Right to Information Wiki

Ayushman Bharat (PM-JAY) β€” Rs 5 lakh/year health cover free (2026)

India's working reference for the RTI Act, 2005 β€” current, sourced, and free.

Ayushman Bharat (PM-JAY) β€” Rs 5 lakh/year health cover free (2026)

Rs 5 lakh per family per year cashless at 30,000+ empanelled hospitals β€” free, no premium.

Launched: 2018 Β· Issued by: Ministry of Health & Family Welfare / National Health Authority

Who is eligible

  • SECC 2011 deprivation list (rural) OR occupational categories (urban)
  • Senior 70+ β€” auto-eligible since September 2024 (any income)
  • Aadhaar + ration card or occupational ID
  • NOT eligible if all family members in formal sector with private insurance

What you get

Rs 5 lakh per family per year at 30,000+ empanelled hospitals. Coverage: 1,393 packages including cancer, cardiology, neurology, joint replacement, dialysis, NICU/PICU. No waiting period for pre-existing conditions. Cashless and paperless.

How to apply (step-by-step)

  1. Verify eligibility at beneficiary.nha.gov.in β€” Search by name + state + Aadhaar / ration card.
  2. Get Ayushman card β€” CSC, empanelled hospital, or Ayushman Mitra desk.
  3. Aadhaar verification + photo + biometric β€” Each family member separately.
  4. PVC or e-card issued same-day β€” Carry to any empanelled hospital for cashless treatment.
  5. Walk in to empanelled hospital β€” Show card + Aadhaar; hospital auto-bills NHA.
  6. Treatment cashless β€” No upfront payment; NHA reimburses hospital.

Documents needed

  • Aadhaar
  • Ration card / SECC 2011 ID
  • Age proof (for 70+ extension)

Full document checklist: Documents required for ayushman bharat card

Timeline

Card issuance: same-day. Cashless treatment: on-the-spot at empanelled hospitals.

Portal + helpline

Common issues

  • SECC 2011 list missing your name β€” apply for state-supplementary scheme (CMCHIS, MJPJAY, ABRY etc.).
  • Aadhaar mismatch with SECC β€” name spelling differs; update Aadhaar.
  • Hospital not empanelled β€” use list at hospitals.pmjay.gov.in.
  • Cashless denied at empanelled hospital β€” file complaint at pmjay.gov.in/grievances.

Benefit delayed or rejected? File an RTI

Most β€œdelays” or β€œrejections” clear within 7-15 days of an RTI being filed. Use this 5-question template:

1. Status of my application no. _____ dated _____ as on date.
2. Name + designation of dealing officer assigned to my file.
3. Reasons for delay beyond the statutory timeline.
4. Copy of any noting / movement of my file in the past 30 days.
5. Likely date of disbursement / decision.

Auto-fill the PIO + your case: Open the AI RTI Drafter β†’

More schemes for you: All senior citizens schemes

Frequently asked questions

Senior 70+ β€” really income-free?

Yes β€” September 2024 expansion. Apply with just Aadhaar + age proof.

Pre-existing illness covered?

Yes β€” no waiting period. Covered from day 1.

Can I use across states?

Yes β€” pan-India empanelled hospitals. Cashless treatment everywhere.

OPD covered?

No β€” only in-patient. OPD covered separately under Ayushman Arogya Mandir at PHC/SHC.

Summary + next step

Bottom line: Rs 5 lakh per family per year cashless at 30,000+ empanelled hospitals β€” free, no premium. Apply at beneficiary.nha.gov.in. If delayed beyond timeline, file an RTI β€” most cases clear within 15 days.

Sources

  • Official portal: beneficiary.nha.gov.in
  • Issued by: Ministry of Health & Family Welfare / National Health Authority
  • Launched: 2018
  • Citizen feedback via %%AwaazRTI%% (composite, identifying details removed)

Last reviewed: 26 April 2026.