Ayushman Bharat Eligibility One-Minute Summary
Ayushman Bharat, also called PM-JAY, provides eligible families with free hospital treatment worth ₹5 lakh per year. You do not apply for this scheme in the usual sense. You are either already on the list or not.
Rural households qualify through deprivation categories from the 2011 socio-economic census. Urban households qualify through specific job categories.
Every citizen aged 70 or older qualifies, regardless of income. This guide shows you exactly how to check your name, what documents you need, and what to do if your name is missing.
What Is Ayushman Bharat (PM-JAY)?
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is a government health cover scheme. It pays for hospital treatment at government and private hospitals that have signed up for the scheme. The cover is ₹5 lakh per family per year. This amount is shared by the whole family, and there is no cap on family size or on members’ ages.
The scheme pays for more than 1,900 medical procedures. This includes surgery, cancer care, heart treatment, and childbirth-related complications. It also covers 3 days of expenses before you are admitted and 15 days of expenses after you are discharged, such as medicines and follow-up tests.
Treatment under this scheme is cashless. You do not pay the hospital at any point, as long as the hospital is impaneled under PM-JAY and your treatment is a covered procedure.
The scheme runs on a list. Your name is either already in the government’s eligibility database, or it is not. This is different from most insurance, where you fill a form and buy a policy. Here, eligibility depends on where your household is listed in national and state records, primarily the Socio-Economic Caste Census of 2011, with some newer additions.
Why Does It Matter?
Medical bills push lakhs of Indian families into debt every year. A single hospital stay for surgery or a serious illness can wipe out years of savings for a low-income household. Ayushman Bharat exists to stop this.
Knowing your eligibility status matters for three reasons.
First, if you are eligible and do not know it, you may pay full hospital charges out of pocket for treatment that should have been free.
Second, hospitals in your area need to know you are covered before they open a cashless claim. If your name is not verified in advance, emergency admission can be delayed while staff checks your status.
Third, the scheme has expanded significantly since it launch in 2018. New categories of people, including all senior citizens aged 70 and above, and certain frontline workers, have been added over time. Many people who were not eligible a few years ago are eligible today and simply have not checked.
Key Details at a Glance
| Detail | Information |
|---|---|
| Scheme name | Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) |
| Launched | 23 September 2018 |
| Cover amount | ₹5 lakh per family, per year |
| Basis of eligibility | SECC 2011 deprivation and occupational categories, plus later additions |
| Coverage | Cashless treatment across impaneled government and private hospitals nationwide |
| Special universal category | All citizens aged 70 and above, regardless of income |
| Where to check | pmjay.gov.in, mera.pmjay.gov.in, beneficiary.nha.gov.in, Ayushman App, or 14555 helpline |
| Cost to beneficiary | Free. There is no premium and no application fee |
Who Is Eligible?
Eligibility varies depending on whether you live in a rural or urban area, with a single universal category that applies to everyone.
Rural households
Rural eligibility uses seven deprivation markers drawn from the 2011 census data. A household typically qualifies if it falls into categories such as these.
- The household lives in a single-room home with poor-quality (kutcha) walls or roof.
- There is no adult member between 16 and 59 years of age.
- The household is headed by a woman with no adult male member.
- A member has a disability, and there is no able-bodied adult in the family.
- The household belongs to a Scheduled Caste or Scheduled Tribe.
- The household has no land and depends mainly on manual labor for income.
- The family is landless and earns most of its income from casual manual work.
Certain groups are automatically included regardless of these markers, such as households identified as destitute, those living on alms, families of manual scavengers, and legally released bonded laborers.
Urban households
Urban eligibility works differently. Instead of housing or land criteria, it is based on your occupation. Workers in a defined list of low-income urban occupations qualify. This list includes, among others, rag pickers, domestic workers, street vendors, construction workers, home-based artisans, sweepers, sanitation workers, and drivers of hand-pulled or cycle rickshaws.
If your occupation is on the list but your name does not appear in the beneficiary database, this usually means the local survey used to build the urban list missed your household. This is common, and a fix is covered in the next section.
Universal inclusion for senior citizens
Since a 2024 Cabinet decision, every Indian citizen aged 70 years or above qualifies for PM-JAY cover, regardless of income or occupation. This applies even if no one else in the family is otherwise eligible.
Senior citizens in this category receive an Ayushman Vay Vandana card and an additional ₹5 lakh of cover that is exclusively theirs. It is not shared with the rest of the family’s existing PM-JAY entitlement.
If a senior citizen already benefits from a scheme like the Central Government Health Scheme or the Ex-Servicemen Contributory Health Scheme, they can choose to stay with that scheme or switch to PM-JAY. They cannot use both at the same time.
Recent additions
The government periodically expands who is covered. As of 2026, this includes ASHA workers, Anganwadi workers, and Anganwadi helpers, along with their families, in recognition of their frontline health service.
Some states have also added their own categories, such as widows and persons with disabilities receiving state financial assistance. Because these additions happen state by state, always check your specific state’s rules rather than assuming a national rule applies everywhere.
Who is generally excluded?
Certain households are intentionally excluded from the scheme because it targets economically vulnerable families.
