Ayushman Bharat (PM-JAY) card rejected / not eligible

• Not in SECC 2011 list — most common. Apply for state-supplementary scheme.
• Aadhaar mismatch with SECC — name spelling differs. Update Aadhaar.
• Already in another family's card — happens with married daughters; remove + re-add to current family.
• Senior citizen 70+ rejected — Sept 2024 norm not yet in your state. Appeal to State Health Agency (SHA).
• Empanelled hospital denied — hospital error, not eligibility. NHA grievance portal.

1. Verify SECC 2011 listing — beneficiary.nha.gov.in → search by name + state. Note ration card number too.
2. If not in SECC — try state scheme — TN: CMCHIS · MH: MJPJAY · KA: ABARK · WB: ABRY · KL: KASP · etc. Convergence with PMJAY in 28 states.
3. Senior 70+ — apply via beneficiary.nha.gov.in — Sept 2024 norm. Aadhaar + age proof (passport / 10th cert / pension order).
4. Aadhaar name mismatch fix — Update Aadhaar to match SECC name OR vice-versa. SECC corrections via State Health Agency.
5. In wrong family's card — Visit nearest CSC / Ayushman Mitra. Remove from old family, add to current.
6. Hospital denied cashless — NHA grievance portal: pmjay.gov.in/grievances → 7-day disposal. Or call 14555.
7. Appeal to State Health Agency — Each state has SHA. Free. Cite PMJAY operational guidelines.
8. RTI to NHA + SHA — For: SECC ranking, exclusion rationale, hospital empanelment status.

• Statutory appeal route: PMJAY grievance: Hospital → SHA (state) → NHA (national) → CPGRAMS.
• Appeal window: 30 days at each level
• Fee: Free at all stages.

• Updated Aadhaar (matching SECC name)
• Ration card
• Age proof (for 70+ extension)

Government rejection orders often lack actual rationale. RTI brings out the file noting + officer name + actual basis — and that visibility usually resolves the case. Use this template:

1. Copy of the rejection order + complete file noting on application no. _____ dated _____.
2. Name + designation of the officer who took the rejection decision.
3. Specific Section / Rule / Circular under which rejection was made + supporting evidence relied upon.
4. Number of similar applications in the past 12 months that were (a) approved, (b) rejected — for the same officer.
5. The procedure + timeline for filing an appeal + the office of the appellate authority.

Auto-fill the PIO + your case: Open the RTI Drafter →

Re-apply guide: How to apply for ayushman bharat

Track your application status: Status check guide

SECC 2021 census data not yet released as official deprivation list. Use state schemes meantime.

Yes — PMJAY is supplementary. Private covers OPD/elective; PMJAY covers IP-emergency at Rs 5L.

Yes — no waiting period under PMJAY.

Empanelment can pause for compliance. Try another empanelled hospital OR pay + claim reimbursement (limited under PMJAY).

NHA + Health Ministry. Critical illness: writ to HC under Article 21.

• 25 how-to-apply guides
• 25 status-check guides
• 30 documents-required checklists
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• Statutory appeal under relevant Act/Rule — see legal framework section.
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