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apply-ayushman-bharat-abha-card-2026 [2026/08/02 01:28] (current) – created - external edit 127.0.0.1
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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.)}}
  
 +====== How to apply for the Ayushman Bharat (PMJAY) and ABHA card ======
 +{{ :social:auto:apply-ayushman-bharat-abha-card-2026.png?direct&1200 |How to apply for Ayushman Bharat PMJAY and ABHA card India 2026}}
 +
 +
 +<WRAP info>
 +**Quick Reply:** "Ayushman Bharat" is two different things people confuse:
 +  * **[[/apply-ayushman-bharat-pmjay-card-2026|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}}
 +===== How to apply for Ayushman Bharat ABHA card 2026: Registration, eligibility, and benefits =====
 +
 +Ayushman Bharat ABHA card 2026 — complete guide on registration, eligibility, benefits, and how to apply:
 +
 +  - **Step 1: What is the Ayushman Bharat ABHA card?** (a) the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) — was launched in 2018 — and was expanded in 2024 — to cover all senior citizens (70+) — and the new name — is Ayushman Bharat (AB) — with the ABHA (Ayushman Bharat Health Account) — as the digital health ID, (b) the scheme — provides: (i) the cashless treatment — of up to Rs 5 lakh per family per year — at the empaneled hospitals — (government and private), (ii) the coverage — for the secondary and tertiary care — including the surgeries, the ICU, the diagnostics, and the medicines, (iii) the pre-existing conditions — are covered — from day one — no waiting period, (c) the ABHA (Ayushman Bharat Health Account): (i) a 14-digit health ID — that stores the medical records — digitally, (ii) linked to the DigiLocker — and the health facilities, (iii) the ABHA — is separate — from the PMJAY card — but both — are part of the Ayushman Bharat ecosystem.
 +  - **Step 2: Who is eligible for Ayushman Bharat 2026?** (a) the PMJAY eligibility — is based on the SECC (Socio-Economic Caste Census) 2011 — and the state-specific criteria: (i) the vulnerable families — in the rural and urban areas — based on the deprivation — and the occupational criteria, (ii) the eligible families — are identified — and the Ayushman card — is issued, (b) the expanded eligibility — from 2024: (i) all senior citizens — aged 70 years and above — are eligible — regardless of the income — (the new component — announced in September 2024), (ii) the senior citizens — get a separate Ayushman card — with the Rs 5 lakh cover — on a per-person basis — (not per family), (c) the state-specific eligibility: (i) some states — have the additional criteria — like the income limit — or the occupation, (ii) some states — have the state-specific schemes — that are merged — with the PMJAY — like the Mukhyamantri Jan Arogya Yojana — in some states, (d) the exclusion: (i) the government employees — and the regular salaried — are generally excluded — from the PMJAY — (but the 70+ category — includes all), (ii) the income tax payers — are excluded — from the PMJAY — (but the 70+ category — includes all).
 +  - **Step 3: How to apply for the Ayushman Bharat ABHA card 2026.** (a) check the eligibility: (i) visit beneficiary.nha.gov.in — and check the eligibility — using the mobile number — or the Aadhaar — or the name, (ii) if eligible — the Ayushman card — can be downloaded — or the application — can be made, (b) apply at the CSC (Common Service Center): (i) visit the nearest CSC — with the Aadhaar card — and the mobile number, (ii) the CSC operator — verifies the eligibility — and issues the Ayushman card, (c) apply at the hospital: (i) visit the empaneled hospital — with the Aadhaar card — and the mobile number, (ii) the hospital — verifies the eligibility — and issues the Ayushman card — and the treatment — can be availed — immediately, (d) apply for the ABHA: (i) visit abha.abdm.gov.in — and create the ABHA — using the Aadhaar — or the driving license, (ii) the ABHA — is a 14-digit health ID — and is linked — to the DigiLocker, (e) the documents: (i) the Aadhaar card — is the primary document — for the PMJAY — and the ABHA, (ii) the mobile number — linked to the Aadhaar — is required — for the OTP, (iii) the ration card — or the family ID — may be required — in some states.
