Everything about Ayushman Bharat Yojana -- check your eligibility, find empanelled hospitals near you, and learn how to apply for the ABHA health card online in 2026.
Healthcare costs in India can be devastating for middle-class and lower-income families. A single hospitalisation can wipe out years of savings. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) -- the world's largest publicly funded health insurance scheme -- provides free health coverage of Rs 5 lakh per family per year to over 55 crore beneficiaries. In 2026, the scheme has been expanded to include all senior citizens aged 70 and above, regardless of income.
Here is your complete guide to the Ayushman Bharat card -- who qualifies, what is covered, and exactly how to apply.
What Is Ayushman Bharat - PMJAY?
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) was launched on 23 September 2018. It provides:
- Rs 5 lakh health coverage per family per year
- Cashless and paperless treatment at empanelled hospitals
- Coverage for secondary and tertiary care including surgeries, diagnostics, medications, and hospital stay
- No cap on family size -- all members of an eligible family are covered
- Pre-existing conditions covered from day one
- Coverage across India -- you can use the card at any empanelled hospital in any state
The scheme covers over 1,949 treatment packages across 27 specialities, with costs pre-determined so hospitals cannot overcharge.
Who Is Eligible?
Original PMJAY Eligibility (Income-Based)
Eligibility is determined by the Socio-Economic Caste Census (SECC) 2011 data. In rural areas, families must meet at least one of these deprivation criteria:
- Households with only one room, kucha walls, and kucha roof
- Households with no adult member between ages 16-59
- Female-headed households with no adult male member
- Households with a disabled member and no able-bodied adult
- SC/ST households
- Landless households with major income from manual casual labour
In urban areas, the following occupational categories are eligible:
- Rag pickers, beggars, domestic workers
- Street vendors, cobblers, hawkers
- Construction workers, plumbers, painters, welders
- Transport workers, rickshaw pullers
- Shop workers, assistants, peons, delivery workers
- Electricians, mechanics, assemblers, repair workers
- Washermen, chowkidars, sweepers, sanitation workers
Senior Citizen Expansion (2026)
From October 2024, the scheme has been expanded to cover all senior citizens aged 70 and above, regardless of income or SECC status. This is a significant expansion:
- Separate Rs 5 lakh cover for senior citizens aged 70+
- Available even if the family is not in the SECC list
- Applicable to senior citizens already covered under other schemes (they get additional top-up)
- Covers approximately 6 crore additional senior citizens
What Does Ayushman Bharat Cover?
Covered Treatments (1,949+ Packages)
| Speciality | Examples |
|---|---|
| Cardiology | Bypass surgery, angioplasty, valve replacement |
| Oncology | Chemotherapy, radiation therapy, tumour removal |
| Orthopaedics | Joint replacement, fracture treatment, spine surgery |
| Neurology | Brain surgery, stroke treatment, epilepsy management |
| Nephrology | Dialysis, kidney transplant |
| Ophthalmology | Cataract surgery, retina treatment |
| Gynaecology | C-section delivery, hysterectomy |
| General surgery | Appendectomy, hernia repair, gallbladder removal |
| ENT | Tonsillectomy, cochlear implant |
| Paediatrics | Neonatal care, paediatric surgery |
What Is Not Covered?
- OPD (outpatient) consultations and medicines
- Fertility treatments and IVF
- Cosmetic surgery
- Drug and alcohol rehabilitation
- Individual member coverage (it is family-based)
- Treatments not listed in the package list
How to Check Eligibility
Method 1: Online Portal
- Visit the official website: pmjay.gov.in
- Click on "Am I Eligible?"
- Enter your mobile number and captcha
- Receive OTP and verify
- Search by name, Ration Card number, or RSBY URN
- The system will show if your family is eligible
Method 2: Ayushman App
- Download the "Ayushman Bharat" app from Google Play Store or Apple App Store
- Register with your mobile number
- Search your eligibility using name, Ration Card, or mobile number
- View your e-card if eligible
Method 3: Common Service Centre (CSC)
Visit your nearest Common Service Centre with your Aadhaar card. The CSC operator will check your eligibility and help you create your Ayushman card on the spot.
Method 4: Helpline
Call the Ayushman Bharat helpline: 14555 (toll-free) to check your eligibility.
How to Apply for Ayushman Bharat Card (ABHA Card)
Step 1: Verify Eligibility
Use any of the methods above to confirm your family is eligible under PMJAY.
Step 2: Visit an Empanelled Hospital or CSC
Carry these documents: - Aadhaar card (mandatory) - Ration card (if available) - SECC reference number (if known) - Any government ID proof
Step 3: eKYC Verification
The hospital or CSC will perform Aadhaar-based eKYC (fingerprint or iris scan). This verifies your identity and links your Ayushman card to your Aadhaar.
Step 4: Card Generation
Once eKYC is complete, your Ayushman Bharat ABHA card is generated digitally. You can: - Download it from the Ayushman app - Print it at the CSC - Access it digitally at any empanelled hospital
The entire process takes 10-15 minutes and is completely free.
