no way to compare when less than two revisions

Differences

This shows you the differences between two versions of the page.

@@ Line 1: / Line 1: @@
+{{htmlmetatags>
+metatag-keywords=(ayushman bharat rejected, pmjay not eligible, ayushman card denied, abha card rejected, secc 2011 not listed)
+metatag-description=(Ayushman Bharat card rejected? Top reason: not in SECC 2011 list. Apply for state-supplementary scheme; or via Sept 2024 senior 70+ extension. RTI for inclusion.)
+}}
+====== Ayushman Bharat (PM-JAY) card rejected / not eligible ======
+{{:social:auto:rejection-recovery-ayushman-bharat-rejected.png?direct&1200 |Ayushman Bharat (PM-JAY) card rejected / not eligible — RTI Wiki}}
+<WRAP info>
+**Quick answer:** Ayushman Bharat (PM-JAY) eligibility is **driven by SECC 2011 deprivation list** (rural) / **occupational categories** (urban). If not listed: **state-supplementary schemes** (CMCHIS in TN, MJPJAY in MH, ABRY in WB, etc.) cover most of the gap. **Sept 2024 expansion: senior 70+ auto-eligible regardless of income**. RTI for SECC 2011 listing.
+</WRAP>
+===== Top reasons for rejection =====
+  * **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.
+===== 7-step recovery checklist =====
+  - **Verify SECC 2011 listing** — beneficiary.nha.gov.in → search by name + state. Note ration card number too.
+  - **If not in SECC — try state scheme** — TN: CMCHIS · MH: MJPJAY · KA: ABARK · WB: ABRY · KL: KASP · etc. Convergence with PMJAY in 28 states.
+  - **Senior 70+ — apply via beneficiary.nha.gov.in** — Sept 2024 norm. Aadhaar + age proof (passport / 10th cert / pension order).
+  - **Aadhaar name mismatch fix** — Update Aadhaar to match SECC name OR vice-versa. SECC corrections via State Health Agency.
+  - **In wrong family's card** — Visit nearest CSC / Ayushman Mitra. Remove from old family, add to current.
+  - **Hospital denied cashless** — NHA grievance portal: pmjay.gov.in/grievances → 7-day disposal. Or call 14555.
+  - **Appeal to State Health Agency** — Each state has SHA. Free. Cite PMJAY operational guidelines.
+  - **RTI to NHA + SHA** — For: SECC ranking, exclusion rationale, hospital empanelment status.
+===== Appeal route, window, and fee =====
+  * **Statutory appeal route:** PMJAY grievance: Hospital → SHA (state) → NHA (national) → CPGRAMS.
+  * **Appeal window:** 30 days at each level
+  * **Fee:** Free at all stages.
+===== Documents to fix or upgrade =====
+  * Updated Aadhaar (matching SECC name)
+  * Ration card
+  * Age proof (for 70+ extension)
+===== File an RTI in parallel — most rejections clear within 15 days =====
+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:
+<code>
+. Copy of the rejection order + complete file noting on application no. _____ dated _____.
+. Name + designation of the officer who took the rejection decision.
+. Specific Section / Rule / Circular under which rejection was made + supporting evidence relied upon.
+. Number of similar applications in the past 12 months that were (a) approved, (b) rejected — for the same officer.
+. The procedure + timeline for filing an appeal + the office of the appellate authority.
+</code>
+**Auto-fill the PIO + your case:** [[:rti-for-ayushman-bharat-claim|Open the RTI Drafter →]]
+**Re-apply guide:** [[:how-to-apply:ayushman-bharat|How to apply for ayushman bharat]]
+**Track your application status:** [[:check-status:ayushman-bharat-status|Status check guide]]
+===== Frequently asked questions =====
+==== SECC 2011 doesn't reflect current poverty. Update? ====
+SECC 2021 census data not yet released as official deprivation list. Use state schemes meantime.
+==== I have private insurance + PMJAY — both work? ====
+Yes — PMJAY is supplementary. Private covers OPD/elective; PMJAY covers IP-emergency at Rs 5L.
+==== Pre-existing illness — covered from day 1? ====
+Yes — no waiting period under PMJAY.
+==== Hospital said "not empanelled today" — fix? ====
+Empanelment can pause for compliance. Try another empanelled hospital OR pay + claim reimbursement (limited under PMJAY).
+==== SHA rejected appeal — final option? ====
+NHA + Health Ministry. Critical illness: writ to HC under Article 21.
+===== Summary + what to do next =====
+<WRAP center round tip 90%>
+**Bottom line:** Don't accept a rejection at face value — request the file noting via RTI, fix the underlying document gap, and file the statutory appeal within 30 days at each level. Most rejections reverse with corrected documents.
+  * **File RTI immediately:** [[:rti-for-ayushman-bharat-claim|RTI Drafter — auto-fills PIO]]
+  * **Re-apply correctly:** [[:how-to-apply:ayushman-bharat|Apply guide]]
+  * **Talk to others who fixed this:** [[https://righttoinformation.wiki/tools/awaaz-rti.html|AwaazRTI community]]
+  * **Browse all rejection-recovery guides:** [[:rejection-recovery:start|All 15 recovery guides]]
+</WRAP>
+===== Related reading =====
+  * [[:how-to-apply:start|25 how-to-apply guides]]
+  * [[:check-status:start|25 status-check guides]]
+  * [[:documents:start|30 documents-required checklists]]
+  * [[:citizen-rti-playbook|Full RTI Playbook — 100+ scenarios]]
+===== Sources =====
+  * Statutory appeal under relevant Act/Rule — see legal framework section.
+  * Citizen feedback collected via [[https://righttoinformation.wiki/tools/awaaz-rti.html|AwaazRTI]] (composite, identifying details removed).
+//Last reviewed: 25 April 2026.//
+{{tag>rejection-recovery ayushman-bharat-rejected appeal rti-fallback}}