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| + | ====== Ayushman Bharat PM-JAY status check — citizen guide 2026 ====== | ||
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| + | {{ : | ||
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| + | <WRAP info> | ||
| + | **Last reviewed: 20 August 2026.** Official portals: [[https:// | ||
| + | </ | ||
| + | |||
| + | <WRAP info> | ||
| + | **Quick answer:** Open [[https:// | ||
| + | </ | ||
| + | |||
| + | Check the official NHA beneficiary portal first. Do not pay an agent. The National Health Authority runs PM-JAY; State Health Agencies run the state database. ABHA is a separate health-record ID. Use [[https:// | ||
| + | |||
| + | ===== Quick facts ===== | ||
| + | | **What you need** | Mobile number + Aadhaar (for verification) | | ||
| + | | **Beneficiary portal** | [[https:// | ||
| + | | **Hospital empanelment** | [[https:// | ||
| + | | **Mobile app** | Ayushman Bharat (Android/ | ||
| + | | **Coverage** | Rs. 5 lakh/ | ||
| + | | **Helpline** | **14555** (toll-free, 24/7) · State helplines vary | | ||
| + | | **Email** | [email protected] | | ||
| + | | **Statutory base** | PMJAY Operational Guidelines 2018; SECC 2011 base | | ||
| + | | **ABHA (separate)** | [[https:// | ||
| + | | **Also read** | [[: | ||
| + | |||
| + | ===== Step-by-step ===== | ||
| + | - Visit beneficiary.nha.gov.in → Login → enter Mobile Number → OTP. | ||
| + | - Search by **Aadhaar** OR **Name + Father' | ||
| + | - If eligible, your family' | ||
| + | - Click **Download e-Card** — PDF with Aadhaar-OTP-protected card. | ||
| + | - For **hospital admission**: | ||
| + | - For **claim status** post-discharge: | ||
| + | - If not in eligibility list, check **State Health Agency** for additional state-only schemes (Mukhyamantri Jan Arogya, etc.). | ||
| + | |||
| + | ===== Real story from a citizen ===== | ||
| + | Dr. Shrawan Kumar Pathak took his father to an empanelled hospital. The desk said the family was "not eligible" | ||
| + | |||
| + | ===== 7 reasons your status may be stuck ===== | ||
| + | * **Not in SECC 2011** — primary eligibility base. Some states added post-SECC categories (e.g., Maharashtra added construction workers). Check state-specific. | ||
| + | * **Aadhaar-mobile mismatch** — family verification fails. Fix: link Aadhaar with mobile via UIDAI. | ||
| + | * **Hospital not empanelled** for that procedure — check [[https:// | ||
| + | * **Pre-authorisation rejected** — hospital didn't submit pre-auth on time, or TPA rejected. Fix: appeal via SHA. | ||
| + | * **Treatment not in PMJAY package list** — only listed procedures covered (1,800+ packages). Check at hospitals.pmjay.gov.in. | ||
| + | * **Annual cap reached** — ₹5 lakh per family per year has been used. Confirm remaining cover on the beneficiary portal or with the PMAM desk. | ||
| + | * **Migration / cross-state** — PMJAY allows portability (treatment in any state with home-state card), but some hospitals don't recognise portability. RTI for SHA portability policy. | ||
| + | |||
| + | ===== Pro tips most don't know ===== | ||
| + | * **ABHA ID** (Ayushman Bharat Health Account) is a separate health-record ID — different from PMJAY. Get free at [[https:// | ||
| + | * **Pradhan Mantri Aarogya Mitra (PMAM)** at every empanelled hospital — they verify eligibility + pre-auth on the spot. Always go to PMAM first. | ||
| + | * **Reimbursement (post-payment) claims** are possible if you paid first — file with SHA within 30 days of discharge with all bills + hospital empanelment proof. | ||
| + | * **State top-ups** — Maharashtra, | ||
| + | * **Senior Citizens (70+)** — universal coverage announced 2024; no SECC requirement. Apply at [[https:// | ||
| + | |||
| + | ===== Helpline + contact ===== | ||
| + | PM-JAY: **14555** (toll-free). For Ayushman Vay Vandana (70+), PIB also lists missed-call support on **1800-110-770**. State Health Agencies have their own helpdesks — find them on [[https:// | ||
| + | |||
| + | ===== If status is delayed beyond SLA — file an RTI ===== | ||
| + | |||
| + | If the portal, hospital desk or helpline cannot explain a denial, you have a statutory right under **RTI Act 2005 §6** to ask the public authority. A reply is due in **30 days** under §7(1). | ||
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| + | **File an RTI to**: //State Health Authority (SHA) + National Health Authority (NHA)// | ||
