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+{{htmlmetatags>metatag-keywords=(how to apply ayushman bharat 2026,pmjay card online,ayushman card download,abha card create,abha health id,ayushman bharat eligibility,pmjay 14555,setu pmjay,abdm 2026,ayushman card not showing)&metatag-description=(How to apply for the Ayushman Bharat PMJAY card and the ABHA health ID in 2026 — eligibility, where to apply, fees, common rejections and what to do if your name isn't in the SECC list. Plain language for citizens.)}}
+====== How to apply for the Ayushman Bharat (PMJAY) and ABHA card — complete 2026 guide ======
+{{ :social:auto:apply-ayushman-bharat-abha-card-2026.png?direct&1200 |How to apply for Ayushman Bharat PMJAY and ABHA card India 2026}}
+{{page>snippets:dpdp-banner}}
+<WRAP info>
+**Quick answer.** "Ayushman Bharat" is two different things people confuse:
+  * **PMJAY (Ayushman Card)** — health **insurance** of **₹5 lakh per family per year** for secondary + tertiary care at 27,000+ empanelled hospitals. **Eligibility-based** (SECC 2011 list + state-extended categories). Apply at **pmjay.gov.in / setu.pmjay.gov.in** or any CSC. Cost: free at empanelled hospital, ~₹30 at CSC.
+  * **ABHA (Ayushman Bharat Health Account)** — your **digital health ID** (14-digit) for storing prescriptions, lab reports, history. Anyone can create it free at **abha.abdm.gov.in** with Aadhaar OTP — takes 60 seconds. No insurance attached.
+Helpline: **14555** (PMJAY, 24x7).
+</WRAP>
+===== Rajesh's story — "It was a name mismatch all along" =====
+<WRAP center round box 80%>
+//Rajesh Kumar Singh, 47, daily-wage construction worker from Lucknow. SECC 2011 lists him as BPL. He had been trying to get an Ayushman Card since 2023.//
+> "I went to the CSC three times. Each time the operator typed my Aadhaar number, the screen showed 'name not in SECC list'. I almost gave up. The list had me as 'Rajesh Kumar' — the surname 'Singh' was missing. My Aadhaar said 'Rajesh Kumar Singh'. The auto-matcher couldn't see I was the same person. I called helpline 14555 — they said 'wait for next data refresh', could be months. A volunteer at our basti told me about RTI. I posted an application to the State Health Authority Uttar Pradesh — ₹10 stamp, registered post. Reply came in 26 days from a junior consultant: 'Your record exists in the SECC database. Manual addition will be initiated under Beneficiary Addition policy.' Within 8 days the CSC operator could see my name; card issued same visit. **Two months later my father needed a heart bypass at a Lucknow private hospital. PMJAY paid ₹1.4 lakh. We paid zero.** That ₹10 letter probably saved my father's life."
+—Rajesh, August 2025
+</WRAP>
+PMJAY (Pradhan Mantri Jan Arogya Yojana) is the world's largest government-funded health insurance scheme. It has saved an estimated **6.7 crore families** from catastrophic medical bills since launch in 2018. But the **biggest barrier to access remains the SECC 2011 list** — which is now 13 years old and full of name-spelling mismatches like Rajesh's. This guide tells you the full apply route AND exactly what to do when the system says "you're not eligible" but you actually are.
+===== What this is + who needs it =====
+**Pradhan Mantri Jan Arogya Yojana (PMJAY)** was launched on **23 September 2018** by the National Health Authority (NHA) under the Ministry of Health & Family Welfare. It provides:
+  * **₹5 lakh per family per year** of cashless cover
+  * Coverage for **secondary and tertiary** hospitalisation (1,949 procedure packages)
+  * Treatment at **27,000+ empanelled hospitals** (public + private)
+  * No cap on family size, no age limit, no pre-existing exclusion
+**Eligibility (PMJAY):**
+  * **Rural** (SECC 2011): families with at least **one of the 7 deprivation criteria** (kachha house, no adult earner, SC/ST, no land, manual scavenger, etc.)
+  * **Urban** (SECC 2011): one of **11 occupational categories** (rag picker, beggar, domestic worker, street vendor, construction labour, sweeper, etc.)
