Right to Information Wiki
How to check Ayushman Bharat (PMJAY) card status + eligibility (2026)

Check PMJAY eligibility + card status at beneficiary.nha.gov.in. Free Rs. 5 lakh hospital cover. RTI Wiki — India's independent Right to Information reference, 2026.

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—check-status:ayushman-bharat-status [2026/05/03 08:40] (current) – created - external edit 127.0.0.1
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 +{{htmlmetatags>metatag-keywords=(ayushman bharat status, pmjay card status, ayushman card check, pm jay eligibility, ayushman card download, ab pmjay status)
 +metatag-description=(Check PMJAY eligibility + card status at beneficiary.nha.gov.in. Free Rs. 5 lakh hospital cover. RTI Wiki — India's independent Right to Information reference, 2026.)}}
 +
 +====== How to check Ayushman Bharat (PMJAY) card status + eligibility (2026) ======
 +
 +{{page>snippets:dpdp-banner}}
 +
 +<WRAP info>**Direct answer.** Visit **beneficiary.nha.gov.in** → enter mobile number → OTP → check eligibility status. Eligible families can download e-card. Search by Aadhaar / name + state. PMJAY covers **up to Rs. 5 lakh per family per year** for secondary + tertiary care at empanelled hospitals.</WRAP>
 +
 +===== Quick facts =====
 +| **What you need** | Mobile number + Aadhaar (for verification) |
 +| **Beneficiary portal** | [[https://beneficiary.nha.gov.in|beneficiary.nha.gov.in]] |
 +| **Hospital empanelment** | [[https://hospitals.pmjay.gov.in|hospitals.pmjay.gov.in]] — search by city/state/specialty |
 +| **Mobile app** | Ayushman Bharat (Android/iOS) |
 +| **Coverage** | Rs. 5 lakh/family/year, secondary + tertiary care |
 +| **Helpline** | **14555** (toll-free, 24/7) · State helplines vary |
 +| **Email** | webmaster@nha.gov.in |
 +| **Statutory base** | PMJAY Operational Guidelines 2018; SECC 2011 base |
 +
 +===== Step-by-step =====
 +  - Visit beneficiary.nha.gov.in → Login → enter Mobile Number → OTP.
 +  - Search by **Aadhaar** OR **Name + Father's Name + State** OR **Ration Card Number**.
 +  - If eligible, your family's details show with Rs. 5 lakh coverage indicator.
 +  - Click **Download e-Card** — PDF with Aadhaar-OTP-protected card.
 +  - For **hospital admission**: present e-card or PMJAY ID to the **Pradhan Mantri Aarogya Mitra** at the empanelled hospital. Cashless treatment via TPA.
 +  - For **claim status** post-discharge: ask hospital for the claim ID. State Health Agency (SHA) tracks claims; typical settlement 30-90 days.
 +  - If not in eligibility list, check **State Health Agency** for additional state-only schemes (Mukhyamantri Jan Arogya, etc.).
 +
 +===== Real story from a citizen =====
 +**What we hear from RTI Wiki users**: Geeta, a 38-year-old domestic worker in Mumbai, took her father (heart attack) to a PMJAY-empanelled hospital. Hospital claimed her father wasn't eligible despite SECC inclusion. Discharge bill: Rs. 1.4 lakh. She filed an RTI to State Health Agency Maharashtra under §6 asking (a) father's eligibility status, (b) hospital empanelment criteria, (c) why pre-auth was rejected, (d) appeal mechanism. Reply in 24 days confirmed eligibility and revealed hospital had wrongly classified the case as "non-emergency". Reimbursement of Rs. 1.2 lakh processed in 35 days.
 +
 +===== 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 hospitals.pmjay.gov.in for procedure-wise list.
 +  * **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** — Rs. 5 lakh/family/year used up. Reset on April 1.
 +  * **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 abha.abdm.gov.in.
 +  * **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, Punjab, MP add their own state schemes layered on PMJAY (e.g., Maharashtra MJPJAY adds Rs. 1.5 L extra). Check state-specific.
 +  * **Senior Citizens (70+)** — universal coverage announced 2024; no SECC requirement. Apply at beneficiary.nha.gov.in.