| + | |||
| + | **Ask these 5 questions**: | ||
| + | |||
| + | - eligibility (SECC-linked) | ||
| + | - hospital pre-auth records | ||
| + | - claim status | ||
| + | - denial reasons | ||
| + | - projected release | ||
| + | |||
| + | → **[[https:// | ||
| + | |||
| + | → **[[https:// | ||
| + | |||
| + | → **For deeper case-law** on this scenario: [[: | ||
| + | |||
| + | ===== ABHA card status check ===== | ||
| + | |||
| + | For //abha card status//, //abha health id check//: | ||
| + | |||
| + | - Open [[https:// | ||
| + | - Click **Login** → enter Aadhaar OR mobile → OTP. | ||
| + | - Dashboard shows your **14-digit ABHA number** + linked health records. | ||
| + | - Download ABHA card from //Download ABHA Card//. | ||
| + | |||
| + | ABHA (Ayushman Bharat Health Account) is **separate** from PMJAY card — ABHA is a digital health record ID for everyone, PMJAY is the Rs 5 lakh hospitalisation benefit for SECC-identified poor. Full guide: [[: | ||
| + | |||
| + | ===== PMJAY card download (Ayushman Bharat) ===== | ||
| + | |||
| + | For //pmjay card download//, //ayushman card download//, //ayushman bharat card pdf//: | ||
| + | |||
| + | - Open [[https:// | ||
| + | - Search by Aadhaar / mobile / Ration Card. | ||
| + | - If you find your name, click //Download PMJAY Card// — PDF with QR code. | ||
| + | |||
| + | If your name isn't on the list: | ||
| + | * Verify SECC 2011 deprivation status with the **State Health Authority (SHA)** — eligibility is based on SECC, NOT Aadhaar. | ||
| + | * If you should qualify but don't appear, file an RTI to the SHA. | ||
| + | * Detailed troubleshooting: | ||
| + | |||
| + | ===== Hospital empanelment search ===== | ||
| + | |||
| + | For //ayushman empanelled hospital list//, //pmjay hospital near me//: | ||
| + | |||
| + | - Open [[https:// | ||
| + | - Pick State → District → speciality. | ||
| + | - Map view shows nearest empanelled hospitals with: address, phone, available specialties, | ||
| + | |||
| + | PIB (1 November 2025, PRID 2185049) recorded **over 33,000 hospitals** empanelled nationwide. Always verify the hospital on [[https:// | ||
| + | |||
| + | ===== PMJAY claim status ===== | ||
| + | |||
| + | For //ayushman bharat claim status//, //pmjay claim tracking//: | ||
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| + | Claims are filed by the **hospital**, | ||
| + | - Patient: ask the hospital to share the **Claim ID** generated at admission. | ||
| + | - Ask the hospital whether the claim ID can be tracked on the beneficiary or SHA portal, then keep the Claim ID in writing. | ||
| + | - Settlement time is set by NHA / SHA process, not by this page. If the hospital or SHA will not give a written status, file RTI. | ||
| + | |||
| + | If claim is rejected, the hospital shares the rejection reason — you can challenge via NHA grievance portal. Detailed guide: [[: | ||
| + | |||
| + | <WRAP center round tip 95%> | ||
| + | **🔔 Track Ayushman Bharat coverage expansion + state-PMJAY scheme convergence by email.** **[[https:// | ||
| + | </ | ||
| + | |||
| + | ===== How to check Ayushman Bharat status by mobile number ===== | ||
| + | |||
| + | For //ayushman bharat status check by mobile number//, //pmjay card status by mobile no//: | ||
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| + | - Go to [[https:// | ||
| + | - Click **Login** → enter your **mobile number** (the one linked to your Aadhaar or used at enrollment). | ||
| + | - Enter the **OTP** sent via SMS. | ||
| + | - The portal shows all family members linked to that mobile number with their PMJAY eligibility status and coverage details. | ||
| + | - If eligible, click on a family member' | ||
| + | |||
| + | **If your mobile number is not linked:** | ||
| + | * Visit your nearest **Common Service Centre (CSC)** or **empanelled hospital** with your Aadhaar — they can search using your Aadhaar number or ration card. | ||
| + | * Call **14555** and provide your Aadhaar number — the helpline can verify eligibility over the phone. | ||
| + | |||
| + | ===== Ayushman Bharat card not received? Troubleshooting guide ===== | ||
| + | |||
| + | For //ayushman card not received//, //pmjay card not generated//, | ||
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| + | If you applied for an Ayushman Bharat card but haven' | ||
| + | |||