+  * **State-extended schemes**: most states have piggy-backed their schemes onto PMJAY infrastructure — Maharashtra MJPJAY, Karnataka Karnataka Ayushman Yojana, Tamil Nadu Chief Minister's Comprehensive Health Insurance Scheme, Rajasthan Chiranjeevi (now Mukhyamantri Ayushman Arogya Yojana), Andhra Aarogyasri, Telangana Aarogyasri. These extend coverage to non-SECC families using state criteria (like income, ration card type).
+**ABHA (Ayushman Bharat Health Account)** is a separate, newer system under the **Ayushman Bharat Digital Mission (ABDM, 2021)**. It is:
+  * A **14-digit health ID** unique to you
+  * A **digital wallet** for prescriptions, lab reports, discharge summaries
+  * Free to create, available to **every Indian citizen** regardless of SECC status
+  * **Not** insurance — does not pay any hospital bill
+People often mix the two. If you want **insurance cover**, you need PMJAY. If you want **digital health records**, you need ABHA. They're linked but separate.
+===== Step-by-step process =====
+==== Step 1 (PMJAY) — Check eligibility ====
+  - Go to https://beneficiary.nha.gov.in (or https://setu.pmjay.gov.in)
+  - Enter your **Aadhaar number** + mobile + OTP
+  - The portal checks the SECC 2011 + state-extended databases
+  - **If found**: name appears with family member list → proceed to Step 2
+  - **If not found**: try the alternate "Search by Family ID" (state ration card number, e.g., RC-XXXXXXXX in UP, BPL Card no. in MP) — sometimes the SECC has the family head's name only and Aadhaar is not auto-linked
+If both routes return "not found", do **not** assume you're ineligible — the SECC database is 13 years old. Move to the stuck-escalation section.
+==== Step 2 (PMJAY) — Visit CSC or empanelled hospital for KYC ====
+After eligibility confirmation:
+  - Find your nearest **CSC (Common Service Centre)** at https://locator.csccloud.in OR walk in to any **empanelled hospital** (full list at hospitals.pmjay.gov.in)
+  - Carry: **Aadhaar**, **ration card** (if available), **mobile** with OTP access
+  - Operator does fresh photo capture + Aadhaar e-KYC
+  - Card issued **same day in digital form** (downloadable PDF)
+  - Physical PVC card dispatched to address in 15-30 days
+**Cost: ₹30 at CSC** (govt-fixed fee for the KYC and printing service). **Free at empanelled hospital** — many hospitals run camps where they enrol you while doing your treatment.
+==== Step 3 (PMJAY) — Download and verify ====
+After KYC:
+  * Login at beneficiary.nha.gov.in → "Download Card" (PDF)
+  * Or use the **Ayushman Bharat app** (Google Play / App Store)
+  * Verify the family member list — every member should be listed individually
+If a family member is missing, raise an **"Add Member" request** via setu.pmjay.gov.in → "Beneficiary Addition" → upload Aadhaar + relationship proof (ration card / birth certificate). SLA: 30 days.
+==== Step 4 (PMJAY) — Use the card ====
+When you need treatment:
+  - Go to **any of the 27,000+ empanelled hospitals** (look for the "Ayushman Bharat" board outside)
+  - Show the card (digital or physical) at the **Pradhan Mantri Arogya Mitra (PMAM)** desk inside the hospital
+  - PMAM verifies eligibility, raises a **pre-authorisation** for your treatment package on the TMS (Transaction Management System)
+  - Hospital does the treatment cashless
+  - You pay zero (subject to ₹5 lakh per family per year cap)
+Common procedures covered: cardiac surgery, dialysis, chemotherapy, joint replacement, neonatal ICU, cataract, deliveries, accident trauma, COVID hospitalisation, knee/hip replacement, etc. Excluded: cosmetic, fertility, organ transplants in most states.
+==== Step 5 (ABHA) — Create your ABHA Health ID ====
+This is independent of PMJAY:
+  - Go to https://abha.abdm.gov.in
+  - Click "Create ABHA"
+  - Choose **"Using Aadhaar"** (recommended) or "Using driving licence"
+  - Enter Aadhaar number + OTP
+  - Verify mobile (separate OTP)
+  - Choose ABHA address (like an email — yourname@abdm)
+  - Done — you get a 14-digit ABHA number
+The whole process takes **under 60 seconds**. Free. Available to anyone with Aadhaar + an Indian mobile.
