Verified by Editorial Team, EligibilityTools.in
Fact-Checked: 2026-07-20
Editorial Policy

Ayushman Bharat PM-JAY Eligibility Checker (2026)

Ayushman Bharat PM-JAY provides cashless health insurance of ₹5 lakh per family per year at empanelled hospitals, covering secondary and tertiary hospitalisation. Senior citizens aged 70 and above get a separate ₹5 lakh/year cover under Ayushman Vay Vandana Yojana — regardless of income or existing cover.

This tool gives an indicative assessment only. Always verify your name at mera.pmjay.gov.in or call 14555 before visiting a hospital.

If you are 70 or above, you qualify for Ayushman Vay Vandana Yojana regardless of other factors

About Ayushman Bharat PM-JAY

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is the world's largest publicly funded health insurance scheme. It covers ₹5 lakh per family per year for hospitalisation at any empanelled government or private hospital — cashless and paperless.

Who Is Covered?

Eligibility is based on the Socio-Economic and Caste Census 2011 (SECC 2011). Rural households qualifying under any of the 7 deprivation criteria (D1–D7) and urban households in 11 occupational categories are automatically covered.

Ayushman Vay Vandana Yojana (Age 70+)

Any Indian resident aged 70 or above qualifies for a separate ₹5 lakh/year top-up cover under Ayushman Vay Vandana Yojana — regardless of income, existing insurance, or SECC status. Only Aadhaar is required. Launched 29 September 2024.

Delhi Residents

Delhi is currently the only state/UT that has not implemented PM-JAY. Delhi residents should explore the Delhi government's own health assistance schemes.

What Is Covered?

  • Over 1,929 medical procedures including surgery, medical and daycare treatments
  • Pre-hospitalisation (up to 3 days) and post-hospitalisation (up to 15 days) expenses
  • All pre-existing conditions covered from day one
  • No cap on family size or age

How to Check and Use

  1. Check at mera.pmjay.gov.in (OTP login with your mobile) or call 14555 / 1800-111-565
  2. At the hospital, show your Aadhaar card. An Ayushman Mitra will assist you
  3. No upfront payment required for covered procedures

Source: National Health Authority (nha.gov.in); PIB; SECC 2011. Information verified July 2026.

Frequently Asked Questions

My name was on the PM-JAY list earlier but I cannot find it now. What should I do?

Beneficiary lists are maintained by state governments and can be updated. Call the PM-JAY helpline at 14555 or visit the nearest Common Service Centre (CSC) or empanelled hospital's Ayushman Mitra desk with your Aadhaar card for assistance. You can also check beneficiary.nha.gov.in.

Can I use PM-JAY at a private hospital?

Yes. PM-JAY covers treatment at both government and empanelled private hospitals. Check the list of empanelled hospitals in your area at hospitals.pmjay.gov.in. Show your Aadhaar and the Ayushman e-card at the hospital.

Is there a limit on the number of family members covered?

No. PM-JAY covers the entire family with no cap on family size and no age restriction. The ₹5 lakh annual cover is per family, not per person.

I already have a private health insurance policy. Can I still use PM-JAY?

Yes. PM-JAY benefits are independent of other health insurance policies. You can use PM-JAY for any covered treatment at empanelled hospitals regardless of other insurance you hold. For Ayushman Vay Vandana Yojana (age 70+), the benefit is in addition to any existing cover.

Does PM-JAY cover OPD (outpatient) expenses?

No. PM-JAY covers inpatient (hospitalisation) expenses only — procedures requiring at least one overnight stay, or approved daycare procedures. Outpatient consultations, medicines bought outside hospital, and diagnostic tests without hospitalisation are not covered.

Disclaimer: This tool provides an indicative assessment and does not constitute an official PM-JAY eligibility determination. Actual eligibility is determined by your state government's SECC 2011-based beneficiary list. Always verify at mera.pmjay.gov.in or by calling 14555 before assuming coverage. Information verified against NHA guidelines and PIB releases as of July 2026.

Logic mapped to Finance Act 2026 and Section 139(1) View Editorial Policy

Last Fact-Checked: | Source: Income Tax Act, 1961

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