| + | * **Name mismatch with Aadhaar** — the name in SECC 2011 data must match your Aadhaar. Even minor spelling differences can block card generation. See: [[: | ||
| + | * **Mobile number not linked to Aadhaar** — update at a UIDAI enrolment centre. See: [[: | ||
| + | * **Family not in SECC 2011 database** — SECC is the primary eligibility list. If your family wasn't surveyed or was categorised differently, | ||
| + | * **Aadhaar not seeded with PMJAY** — visit a CSC or PMAM desk at an empanelled hospital to complete biometric seeding. | ||
| + | * **State-specific issues** — some states (e.g., West Bengal, Delhi, Odisha) operate their own health schemes instead of or alongside PMJAY. See state-wise section below. | ||
| + | * **Data entry error in SECC** — if your family was wrongly excluded, file an RTI to the State Health Authority demanding your SECC deprivation category and inclusion status. | ||
| + | |||
| + | **What to do:** | ||
| + | - First, search at [[https:// | ||
| + | - If still not found, visit the nearest CSC or PMAM at an empanelled hospital. | ||
| + | - If you believe you are wrongly excluded, **file an RTI** to the State Health Authority — see our [[: | ||
| + | - Beware of agents offering to " | ||
| + | |||
| + | ===== What is the difference between PM-JAY and PM-JAY SEHAT? ===== | ||
| + | |||
| + | For //pmjay vs pmjay sehcat//, //pm jay vs sehcat//, // | ||
| + | |||
| + | **PM-JAY (Pradhan Mantri Jan Arogya Yojana)** is the central scheme. It provides **₹5 lakh per family per year** for listed secondary and tertiary hospitalisation. The National Health Authority publishes current beneficiary counts on [[https:// | ||
| + | |||
| + | **PM-JAY SEHAT (Social Health Insurance Scheme for All)** was launched in December 2020. It extends PM-JAY-style coverage to **all residents of Jammu & Kashmir**, including those not in the SECC list. While PM-JAY is for SECC-identified poor across India, SEHAT covers the universal population of JK. | ||
| + | |||
| + | Key differences: | ||
| + | | **Feature** | **PM-JAY** | **PM-JAY SEHAT (JK)** | | ||
| + | | **Launch** | September 2018 | December 2020 | | ||
| + | | **Coverage** | SECC-identified families (see NHA dashboard) | All JK residents | | ||
| + | | **Sum insured** | Rs. 5 lakh/ | ||
| + | | **Eligibility base** | SECC 2011 deprivation criteria | Universal (JK residents) | | ||
| + | | **Administrator** | National Health Authority | JK State Health Agency | | ||
| + | | **Portability** | Pan-India | Pan-India (via NHA) | | ||
| + | |||
| + | **State variants:** Several states run their own convergent schemes — e.g., **Mukhyamantri Jan Arogya Yojana (Maharashtra)**, | ||
| + | |||
| + | ===== How to check Ayushman Bharat eligibility by state ===== | ||
| + | |||
| + | PM-JAY eligibility varies by state because each State Health Authority (SHA) manages its own beneficiary database. While the core eligibility comes from SECC 2011, many states have added their own categories: | ||
| + | |||
| + | * **Rural poor** identified through SECC 2011 deprivation indicators (D1–D7) | ||
| + | * **Urban occupational workers** — rag pickers, beggars, domestic workers, street vendors, construction workers (see [[: | ||
| + | * **State-specific additions** — some states include construction workers, pregnant women, disabled persons, or SC/ST households | ||
| + | * **Senior citizens 70+** — universal coverage (announced 2024, rolling out 2025-2026) | ||
| + | |||
| + | **To check your state-specific eligibility: | ||
| + | - Search at [[https:// | ||
| + | - Contact your **State Health Authority** — find contact details on [[https:// | ||
| + | - Visit your nearest **CSC** or **empanelled hospital' | ||
| + | - For state-specific health schemes, see our [[: | ||
| + | |||
| + | ===== How to check Ayushman Bharat status offline (without internet) ===== | ||
| + | |||
| + | For //ayushman card check offline//, //pmjay status without internet//: | ||
| + | |||
| + | Not everyone has internet access. You can check your PMJAY eligibility offline: | ||
| + | |||
| + | - **Call 14555** (toll-free, 24/7) — provide your Aadhaar number or ration card number. The helpline operator will confirm your eligibility and coverage. | ||
| + | - **Visit a Common Service Centre (CSC)** — there are over 4 lakh CSCs across India. The operator can search the PMJAY database using your Aadhaar. | ||
| + | - **Visit any empanelled hospital' | ||
