Ayushman Bharat PM-JAY Explained: Cover, Eligibility, Hospitals
Ayushman Bharat PM-JAY is the central health assurance scheme covering hospital treatment for eligible households at empanelled public and private hospitals.
What it covers
Secondary and tertiary hospital care up to the annual family cover limit, on a cashless basis at empanelled hospitals. The package includes pre-admission tests, treatment, medicines during the stay and a defined post-discharge period. There is no cap on family size or age, and existing conditions are covered from day one.
What it does not cover
Routine outpatient consultation, most dental and cosmetic work, and treatment at hospitals outside the empanelled network. The cover is per family per year and resets at the start of the policy year.
Who is eligible
Eligibility is drawn from deprivation criteria in the socio-economic census for rural households and occupational categories for urban ones, plus state extensions that widen the list. Several states also extend cover to senior citizens regardless of income. Check the beneficiary status page or ask at any empanelled hospital help desk.
Getting the card
- Verify beneficiary status with a mobile number and Aadhaar on the official portal.
- Complete identity verification, which is usually a face or OTP check.
- Download the card, or get it made free at an empanelled hospital or Common Service Centre.
Using it at a hospital
Every empanelled hospital has a scheme help desk staffed by a coordinator. Take the card and an identity document, get the treatment pre-authorised before admission where possible, and confirm the procedure is inside the package list. Cashless means you should not be asked to pay for covered treatment; if you are, use the state grievance helpline.
Cover amounts, state extensions and the hospital list change periodically, so confirm on the official PM-JAY portal before treatment.