Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)
The Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a revolutionary health insurance scheme launched by the Government of India in September 2018. Also known as Modicare, this scheme provides free health insurance coverage up to ₹5 lakh per family per year for poor and vulnerable people across the country. It is the world’s largest government-funded health assurance program, aiming to make healthcare accessible and affordable for all.
Objective of PM-JAY
The main objective of PM-JAY is to:
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Provide cashless and paperless health care services to the poor.
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Reduce out-of-pocket medical expenses.
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Ensure universal health coverage (UHC) for all.
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Promote affordable and quality treatment in both public and private hospitals.
Key Features of PM-JAY
| Feature | Details |
|---|---|
| Scheme Name | Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) |
| Launched by | Government of India |
| Launch Year | 2018 |
| Coverage Amount | ₹5 Lakh per family per year |
| Coverage Type | Secondary and Tertiary Care Hospitalization |
| Mode of Service | Cashless and Paperless |
| Hospitals Covered | Public and Empaneled Private Hospitals |
| Beneficiaries | More than 10 crore families (approx. 50 crore people) |
Eligibility for PM-JAY
Eligibility for PM-JAY is based on the Socio-Economic Caste Census (SECC) 2011 data. No separate registration is required. Here are the eligibility criteria:
Rural Area Criteria (any one condition):
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Families with no adult male between 16 and 59 years
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Families living in kaccha (non-concrete) house
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Families with no educated adult above 25 years
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SC/ST households
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Landless households earning through casual labor
Urban Area Criteria:
People working in one of the following 11 occupation categories:
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Ragpicker
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Beggar
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Domestic worker
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Street vendor
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Construction worker
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Plumber, electrician, mason, etc.
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Rickshaw puller
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Handicraft worker
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Sanitation worker
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Transport worker
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Other manual labor
✅ Note: If your name is in SECC 2011 data, you are automatically eligible.
Diseases and Treatments Covered
Under PM-JAY, more than 1,600 medical packages are included. These cover:
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Heart surgery
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Knee and hip replacement
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Chemotherapy
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Dialysis
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Cataract surgery
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Child delivery services
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Skull fracture surgeries
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COVID-19 treatment (in some states)
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Emergency services
What is Not Covered?
Certain exclusions under PM-JAY:
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OPD (Outpatient Department) consultations
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Cosmetic surgery
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Drug de-addiction treatments
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Fertility treatments
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Organ transplant (covered only in specific cases)
How to Check Eligibility
You can check whether you are eligible for PM-JAY in the following ways:
1. Online through the official website
Visit https://pmjay.gov.in
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Click on ‘Am I Eligible’
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Enter your mobile number and OTP
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Verify your details like state, name, ration card, etc.
2. Through Common Service Centres (CSCs)
Visit the nearest CSC with ID proof (Aadhaar card/ration card) and get assistance.
3. Ayushman Mitra at Hospitals
Each empaneled hospital has Ayushman Mitra or helpdesk that helps verify and register beneficiaries.
How to Get Treatment Under PM-JAY
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Visit a nearby empaneled hospital.
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Show your PM-JAY card, Aadhaar card, or other ID proof.
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Hospital will verify your eligibility.
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Once verified, get cashless treatment without paying money.
🧑⚕️ Over 24,000 hospitals are registered under PM-JAY across India.
Benefits of Ayushman Bharat PM-JAY
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💸 No need to pay money for hospitalization
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👨👩👧 Whole family covered, not just individual
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🏥 Private hospital access available for poor
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📲 Simple online process
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🔄 Covers pre-existing conditions
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💼 Covers over 1,600 procedures
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📍 Available in all states and union territories
PM-JAY vs Regular Health Insurance
| Aspect | PM-JAY | Regular Insurance |
|---|---|---|
| Premium | Free | Paid yearly/monthly |
| Coverage | ₹5 lakh | Varies |
| Enrollment | Based on SECC data | Voluntary |
| Hospitals | Government + Private | Mostly Private |
| Eligibility | For poor/vulnerable only | Open to all |
Latest Updates
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Digital Ayushman Cards are being issued to all eligible families.
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PM Digital Health Mission integrated with Ayushman Bharat.
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State-specific health schemes like BSKY (Odisha), Mahatma Jyotiba Phule Jan Arogya Yojana (Maharashtra) are now linked with PM-JAY.
Conclusion
Ayushman Bharat – PM-JAY is a game-changer in India’s healthcare sector. It ensures that financial constraints do not stop people from getting the treatment they need. If you or someone you know is eligible, make sure they take advantage of this free health insurance scheme.
Frequently Asked Questions (FAQs)
Q1. Is Aadhaar card mandatory for PM-JAY?
🟢 Not mandatory, but it helps in easy verification.
Q2. Can I include new family members?
🔴 No new names can be added unless the government updates SECC data.
Q3. Do I need to pay any amount to get PM-JAY benefits?
🟢 No, treatment is completely free.
Q4. Can I use PM-JAY outside my state?
🟢 Yes, it has pan-India portability.