+==== Step 6 (ABHA) — Link health records ====
+After ABHA creation:
+  * Use the **ABHA app** or any partner app (Practo, Apollo 24/7, eSanjeevani) to link past prescriptions and reports
+  * When you visit any ABDM-compliant hospital, mention your ABHA — the hospital will automatically push your discharge summary, lab reports, and prescription to your ABHA wallet
+  * You can share records selectively (consent-based) with new doctors
+==== Step 7 — Empanelled hospital lookup ====
+Before any planned treatment:
+  * Go to https://hospitals.pmjay.gov.in
+  * Filter by state, district, specialty
+  * Check whether private or public — for emergencies, the nearest empanelled hospital is bound to admit you
+  * Note the hospital's PMJAY ID and helpline
+==== Step 8 — Keep your card details safe ====
+  * The PMJAY card should not be shared with non-empanelled "agents" — they sometimes use it to file fake claims
+  * Report any unsolicited "Ayushman card delivery agent" calls to **14555**
+  * The card is family-linked — losing physical doesn't lose entitlement, just re-download from beneficiary.nha.gov.in
+===== Required documents — quick reference =====
+<code>
+For PMJAY (Ayushman Card):
+-----------------------------------------------
+Aadhaar (mandatory)                 Yes
+Ration card (optional but useful)   Yes — helps if SECC mismatch
+Mobile number with active OTP       Yes
+Family ID / RSBY URN (if any)       Helpful if pre-2018 RSBY beneficiary
+Income certificate                  Only for state-extended scheme
+                                    (e.g., MJPJAY in Maharashtra)
+Photo (live capture at CSC/hospital) Yes
+Birth certificate of family members For "Add Member" requests
+Cost                                 ₹30 (CSC) or free (empanelled hospital)
+For ABHA:
+-----------------------------------------------
+Aadhaar (with mobile linked)        Yes (recommended)
+OR Driving licence + face match     Alternative
+Active mobile number                Yes
+Cost                                Free
+Time taken                          ~60 seconds online
+-----------------------------------------------
+</code>
+===== Common reasons it gets stuck =====
+  - **SECC 2011 list excludes you (data is 13 years old)** — you might be genuinely poor today but the 2011 census didn't capture it. Fix: state Beneficiary Addition + RTI route below.
+  - **Name mismatch SECC vs Aadhaar** (Rajesh's case — surname missing). Fix: RTI to State Health Authority for manual addition.
+  - **Family head name only in SECC, others not auto-included**. Fix: file "Add Member" with relationship proof.
+  - **Aadhaar e-KYC failure at CSC** (biometric mismatch, OTP not coming). Fix: update Aadhaar at UIDAI; ask CSC to retry with face-match alternate.
+  - **CSC operator backlog** — operator says "system slow, come tomorrow" repeatedly. Fix: try a different CSC or empanelled hospital.
+  - **State portal vs central NHA portal sync issues** — eligibility shows on one but not the other. Fix: try both setu.pmjay.gov.in and the state Health Authority's portal (e.g., kaymanya.gov.in for Karnataka, mjpjay.gov.in for Maharashtra).
+  - **Hospital refuses to accept card despite empanelment** — happens when hospital owes the State Health Authority money or has been suspended. Fix: complain to 14555; in emergency, escalate to District Health Officer.
+  - **Pre-authorisation rejected by TMS** — hospital says treatment doesn't fit a package. Fix: ask hospital to file "Special Approval" request with documentation; if denied, see [[:rti-for-ayushman-bharat-claim-denial|RTI for Ayushman Bharat claim denial]].
+===== If stuck — what to do =====
+==== Level 1 — PMJAY helpline 14555 ====
+**14555** is toll-free, 24x7. Hindi, English, and most regional languages. Have your Aadhaar and date of attempt ready. The agent can: confirm SECC eligibility, log a complaint, escalate to State Health Authority. They cannot directly add you to the database.
+State helplines also exist (Karnataka 080-2225-3000, Maharashtra 155-388, Tamil Nadu 1455). Full list at [[:helplines:start|All helplines]].
+==== Level 2 — setu.pmjay.gov.in grievance ====
+Online grievance: https://setu.pmjay.gov.in/setu/cgrms → "File Complaint" → upload Aadhaar + describe issue. SLA: 30 days. Track with your ticket ID.
