up to 3 days of pre-hospitalization and 15 days of post-hospitalization expenses for covered admission. Confirm the exact package and exclusions with the hospital’s Ayushman Mitra.
🎯 Eligibility — who can get it?
- Check the beneficiary database through the official PM-JAY beneficiary portal or at an empanelled hospital/CSC.
- Traditional PM-JAY eligibility is based on notified beneficiary databases and rural deprivation / urban occupation criteria; state-specific beneficiary extensions may also apply.
- People aged 70 years and above have a separate expanded eligibility pathway announced by the Government; check the current official portal for enrollment and card steps.
- Do not assume eligibility only because you hold a ration card or Aadhaar. Confirm your name/family record in the official system.
📄 Documents to keep ready
- Aadhaar or another government-approved identity proof accepted by the operator.
- Ration card / family ID or another accepted family record, as required for beneficiary matching.
- Registered mobile phone for OTP/e-KYC where requested.
- Any scheme/beneficiary reference details already available (for example, PM-JAY letter or relevant ID).
The exact documents depend on the beneficiary record and current verification instructions. Do not upload or share Aadhaar/OTP on unofficial websites or with unknown agents.
📝 How to check eligibility and get the card
Open the NHA beneficiary portal and search/check the family record using the available options.
If the record is found, follow the portal's current instructions. A CSC or an Ayushman Mitra at an empanelled hospital can help with assisted verification.
Provide identity and family proof that matches the beneficiary record. The authorized operator submits the details for verification/approval.
After approval, access/download the e-card through the official portal/app or request help from the authorized centre.
PM-JAY is entitlement-based; a general open enrollment form may not exist for people who are not in an eligible beneficiary group. Do not pay unofficial agents for guaranteed approval.
🏥 Ayushman hospitals and treatments
PM-JAY covers specified secondary and tertiary hospitalization packages at participating empanelled hospitals. The covered package list can include surgeries, medical treatment, diagnostics, ICU care and other defined procedures. Availability differs by hospital and package; this is not a promise that every disease or outpatient visit is covered.
🏥 Find a hospital
Search the official empanelled-hospital directory by state, district and hospital.
Search hospitals ↗💊 Confirm treatment package
Before admission, ask the hospital's Ayushman Mitra to confirm whether the exact procedure/package is available and whether pre-authorization is required.
NHA scheme information ↗Common cost categories in covered packages
- Medical examination, consultation and treatment charges
- Medicines, consumables and diagnostic/laboratory investigations
- Ward/accommodation, ICU, OT, doctor and surgeon charges when included in the approved package
- Eligible pre- and post-hospitalization expenses as allowed by the scheme package
The hospital directory and current package rules on official government portals are authoritative. Always check current availability rather than relying on a general list.
💳 How to claim / use the benefit
For beneficiaries, PM-JAY generally works as a cashless hospital benefit, not as a routine reimbursement claim paid directly to the patient. The empanelled hospital raises the package claim through the scheme system.
Bring your Ayushman card/e-card and accepted identity proof. Ask for the Ayushman Mitra/help desk.
The hospital checks your beneficiary status and confirms the required treatment package and any pre-authorization.
Follow hospital instructions. Ask for a written explanation before paying for any item said to be outside the covered package.
The hospital submits the claim with discharge and clinical documents through the scheme process. Keep discharge summary and receipts/records for your reference.
🛟 If a hospital refuses covered treatment
- Ask for the hospital Ayushman Mitra or PM-JAY nodal officer.
- Record the hospital name, date, department and a clear explanation of the refusal/charge.
- Use the official PM-JAY/NHA grievance channel or contact details published on the official NHA website.
- In a medical emergency, seek urgent medical care immediately; do not delay emergency treatment while resolving a portal issue.
🔗 Official links
- PM-JAY Beneficiary Portal — eligibility and card access
- PM-JAY Empanelled Hospital Search
- National Health Authority (NHA)
- MyScheme — AB PM-JAY overview
Samacharaseva is an information guide and links to official resources. It does not issue Ayushman cards, approve eligibility, authorize treatment or process claims.