Ayushman Bharat PMJAY Eligibility Checker
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) provides ₹5 lakh per family per year in cashless hospitalisation cover to economically vulnerable households, based on SECC 2011 deprivation and occupational criteria. Since September 2024, the Ayushman Vay Vandana Yojana extends a separate ₹5 lakh/year cover to every resident aged 70 and above, regardless of income. This tool gives you a quick, informational read on your likely eligibility — always confirm your final status on the official portal.
How PM-JAY Eligibility Actually Works
PM-JAY eligibility is not based on applying or filling a form — it is determined by whether your household appears in the SECC 2011 (Socio-Economic Caste Census) database under specific deprivation (rural) or occupational (urban) categories. There is no income-based application process for the base scheme.
Rural Deprivation Criteria (D1–D7)
Rural households are automatically included if they meet at least one of: D1 (only one room with kucha walls/roof), D2 (no adult member aged 16–59), D3 (female-headed household with no adult male member 16–59), D4 (disabled member, no able-bodied adult), D5 (SC/ST household), or D7 (landless households earning mainly from manual casual labour). D6 is not used as a PM-JAY inclusion criterion. Destitute households, manual scavengers, primitive tribal groups, and legally released bonded labourers are automatically included regardless of other criteria.
Urban Occupational Categories
Urban households are covered if the primary earner works in one of 11 recognised informal occupations — ragpicker, beggar, domestic worker, street vendor/hawker/cobbler, construction worker, sanitation worker, home-based artisan, transport worker (driver, rickshaw puller), shop assistant/peon/delivery worker, electrician/mechanic, or washerman/chowkidar.
Ayushman Vay Vandana Yojana — Universal Cover for 70+
Announced 29 September 2024, this scheme gives every Indian resident aged 70 and above a separate ₹5 lakh/year cover, completely independent of income, SECC 2011 status, or existing PM-JAY/CGHS/ECHS/private insurance. The only document required is an Aadhaar card. This cover is per senior citizen, not per family — multiple eligible seniors in one household each get their own ₹5 lakh cover.
Common Exclusion Signals
Based on commonly published SECC 2011 exclusion guidance (not a single official statute), households are typically excluded if a member pays income tax, is a current/former regular government employee, owns a motorised vehicle, owns over 2.5 acres of irrigated land with mechanised equipment, or already lives in a pucca house. These signals are indicative, not exhaustive or final — only the official Beneficiary Identification System can confirm your status.
Coverage Details
PM-JAY provides ₹5 lakh per family per year for secondary and tertiary care hospitalisation, covering 3 days pre-hospitalisation and 15 days post-hospitalisation expenses, with no restriction on family size, age, or gender, and pre-existing conditions covered from day one. Some states (e.g. Maharashtra's MJPJAY, Tamil Nadu's CMCHIS) run their own complementary scheme alongside PM-JAY, funded entirely by the state.
State Coverage Status
As of 2026, PM-JAY has been implemented in 36 states/UTs, with West Bengal being the most recent to join. Delhi remains the only state/UT that has not implemented AB PM-JAY. If you live in Delhi, check the Delhi government's own health schemes instead.
How to Verify Your Eligibility Officially
- Visit mera.pmjay.gov.in and use the "Am I Eligible" tool (login via mobile OTP)
- Visit your nearest empanelled hospital or Common Service Centre (CSC) and ask the Ayushman Mitra to check your status
- Call the toll-free helpline 14555 (multi-lingual, 24x7)
Frequently Asked Questions
Do I need to apply for PM-JAY, or am I automatically enrolled?
There is no separate application for the base PM-JAY scheme — eligibility is determined by your household's presence in the SECC 2011 database. You simply need to verify your status and get your Ayushman Card issued at mera.pmjay.gov.in, a Common Service Centre, or an empanelled hospital.
I am 70+ but my family already has a PM-JAY card. Do I get extra coverage?
Yes. The Ayushman Vay Vandana Yojana gives every resident aged 70 and above a separate ₹5 lakh/year cover, in addition to and independent of any existing family PM-JAY cover. If multiple seniors live in one household, each gets their own ₹5 lakh cover.
I live in Delhi — can I get a PM-JAY card?
Delhi has not implemented AB PM-JAY as of 2026. Delhi residents should check the Delhi government's own health insurance schemes (such as the Delhi Arogya Kosh) instead, as PM-JAY's central scheme has not been rolled out in the NCT of Delhi.
What if this tool says I'm "likely eligible" but I want a definite answer?
This tool is an informational guide based on commonly published SECC 2011 criteria — it cannot give a legally binding determination. The only way to get a definite answer is through the official Beneficiary Identification System at mera.pmjay.gov.in, by visiting an empanelled hospital, or by calling 14555.
Does PM-JAY cover pre-existing diseases?
Yes. All pre-existing medical conditions are covered from day one of enrollment under PM-JAY — there is no waiting period, unlike most private health insurance policies.
Recommended Eligibility Tools
Informational only: This tool provides a guideline based on publicly available SECC 2011 deprivation and occupational criteria. It is not an official eligibility determination and does not replace verification via the official PM-JAY Beneficiary Identification System (mera.pmjay.gov.in) or the 14555 helpline. Eligibility criteria and state implementation status are subject to change by the National Health Authority and respective state governments.