Health & Insurance Schemes in India 2026

Healthcare in India is unaffordable for most — a single hospital admission can wipe out years of savings. Government schemes now cover the cost: ₹5 lakh free hospitalisation under Ayushman Bharat (every 70+ citizen since Oct 2024), free online doctor consultations under e-Sanjeevani, and state top-ups that take cover up to ₹25 lakh in some states.

• ₹5 lakh free hospital cover/year → Ayushman Bharat (PMJAY)
• Available to: SECC-listed families + every Indian citizen aged 70+ since 29 Oct 2024
• Free online doctor: e-Sanjeevani (24×7, government-run)
• 27,000+ empanelled hospitals nationwide (public + private)
• Pre-existing conditions covered Day 1 (no waiting period)
• Helpline: 14555 / 1800-111-565 (toll-free, 24×7)
• Stuck or denied? 🪄 Free RTI in 60 sec → 30-day reply mandatory.

• Anyone with a family member aged 70+ — automatic eligibility regardless of income
• SECC-2011 listed households — long-standing PMJAY beneficiary base
• Frequent doctor visitors who can't afford private fees — e-Sanjeevani is free
• People living in tier-2/3 cities with limited specialist access — telemedicine reaches everyone
• Pregnant women, mothers — additional schemes (PMMVY, JSY) under Women's category

• Ayushman Bharat — Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) — ₹5 lakh per family per year for secondary + tertiary care. 1,961 treatment packages. Cashless at empanelled hospitals.
• AB-PMJAY Vay Vandana (October 2024 expansion) — extends ₹5 lakh cover to every citizen aged 70+ regardless of income, on top of any existing scheme.
• State top-ups:
  • Rajasthan Mukhya Mantri Chiranjeevi — ₹25 lakh extra
  • Karnataka Yashasvini (farmers) — ₹5 lakh extra
  • Tamil Nadu CMCHIS — ₹5 lakh extra
  • Maharashtra MJPJAY — ₹10 lakh extra
  • Andhra Pradesh NTR Vaidya Seva — ₹25 lakh extra
  • Telangana Aarogyasri — ₹10 lakh extra
  • Punjab Sarbat Sehat Bima — ₹5 lakh extra
  • Kerala KASP — ₹5 lakh extra

• e-Sanjeevani — government's free telemedicine. Covers OPD which Ayushman Bharat doesn't. 100M+ consultations done. Available in 22 Indian languages. Doctors are real (not chatbots).

• Janani Suraksha Yojana (JSY) — cash assistance for institutional delivery (₹1,400 rural / ₹1,000 urban for BPL women).
• PM Matru Vandana Yojana — ₹6,000–12,000 for pregnant + lactating mothers. See full guide.

• National Programme for Health Care of the Elderly (NPHCE) — free OPD + medicines at District Hospitals. 60+ priority.
• Rashtriya Vayoshri Yojana — free aids/appliances (walking sticks, hearing aids, dentures) for BPL seniors.

1. You don't apply in advance — you check eligibility at https://beneficiary.nha.gov.in.
2. If listed, do KYC (Aadhaar OTP + selfie) at any CSC or self-service. Card generated in 15 minutes.
3. Save the digital card in Ayushman Bharat app.
4. At hospital admission: show card + biometric (fingerprint / iris).
5. Hospital does cashless billing — you pay ₹0.

• Refuse politely.
• Ask for the Ayushman Mitra desk (every empanelled hospital has one).
• Call 14555 (toll-free 24×7). They call the hospital directly.
• File complaint via Mera-PMJAY in the app.

1. Visit https://esanjeevani.in (or download app).
2. Login with mobile + Aadhaar OTP.
3. Pick state → district → speciality.
4. Token allotted. Wait time: 5–30 minutes.
5. Doctor calls back via video (or audio if low bandwidth).
6. Prescription generated digitally, sent to your phone.
7. You pay ₹0.

• Going to non-empanelled hospital thinking Ayushman covers — it doesn't (except verified emergencies).
• Not doing KYC — name in eligibility list ≠ active card. KYC is required.
• Hiding pre-existing conditions — counter-productive. PMJAY covers them Day 1; lying delays admission.
• Believing private agents who charge for “Ayushman card” — card is 100% free. Anyone charging is a fraud.
• Skipping helpline 14555 — it's free, fast, English/Hindi/regional.

Yes — since October 2024, every citizen 70+ gets ₹5 lakh PMJAY cover on top of any existing scheme. Use whichever is better in any given admission.

No — only secondary + tertiary hospitalisation. For OPD, use e-Sanjeevani (free, online). District Hospitals also have free OPD.

33 of 36 states/UTs signed on. Delhi (has its own Delhi Government Scheme), Odisha (Biju Swasthya), West Bengal (Swasthya Sathi) — these states have their own programs which work similarly.

A medical condition you had before card activation. PMJAY covers all pre-existing conditions from Day 1 (no waiting period) — unlike most private health insurance.

Card is digital — re-download from beneficiary.nha.gov.in or the app. No replacement charge.

No — ₹5 lakh is the family cap, per year, on a floater basis. If one member uses ₹4 lakh, ₹1 lakh remains for the family until renewal (1 April).

Refuse + call 14555 + file complaint via Mera-PMJAY app. Empanelled hospital cannot demand cash from PMJAY beneficiary; doing so violates their MoU.

Yes — fully portable across India. Any empanelled hospital in any state accepts your card.

• 🪄 AI RTI Drafter
• 🎤 AwaazRTI
• 🌐 Citizen 360 — find local hospitals + civic services

• 🏛 Top schemes — pillar guide
• 💰 Financial Support
• 👩 Women & Social Welfare
• 🌿 Home remedies — common illnesses
• ⚠ Digital arrest scam (health-fraud variant)

• National Health Authority — PMJAY official
• Beneficiary portal — eligibility check
• Empanelled hospital finder
• e-Sanjeevani — official
• Ministry of Health & Family Welfare
• Helplines: 14555 · 1800-111-565 · 104

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Last reviewed: 3 May 2026.