Quick Answer
Everyone aged 70 or above qualifies automatically, regardless of income — no application beyond registering for your card.
Below that age, eligibility depends on deprivation criteria from the SECC database, not on a simple income cut-off: households without a steady-earning adult, landless laborers, and similar categories are usually covered.
What is Ayushman Bharat PM-JAY?
PM-JAY is India’s flagship health insurance scheme, part of the wider Ayushman Bharat mission. It gives eligible families cashless treatment worth ₹5 lakh per family per year, covering hospital stays and major treatments at both government and private hospitals empanelled under the scheme.
It’s one of the largest health insurance programs in the world by the number of families it covers. Unlike private insurance, there’s no premium to pay, no annual renewal, and no medical underwriting based on pre-existing conditions.
Key details at a glance
| Detail | Amount / Criteria |
|---|---|
| Annual cover | ₹5 lakh per family, per year |
| Age 70+ | Automatic, regardless of income (Ayushman Vay Vandana Card) |
| Below age 70 | Based on SECC deprivation criteria |
| Treatment packages | 1,900+ across most major specialities |
| Cost to patient | Fully cashless and paperless at empanelled hospitals |
| Applies since | September 2024 (for the age 70+ track) |
| Official portal | pmjay.gov.in |
Who qualifies
If you’re 70 or older, you qualify automatically. Income doesn’t matter, and this applies even if your family already has a different health scheme or existing PM-JAY coverage — you get a separate, additional cover as a senior citizen, issued as an Ayushman Vay Vandana Card.
If you’re under 70, eligibility is determined by the Socio-Economic Caste Census (SECC) database, not by a simple income figure. You’re likely covered if your household matches categories such as:
- No adult member aged 16–59 in the family.
- Landless households dependent primarily on manual labor.
- Scheduled Caste or Scheduled Tribe households.
- Households with a disabled member and no able-bodied adult earner.
- Street vendors, domestic workers, and similar informal-sector occupations in urban areas.
Many descriptions of the scheme mention families with annual income up to roughly ₹5 lakh as broadly within scope. That’s a useful rule of thumb, but it isn’t the actual test — the SECC database check is what determines your status, not income alone. Two families with identical income can have different outcomes depending on which deprivation category, if any, they fall under.
Who’s excluded
- Income-tax payers, under the standard (below-70) eligibility track.
- Government employees with existing comprehensive coverage under schemes like CGHS, under the standard track — though this exclusion doesn’t apply to the age-70+ automatic track, which layers on top of any existing coverage.
- Households not captured in the SECC database at all, unless they fall under a separately notified inclusion category.
What you get
- Cashless, paperless treatment at any empanelled hospital, government or private, anywhere in India — the cover is portable across states.
- Pre-hospitalization expenses for a defined number of days before admission, and post-hospitalization expenses after discharge.
- Coverage across roughly 1,900 treatment packages, spanning cardiac care, cancer treatment, orthopedic surgery, and most major specialties.
- No cap on family size for the ₹5 lakh annual limit — it covers the whole family unit, not per individual.
How to check your eligibility and get your card
- Go to the official PM-JAY beneficiary portal at pmjay.gov.in.
- Use the “Am I Eligible” tool with your mobile number and state — this checks the SECC database directly.
- If eligible, you’ll need to complete e-KYC and generate your Ayushman card, which is a separate step from being marked eligible.
- Alternatively, visit a Common Service Centre or the Ayushman Mitra help desk at any empanelled hospital for in-person assistance.
- If you’re 70 or older, apply specifically for the Ayushman Vay Vandana Card, even if your family already has standard PM-JAY coverage.
Common mistakes that delay or block coverage
- Assuming eligibility means automatic coverage. Being marked eligible in the database and actually having a usable Ayushman card are two different steps. You must complete e-KYC and generate a card before you can use the benefit at a hospital.
- Not registering separately for the 70+ track. If your family already has standard PM-JAY coverage but a member turns 70, that member still needs their own Vay Vandana Card — it isn’t issued automatically just because their age crosses the threshold.
- Confusing PM-JAY with state-specific schemes. Several states run their own health schemes alongside PM-JAY, sometimes with similar names or overlapping benefits. Confirm you’re checking the central PM-JAY portal specifically, not a state scheme with different rules.
- Assuming a hospital visit before checking eligibility. Confirming your status before you need urgent care means you already know your card is active and which hospitals near you are empanelled — waiting until an emergency is the wrong time to discover a gap.
Frequently asked questions
Do I need to pay anything for treatment?
No. Treatment at empanelled hospitals is cashless and paperless for eligible beneficiaries — there’s no reimbursement process to navigate afterward.
What if I’m 70+ but my family already has PM-JAY coverage?
You get a separate, additional cover as a senior citizen, on top of your family’s existing coverage — the two don’t merge into one shared limit.
How many treatments does it cover?
Around 1,900+ treatment packages across most major specialties, including cardiac care, cancer treatment, and orthopedic surgery.
I don’t know if I’m in the SECC database. What do I do?
Use the “Am I Eligible” tool on the official portal — it checks the database directly using your mobile number and state, so you don’t need to guess.
Is there an income limit for the age 70+ track?
No. Age 70+ eligibility is automatic and doesn’t consider income at all — this differs from the standard SECC-based track for younger applicants.
Can I use PM-JAY at any hospital?
Only at hospitals empanelled under the scheme. Not every hospital participates — check the list of empanelled hospitals in your area on the official portal before assuming a specific hospital is covered.
What happens if my treatment costs more than ₹5 lakh in a year?
Costs above the ₹5 lakh annual family limit aren’t covered under PM-JAY. Some states have supplementary schemes that extend this limit — check your state health department for any additional local coverage.
Does PM-JAY cover pre-existing conditions?
Yes. Unlike most private insurance plans, PM-JAY doesn’t exclude pre-existing conditions or impose a waiting period for them.
Related schemes
If housing, income support, or pension schemes are also relevant to your situation, use the Haqdaar eligibility checker to see everything you may qualify for in one pass, rather than checking each scheme separately.
Last verified: July 2026. Information compiled from the official PM-JAY portal (pmjay.gov.in) and the National Health Authority. This is independent informational content, not affiliated with the Government of India. Eligibility rules can change. Always verify current details on the official portal before relying on coverage.