+==== Level 3 — CSC supervisor / VLE escalation ====
+If the local CSC operator is the bottleneck, escalate to the District CSC Manager — phone numbers at https://csc.gov.in. Operators have been known to charge ₹200-500 unofficially; this is **illegal** and reportable to 14555.
+==== Level 4 — District Implementation Unit (DIU) ====
+Each district has a DIU under the State Health Authority. Walk in with your Aadhaar, ration card, and a written application stating "I am eligible under SECC/state criteria but unable to enrol — please add me manually". Most DIUs have a designated officer for this.
+==== Level 5 — RTI to State Health Authority (SHA) PIO ====
+**RTI works here when:** you have been told "name not in list" despite genuine eligibility, the CSC has refused enrolment without writing the reason, your family member addition request has been pending **more than 30 days**, or a hospital has denied a pre-authorised treatment without explanation.
+**RTI does NOT directly help when:** you are simply not eligible under SECC 2011 or state criteria (RTI cannot expand eligibility — for that you need the SHA's "Beneficiary Addition" policy, which is a separate administrative request, not a transparency request). However, RTI **can** confirm in writing whether you are or aren't on the list — which is itself useful evidence for any further appeal.
+For card-not-issued cases: file an RTI to the **PIO, State Health Authority** (each state has one — Lucknow for UP, Bengaluru for Karnataka, Chennai for TN, Mumbai for Maharashtra, etc.) asking:
+  - Whether my Aadhaar number ........ is matched in the SECC 2011 / state-extended beneficiary database
+  - The exact reason for non-issuance of card despite [eligibility]
+  - The list of documents I need to submit for Beneficiary Addition
+  - The dealing official's name and the SLA for resolution
+For hospital denial cases (hospital refuses to admit you despite card), see [[:rti-for-ayushman-bharat-claim-denial|RTI for Ayushman Bharat claim denial]] — full template, escalation path, and CIC case-law.
+For the foundational RTI workflow (template, fee, registered post, deadlines), see [[:rti-for-beginners|RTI in 12 simple steps]].
+===== FAQs =====
+**Q. I have an old RSBY card. Is it still valid?**\\
+RSBY (Rashtriya Swasthya Bima Yojana) was subsumed into PMJAY in 2018. Old RSBY beneficiaries are auto-included in PMJAY — but you still need to enrol once at a CSC or empanelled hospital to get the new Ayushman card.
+**Q. My income is ₹3 lakh/year. Am I eligible?**\\
+PMJAY does **not** use an income test — it uses the SECC 2011 deprivation/occupation criteria. State-extended schemes (Maharashtra MJPJAY, Rajasthan MAA) have income tests (typically ₹1-1.5 lakh annual). Check your state's portal.
+**Q. Is ABHA mandatory?**\\
+No. ABHA is optional. You don't need ABHA to use PMJAY. ABHA is useful for digital health records, especially if you have chronic conditions and visit multiple doctors.
+**Q. Will the hospital ask me to pay anything?**\\
+At an empanelled hospital, for a covered procedure, **zero**. If the hospital asks for cash, food deposit, or "non-medical charges", complain to 14555 immediately — most such demands are illegal under the PMJAY hospital agreement.
+**Q. How is the ₹5 lakh divided in my family?**\\
+It's **floating** — usable by any combination of family members in the financial year. If one person uses ₹4.8 lakh, only ₹20,000 remains for the rest until the year resets on 1 April.
+**Q. Can I use Ayushman Card outside my home state?**\\
+Yes. PMJAY is **portable across India**. Show the card at any empanelled hospital in any state.
+**Q. The portal still says I'm not eligible after RTI confirmed I am. What now?**\\
+Take the RTI reply (a public document) to the District Implementation Unit (DIU) and demand manual addition under the SHA's Beneficiary Addition policy. Most DIUs comply within 7-14 days when shown a written PIO confirmation.
+===== Related =====
+  * [[:rti-for-ayushman-bharat-claim-denial|RTI for Ayushman Bharat claim denial]]
+  * [[:rti-for-beginners|RTI in 12 simple steps]]
+  * [[:helplines:start|All helplines — central & state]]
+  * [[:forms:start|RTI forms + fees by state]]
+//Last reviewed: 26 April 2026.//
+{{tag>ayushman-bharat pmjay abha health-insurance secc-2011 abdm citizen-guide help-first 2026}}