Ayushman Bharat(ABHA), officially known as Pradhan Mantri Jan Arogya Yojana (PM JAY), is India’s flagship health insurance scheme providing cashless hospitalization up to ₹5 lakh per family per year to over 10 crore vulnerable households. Launched in 2018, the scheme operates through a network of empaneled public and private hospitals, ensuring paperless and portable benefits nationwide. Alongside PM JAY, the Ayushman Bharat Yojana also establishes Health and Wellness Centers to deliver comprehensive primary care closer to communities.
What Is Ayushman Bharat?
The Ayushman Bharat Yojana comprises two flagship components:
- Pradhan Mantri Jan Arogya Yojana (PM JAY): Provides secondary and tertiary care hospitalization cover of up to ₹5 lakh per eligible family per year on a cashless basis.(link)
- Health and Wellness Centers (AB HWC): Conversion of 1.5 lakh sub-centers and primary health centers into centers offering preventive, promotive, and basic curative services, including non-communicable disease screening.
Together, these pillars aim to reduce out-of-pocket expenses and strengthen India’s public healthcare infrastructure.
Eligibility For Ayushman Bharat Card
- Socio-Economic and Caste Census (SECC) 2011 Data: Families identified as deprived—landless, manual scavengers, households without shelter, etc.—qualify automatically.
- No Age or Gender Limits: All family members are covered regardless of age, gender, or family size.
- Portability: Beneficiaries can avail benefits at any empaneled hospital across India no local residency requirement.
To verify eligibility, individuals can visit the PM-JAY portal and enter their mobile number or ration card details.
Benefits
- Cashless Hospitalization: Up to ₹5 lakh per family per year for specified secondary and tertiary procedures.
- Wide Coverage: Over 1,600 treatment packages including surgeries, diagnostics, and daycare procedures.
- Zero Premiums: Fully funded by the Central and State Governments no premium or co-payment required from beneficiaries.
- Empaneled Network: Access to more than 27,000 public and private hospitals registered under PM-JAY.
How to Apply
Online
- Visit the National Health Authority’s PM-JAY portal at nha.gov.in/PM-JAY.
- Click “Am I Eligible?” and enter your mobile number or ration card details to check status.
- Download the Ayushman Bharat golden card once eligibility is confirmed.
Offline
- Common Service Centers (CSCs): Visit your nearest CSC to apply for or print the PM-JAY card.
- Empaneled Hospitals: Many hospitals assist in verifying eligibility and issuing the Ayushman card onsite.
Coverage & Packages
- Procedures Covered: From pre-hospitalization (3 days) to post-hospitalization (15 days), including medicines, diagnostics, and travel allowance.
- Special Schemes: Recent expansion includes coverage for senior citizens over 70 years regardless of income, benefitting an additional 4.5 crore families.
Challenges
- Awareness Gaps: Many eligible families remain unaware of their entitlements under Ayushman Bharat.
- Fraudulent Claims: Instances of fake billing have led to de-empanelment of some hospitals, undermining trust.
- Infrastructure Constraints: Insufficient critical-care capacity in remote areas limits the scheme’s reach for complex treatments.
Conclusion
Ayushman Bharat represents a landmark stride toward universal health coverage in India by combining robust insurance protection with strengthened primary care. While challenges persist awareness, fraud control, and infrastructure gaps—the scheme’s cashless benefits, extensive hospital network, and comprehensive service delivery model make it a transformative force in reducing catastrophic health expenditures and improving population health outcomes.