Exclusion criteria commonly include households that own a car, a motorcycle, or a motorized fishing boat, families with a member in regular government employment, and households with a reasonably stable monthly income above a set threshold.
These exclusions apply mainly to the general eligibility route. The 70+ universal category is not affected by these exclusions.
How to Check Your Eligibility
You can check your status online, by phone, or in person. Pick whichever is easiest for you.
Online, through the official website
- Go to the official PM-JAY website and look for the “Am I Eligible” option.
- Choose to log in as a Beneficiary.
- Enter your mobile number and the captcha code shown, then click Verify.
- Enter the one-time password sent to your phone.
- Select your state, district, and scheme, then search using your name, ration card number, household number, or Aadhaar number.
- If your name is in the database, your family’s details will appear on screen.
Online, through the Ayushman App
- Download the Ayushman App from your phone’s app store.
- Log in as a Beneficiary using your mobile number and OTP.
- Search using your state, district, and Aadhaar or Family ID.
- If your name appears, you can complete e-KYC directly in the app using face authentication and generate your card immediately.
By phone
Call the national helpline at 14555. An operator can check your eligibility status using your Aadhaar or ration card details and guide you on the next step.
In person
Visit your nearest Common Service Center (CSC) or an Ayushman Mitra desk at any impanelled hospital. Carry your Aadhaar card and ration card. Staff there can search the database for you and help you complete verification on the spot.
If you are 70 or above
Senior citizens can register directly for the Ayushman Vay Vandana card through the National Health Authority’s dedicated portal for this category, using Aadhaar-based verification. This route does not depend on the family’s existing SECC status.
Common Mistakes to Avoid
Assuming you must "apply" and be rejectedMany people believe they need to submit an application and wait for approval, similar to a loan. This is incorrect for the standard categories. You are either on the list or not, and checking takes a few minutes.
Giving up after one failed searchIf your name does not appear under your mobile number, try searching again using your ration card number, Aadhaar number, or family ID instead. Data entry differences across these documents are a common reason valid names do not show up on the first try.
Not checking again after a life changeIf a family member turns 70, or your state recently expanded eligibility to a new occupational category, check again. Eligibility can change even if your household situation has not.
Ignoring state-specific rolloutsSome states have only recently joined PM-JAY or run add-on schemes with wider eligibility than the national scheme. Always check your state’s specific portal or helpline in addition to the national one.
Pay at a hospital before checking your status
If you are being asked to pay for a procedure that PM-JAY typically covers, ask the hospital’s Ayushman Mitra to verify your eligibility before you pay. If a hospital tries to charge you for a covered treatment despite valid eligibility, you can report this by calling 14555.
Confusing the ₹5 lakh cover with a bank deposit or cash benefitThe amount is not paid to you directly. It is a treatment cover that the government pays to the hospital on your behalf.
Bottom Line
Ayushman Bharat eligibility is not something you apply for from scratch. It is something you check.
Rural households qualify based on housing and social deprivation indicators; urban households qualify based on a defined list of occupations; and every citizen aged 70 or above qualifies automatically.
The check itself takes only a few minutes online, by phone, or at a Common Service Center.
If you have never checked your status, or if it has been a while since you last checked, do it today. It costs nothing, and it could save your family from a large, unexpected hospital bill.
Frequently Asked Questions
Is there a fee to check my Ayushman Bharat eligibility or to get a card?
No. Checking your eligibility, completing e-KYC, and receiving your Ayushman card are all free.
My occupation is on the eligible urban list, but my name does not show up. What should I do?
Visit your nearest Common Service Center with your Aadhaar card and ration card and ask for manual verification. Urban lists are built from local surveys, and some eligible households are missed.
Do I need to be below a certain income to qualify if I am 70 or older?
No. The 70-and-above category is universal. Income, occupation, and prior socio-economic category do not matter for this group.
Can I use Ayushman Bharat if I already have private health insurance?
Yes. There is no rule barring you from holding both. You can use whichever cover suits your treatment at the time, as long as you are separately eligible for PM-JAY.
What if my state has not yet signed up for the national scheme?
As of mid-2026, all states and union territories have joined PM-JAY, with West Bengal being the most recent addition in June 2026. If you live in a state with its own separate scheme, that state scheme may run alongside or instead of PM-JAY, so check your state health department’s portal for local rules.
How do I know if a hospital near me is impaneled under PM-JAY?
Use the “Find Hospital” option on the Ayushman App or the official PM-JAY website, and filter by your state, district, and specialty needed.
Related Schemes
- Complete Guide to Government Welfare Schemes in India (2026)
- PM Awas Yojana (housing assistance for eligible households)
- PMSBY (Pradhan Mantri Suraksha Bima Yojana): Complete Guide (2026)
- PMJJBY (Pradhan Mantri Jeevan Jyoti Bima Yojana): Complete Guide (2026)
- National Scholarship Portal (NSP) — Your Gateway to 140+ Scholarships (2026 Guide)
Related Government portal:
Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana
This article is for general information only. Scheme rules, eligibility categories, and application portals can change. Always verify current details on the official PM-JAY website or by calling the 14555 helpline before making decisions based on this guide.