| + | - **Contact your State Health Agency** — each SHA maintains a beneficiary helpdesk. Find your SHA on [[https:// | ||
| + | - **Physical SECC list** — in some states, the SECC 2011 beneficiary list is available at the **Gram Panchayat office** or **Urban Local Body health centre**. | ||
| + | |||
| + | ===== State schemes that sit beside PM-JAY ===== | ||
| + | |||
| + | Some States run their own hospital-cover schemes alongside or instead of the central PM-JAY list. Eligibility can therefore differ by State even when the NHA portal is used. Check [[https:// | ||
| + | |||
| + | ===== Frequently asked questions ===== | ||
| + | |||
| + | ==== How to check if I'm eligible without going online? ==== | ||
| + | |||
| + | Call **14555** with your Aadhaar number — they' | ||
| + | |||
| + | ==== Is treatment fully cashless? ==== | ||
| + | |||
| + | Yes for empanelled hospitals on listed packages. Some non-package items (specific imports, super-luxury room) may have co-pay. Always confirm with the hospital' | ||
| + | |||
| + | ==== What if my hospital demands payment? ==== | ||
| + | |||
| + | Refuse + insist on PMAM contact. If they still insist, file complaint with SHA + RTI for hospital empanelment terms. Detailed steps: [[: | ||
| + | |||
| + | ==== Is dental and OPD covered? ==== | ||
| + | |||
| + | OPD generally NOT covered. Dental only for accident-related, | ||
| + | |||
| + | ==== Senior citizens 70+ — what to do? ==== | ||
| + | |||
| + | Universal coverage announced 2024. Apply at [[https:// | ||
| + | |||
| + | ==== My name is in SECC but card not showing online — what to do? ==== | ||
| + | |||
| + | This is a common data-linking issue. Try searching with different name spellings, your father' | ||
| + | |||
| + | ==== Can I check PMJAY status using just my ration card number? ==== | ||
| + | |||
| + | Yes. At [[https:// | ||
| + | |||
| + | ==== How many family members are covered under one Ayushman card? ==== | ||
| + | |||
| + | PM-JAY covers the entire family as a unit — there is no cap on the number of members. The Rs. 5 lakh per year is shared across all family members on the same card. Eligibility is determined at the family level based on SECC 2011 data. Senior citizens 70+ get their own individual coverage regardless of family status. | ||
| + | |||
| + | ===== Summary + what to do next ===== | ||
| + | |||
| + | To check status: use the official portal listed above with your reference number. SLA is published; if stuck beyond it, file a free RTI. | ||
| + | |||
| + | * **If status is normal** → wait the published SLA, then download/ | ||
| + | * **If status is delayed** → click [[https:// | ||
| + | * **If status is rejected** → demand reasons under §4(1)(d) RTI Act; appeal/ | ||
| + | * **For state-specific guidance** → see [[: | ||
| + | * **For cashless denial** → see [[: | ||
| + | * **For claim rejection** → see [[: | ||
| + | |||
| + | ===== All RTI Wiki tools (free, no login) ===== | ||
| + | |||
| + | * 🪄 **[[https:// | ||
| + | * 🎤 **[[https:// | ||
| + | * 🔮 **[[https:// | ||
| + | * ⚖️ **[[https:// | ||
| + | * 📬 **[[https:// | ||
| + | * 📅 **[[https:// | ||
| + | * 💰 **[[https:// | ||
| + | * 🔍 **[[https:// | ||
| + | |||
| + | ===== Related on RTI Wiki ===== | ||
| + | |||
| + | * **Master guide**: [[: | ||
| + | * **Claim denial RTI**: [[: | ||
| + | * **Apply for card**: [[: | ||
| + | * **ABHA card**: [[: | ||
| + | * **Benefits**: | ||
| + | * **Card download**: [[: | ||
| + | * **Find hospital**: [[: | ||
| + | * **Cashless denied**: [[: | ||
| + | * **Claim grievance**: | ||
| + | * **Eligibility fraud**: [[: | ||
| + | * **Senior citizens 70+**: [[: | ||
| + | * **State-by-state**: | ||
| + | * **All health schemes**: [[: | ||
| + | * **Cashless denied (general)**: | ||
| + | * **Citizen RTI playbook**: [[: | ||
| + | * **The RTI Act 2005**: [[: | ||
| + | * **All status-check guides**: [[: | ||
| + | |||
| + | ===== Sources ===== | ||
| + | |||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * RTI Act 2005 §§6, 7, 19 — statutory right to information and appeal provisions | ||
| + | * PMJAY Operational Guidelines 2018 and SECC 2011 deprivation criteria | ||
| + | * NHA annual reports and PMJAY dashboard (2025-2026 data) | ||
| + | |||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * RTI Act 2005 §§6, 7, 19 | ||
| + | |||
| + | //Last reviewed: 20 August 2026.// This page is information, | ||
| + | |||
| + | {{tag> | ||