Finding Empanelled Hospitals
Online Search
- Visit pmjay.gov.in/hospital
- Select your state and district
- Choose hospital type (public/private/both)
- Choose speciality if needed
- View the list of empanelled hospitals with addresses and contact details
Via Ayushman App
The app shows nearby empanelled hospitals with directions and allows you to filter by speciality.
As of 2026, there are over 30,000 empanelled hospitals across India -- approximately 50% are private hospitals. Every district hospital is empanelled by default.
How to Use Your Ayushman Card at a Hospital
- Visit the Ayushman Arogya Mitra (AAM) desk at the hospital. Every empanelled hospital has a dedicated desk.
- Show your Ayushman card or Aadhaar number. The AAM will verify your details.
- Get admitted. The hospital handles all paperwork and billing internally.
- Treatment is cashless. You do not pay anything. The hospital bills the insurance company directly.
- Post-discharge care: Medicines for up to 15 days and follow-up consultations are included.
Package Rates: How Much Does the Government Pay?
The government pre-determines rates for every treatment. Some examples:
| Treatment | PMJAY Package Rate |
|---|---|
| Cataract surgery | Rs 15,000 -- Rs 30,000 |
| Knee replacement | Rs 80,000 -- Rs 1,10,000 |
| Hip replacement | Rs 85,000 -- Rs 1,20,000 |
| Bypass surgery (CABG) | Rs 1,20,000 -- Rs 1,70,000 |
| Dialysis (per session) | Rs 2,000 -- Rs 3,000 |
| Cancer chemotherapy (per cycle) | Rs 15,000 -- Rs 50,000 |
| Normal delivery | Rs 9,000 -- Rs 12,000 |
| C-section delivery | Rs 15,000 -- Rs 20,000 |
These are maximum rates. Hospitals cannot charge anything above these amounts to the patient.
Ayushman Bharat Digital Mission (ABDM)
In addition to PMJAY, the Ayushman Bharat Digital Mission creates a digital health ecosystem:
- ABHA Number: A unique 14-digit health ID for every citizen
- ABHA Address: A username-like health address (e.g., yourname@abdm)
- Health Records: All your medical records, prescriptions, lab reports linked to your ABHA
- Interoperability: Any hospital or clinic can access your health records (with consent)
Creating an ABHA number is free and available to all citizens, not just PMJAY beneficiaries. Visit abha.abdm.gov.in or use the ABHA app.
Grievance Redressal
If you face issues such as hospitals refusing treatment, demanding payment, or poor quality of care:
- Call 14555: The PMJAY helpline handles complaints and escalations.
- Use the Ayushman app: Submit a grievance through the app with details and photos.
- Visit the District Implementation Unit (DIU): Each district has an office that resolves PMJAY-related issues.
- Online portal: Submit a complaint at cgrms.pmjay.gov.in.
Hospitals found guilty of overcharging or denying treatment can be de-empanelled and penalised.
Fraud Prevention
The scheme has robust fraud-prevention measures:
- Biometric verification (Aadhaar-based) prevents identity fraud
- Treatment pre-authorisation for procedures above Rs 1 lakh
- AI-based claim analysis detects suspicious patterns
- Regular audits of empanelled hospitals
- Whistleblower mechanism for reporting fraud
If someone approaches you offering to make an Ayushman card for a fee, it is a scam. Card generation is always free.
*This article is for educational purposes and does not constitute medical or financial advice. Eligibility and scheme details are subject to change by the government. Visit pmjay.gov.in for the latest information.*
Frequently asked questions
How can I check if I am eligible for Ayushman Bharat?
Visit pmjay.gov.in and click 'Am I Eligible', enter your mobile number for OTP verification, then search by name or Ration Card number. You can also call the toll-free helpline 14555 or visit your nearest Common Service Centre.
Is the Ayushman Bharat card free?
Yes, the Ayushman Bharat card is completely free. There is no charge for eligibility check, card generation, or treatment at empanelled hospitals. If anyone demands payment for making the card, it is a scam.
What is the coverage amount under Ayushman Bharat?
Ayushman Bharat provides health coverage of Rs 5 lakh per family per year on a cashless and paperless basis at empanelled public and private hospitals across India.
Can senior citizens above 70 apply for Ayushman Bharat?
Yes, from October 2024 onwards, all Indian citizens aged 70 and above are eligible for Ayushman Bharat regardless of income. They receive a separate Rs 5 lakh cover in addition to any existing PMJAY coverage for the family.
Does Ayushman Bharat cover pre-existing diseases?
Yes, pre-existing conditions are covered from day one under Ayushman Bharat. There is no waiting period for any illness, unlike most private health insurance policies.
Can I use Ayushman Bharat at private hospitals?
Yes, approximately 50% of the 30,000+ empanelled hospitals are private. You can check the list of empanelled private hospitals near you on pmjay.gov.in/hospital.
What documents are needed for Ayushman Bharat card?
You need your Aadhaar card (mandatory) and optionally a Ration Card or any government ID. The card is generated through Aadhaar-based eKYC (fingerprint or iris verification).
Is there a family size limit for Ayushman Bharat coverage?
No, there is no cap on family size. All members of an eligible family are covered under the Rs 5 lakh annual limit, which is shared among all family members.