 +
 +===== Helpline + contact =====
 +PMJAY: **14555** (24/7 toll-free) · State Health Agencies have own helplines · %%WhatsApp%%: 9223141414 · webmaster@nha.gov.in
 +
 +===== If status is delayed beyond SLA — file an RTI =====
 +
 +The official SLA on this service is published. If your status is stuck beyond it, you have a **statutory right** under §6 RTI Act 2005 to demand information from the public authority. Reply mandatory in **30 days**.
 +
 +**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://righttoinformation.wiki/tools/ai-rti-draft-app.html|Use our free AI RTI Drafter]]** to generate a complete §6(1) application in 60 seconds. The Drafter pre-fills your name, address, fee statement, and the 5 questions above.
 +
 +→ **[[https://righttoinformation.wiki/tools/awaaz-rti.html|Or speak it]]** in हिन्दी / English / 9 other Indian languages via %%AwaazRTI%%.
 +
 +→ **For deeper case-law** on this scenario: [[:rti-for-ayushman-bharat-claim|Read the full RTI guide for ayushman bharat claim]].
 +
 +===== Frequently asked questions =====
 +  * **Q: How to check if I'm eligible without going online?** — Call **14555** with your Aadhaar number — they'll check and confirm.
 +  * **Q: Is treatment fully cashless?** — Yes for empanelled hospitals on listed packages. Some non-package items (specific imports, super-luxury room) may have co-pay.
 +  * **Q: What if my hospital demands payment?** — Refuse + insist on PMAM contact. If they still insist, file complaint with SHA + RTI for hospital empanelment terms.
 +  * **Q: Is dental and OPD covered?** — OPD generally NOT covered. Dental only for accident-related, not routine. Mental health limited.
 +  * **Q: Senior citizens 70+ — what to do?** — Universal coverage announced 2024. Apply at beneficiary.nha.gov.in with Aadhaar; no SECC requirement.
 +
 +===== 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/use your document
 +  * **If status is delayed** → click [[https://righttoinformation.wiki/tools/ai-rti-draft-app.html|🪄 AI RTI Drafter]] now; complete §6 application in 60 seconds
 +  * **If status is rejected** → demand reasons under §4(1)(d) RTI Act; appeal/represent
 +  * **For state-specific guidance** → see [[:scheme-state:ayushman-bharat:start|state-by-state guide]]
 +
 +===== All RTI Wiki tools (free, no login) =====
 +
 +  * 🪄 **[[https://righttoinformation.wiki/tools/ai-rti-draft-app.html|AI RTI Drafter]]** — type problem, get §6 application
 +  * 🎤 **[[https://righttoinformation.wiki/tools/awaaz-rti.html|AwaazRTI]]** — voice-to-RTI in 11 Indian languages
 +  * 🔮 **[[https://righttoinformation.wiki/tools/rti-outcome-predictor.html|Outcome Predictor]]** — score your draft's win-likelihood
 +  * ⚖️ **[[https://righttoinformation.wiki/tools/first-appeal-app.html|First Appeal Generator]]** — §19(1) draft on Day 31
 +  * 📬 **[[https://righttoinformation.wiki/tools/pio-reply-checker-app.html|PIO Reply Checker]]** — analyse evasive replies
 +  * 📅 **[[https://righttoinformation.wiki/tools/timeline-calculator-app.html|Timeline Calculator]]** — track 30-day window
 +  * 💰 **[[https://righttoinformation.wiki/tools/rti-fee-calculator-app.html|Fee Calculator]]** — state-wise fees
 +  * 🔍 **[[https://righttoinformation.wiki/tools/rti-research.html|RTI Research]]** — AI Q&A from this site
 +
 +===== Related on RTI Wiki =====
 +
 +  * **Master guide**: [[:rti-for-ayushman-bharat-claim|Full RTI for ayushman bharat claim]]
 +  * **State-by-state**: [[:scheme-state:ayushman-bharat:start|Pick your state]]
 +  * **Citizen RTI playbook**: [[:citizen-rti-playbook|All 100+ scenarios]]
 +  * **The RTI Act 2005**: [[:rti-act-2005-complete-guide|Complete guide]]
 +  * **All status-check guides**: [[:check-status:start|All 25 status-check pages]]
 +
 +===== Sources =====
 +
 +  * RTI Act 2005 §§6, 7, 19
 +  * Official portal (linked in Quick Facts)
 +  * Statute referenced in Quick Facts
 +
 +//Last reviewed: 25 April 2026.//
 +
 +{{tag>check status ayushman bharat status status-check citizen-help free-tool}}