 +  - **Step 4: Common Ayushman Bharat issues and solutions.** (a) name not in the beneficiary list: (i) the family — is not in the SECC list — or the name — is misspelled, (ii) the solution: (a) visit the CSC — or the hospital — and update the details, (b) file a grievance — on the NHA portal — nha.gov.in, (c) file RTI — with the NHA — or the state health authority, (b) card not issued: (i) the eligibility — is confirmed — but the card — is not issued, (ii) the solution: (a) visit the CSC — and apply, (b) file RTI — with the NHA, (c) hospital refuses treatment: (i) the empaneled hospital — refuses the cashless treatment — under the PMJAY, (ii) the solution: (a) complain to the hospital — and the NHA — on the helpline 14555, (b) file RTI — with the NHA — for the empanelment — and the compliance, (d) claim rejected: (i) the hospital — submits the claim — but the claim — is rejected — by the NHA, (ii) the solution: (a) the hospital — can appeal — to the NHA, (b) the patient — can complain — to the NHA, (c) file RTI — for the claim status.
 +  - **Step 5: File RTI on Ayushman Bharat.** File RTI with the National Health Authority (NHA) asking for: (a) the eligibility: "Provide the eligibility status — for [name], [Aadhaar number] — under the PMJAY — including: (i) the family ID, (ii) the eligibility — yes or no, (iii) the reason — if not eligible", (b) the card: "Provide the Ayushman card status — for [name], [Aadhaar number] — including: (i) the card number, (ii) the issue date, (iii) the status — active or inactive", (c) the empanelment: "Provide the list — of the empaneled hospitals — in [city/district] — including: (i) the hospital name, (ii) the address, (iii) the specialties, (iv) the status — active or suspended", (d) the claim: "Provide the claim status — for the treatment — at [hospital] — for [name], [Aadhaar number] — including: (i) the claim number, (ii) the claim amount, (iii) the status — approved, rejected, pending, (iv) the reason — if rejected", (e) the grievance: "Provide the grievance status — for the complaint — filed on [date] — reference number [number]".
 +  - **Step 6: The NHA as a public authority.** (a) the National Health Authority (NHA) — is a public authority — under the RTI Act — and the CPIO — is at the headquarters — in New Delhi, (b) the NHA — has the PIOs — at the state health authorities — and the district level, (c) the RTI application — can be filed: (i) online — on the NHA website — or the Department of Posts portal, (ii) by post — to the CPIO, NHA, New Delhi, (iii) the application fee — is Rs 10 — by the IPO — or the online payment.
 +  - **Step 7: Practical tips.** (a) check the eligibility first (check the eligibility — on the beneficiary portal — before applying — to avoid the rejection), (b) carry the Aadhaar (carry the Aadhaar card — and the mobile — to the CSC — or the hospital — for the verification), (c) use the helpline (the NHA helpline — 14555 — is available — for the complaints — and the queries), (d) file RTI (if the card — is not issued — or the treatment — is refused — file RTI — with the NHA — to get the status), (e) Example: A senior citizen — aged 72 — applied for the Ayushman card — under the 70+ category — but the card — was not issued — for 3 months — he filed RTI — with the NHA — the RTI reply showed — that his Aadhaar — was not linked — to the mobile — he linked the mobile — and the card — was issued — within 15 days — and he availed the cashless treatment — for the cataract surgery — at a private hospital.
 +
 +See [[https://righttoinformation.wiki/apply-ayushman-bharat-abha-card-2026|Ayushman ABHA 2026]] and [[https://righttoinformation.wiki/guide/applicant/ayushman-bharat-denial-rti|Ayushman Denial RTI]].
 +
 +{{tag>ayushman bharat abha card 2026 pmjay registration eligibility benefits cashless treatment nha rti 2026}}
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