- Launched in Jharkhand, PMJAY is the world’s largest health insurance program that offers coverage of up to ₹5 lakhs per family.
- Benefits over 12 crore poor and vulnerable families, which equals about 55 crore people, representing the bottom 40% of India's population.
- Other benefits include universal healthcare access, women’s healthcare, covering over 1500 medical procedures, and job opportunities for medical professionals.
- The ABHA card is a 14-digit digital health ID assigned to each citizen, that connects users to healthcare services across India, linking their records with empanelled hospitals, clinics, and labs.
What is Ayushman Bharat Yojana (PMJAY)?
Ayushman Bharat Yojana is a key health program launched by the Indian government, based on the National Health Policy 2017. Its goal is to ensure universal healthcare coverage, providing medical assistance to everyone irrespective of their economic background, gender, age, or other differentiating factors.
Instead of focusing on specific or limited health services, Ayushman Bharat aims to provide a broad and complete healthcare system, addressing all aspects of health, from prevention and health promotion to treatment and care at primary, secondary, and advanced hospital levels.
One of the key components of Ayushman Bharat is PMJAY (Pradhan Mantri Jan Arogya Yojana). Launched on 23 September 2018, in Jharkhand by Prime Minister Narendra Modi, PMJAY is world’s largest health insurance program that offers benefits of up to 5 lakhs per family each year for hospitalization related to secondary and tertiary care. This scheme benefits over 12 crore poor and vulnerable families, which equals about 55 crore people, representing the bottom 40% of India’s population. The families covered under this scheme are selected based on poverty and occupation criteria from the 2011 Socio-Economic Caste Census (SECC) for rural and urban areas.
Top 7 Benefits of Ayushman Bharat Yojana (PMJAY)
Earlier, government-funded health insurance schemes in India had coverage limits between ₹30,000 and ₹3,00,000 per family annually. However, with the introduction of PMJAY scheme, benefits of Ayushman card can now be claimed up to 5 lakhs per eligible family each year for specific secondary and tertiary medical treatments. The top 10 benefits of the PMJAY scheme are:
- ₹5 Lakh Health Insurance Coverage for Families
The PMJAY (Pradhan Mantri Jan Arogya Yojana) provides health insurance coverage of ₹5 lakhs per family. This policy covers expenses for 3 days before hospitalization and up to 15 days after hospitalization, including both intensive and regular healthcare services.
- No Age or Family Size Limitations for Coverage
Ensures that all families listed in the SECC database who meet the criteria will get coverage. There are no age limits or family size restrictions, ensuring everyone, including women, girl children, and the elderly, are covered.
- Targeted Coverage for 10 Crore Poor Families
The scheme aims to provide health protection to about 10 crore families across India, covering 8 crore rural families and 2 crore urban families, focusing on the poor and lower-middle-class sections. The eligible families will be determined based on the latest Socio-Economic Caste Census (SECC) data.
- Extensive Coverage for Secondary and Tertiary Care
The PMJAY covers major secondary and tertiary care hospitalization, offering around 1,350 medical packages. These include daycare treatments, surgeries, medicines, diagnostic tests, transportation, food, and accommodation costs.
- Free and Cashless Treatment at Selected Hospitals
Beneficiaries can access free, paperless, and cashless treatment at government and selected private hospitals. The scheme especially prioritizes coverage for women, girl children, and the elderly.
- Nationwide Portability with 24×7 Support
6. With national portability, PMJAY services are available across India, with multiple private hospital tie-ups. For help or to address any issues, a 24×7 helpline (14555) is available for assistance.
- Immediate Coverage of Pre-Existing Conditions
From day one, all pre-existing illnesses are covered, and no hospital can refuse treatment under PMJAY. Beneficiaries do not need to pay anything for the treatment, and hospitals are prohibited from charging them.
Ayushman Bharat Yojana (PMJAY) is a transformative health insurance scheme that ensures affordable and accessible healthcare for millions of poor and vulnerable families across India. With a coverage of up to ₹5 lakh per family, the scheme offers extensive benefits, including free and cashless treatment, nationwide portability, and immediate coverage for pre-existing conditions.
By removing age and family size restrictions, PMJAY prioritizes inclusivity, offering a lifeline to those in need, particularly women, children, and the elderly. Through this ambitious initiative, the government is paving the way for universal healthcare access, improving the quality of life for millions and contributing to a healthier and more equitable India.
