Ayushman Bharat PM-JAY

The one route anyone can use is age. Every citizen aged 70 and above is now eligible, whatever their income.

Who is eligible for Ayushman Bharat PM-JAY?

The base list came from the Socio-Economic Caste Census. The Cabinet’s own note says 50 crore people were brought in “on the basis of economic caste census”. It started with 10.74 crore poor and vulnerable families — the bottom 40% of the population. In January 2022 the government revised that base from 10.74 crore to 12 crore families, to allow for population growth since 2011.

Two groups were added later. ASHA workers, Anganwadi workers and Anganwadi helpers were brought in with their families. And in September 2024 the Cabinet extended cover to every senior citizen aged 70 and above, regardless of income.

What does the ₹5 lakh cover for senior citizens actually mean?

It depends on whether your family was already covered. The Cabinet note is precise on this. If the family is already a PM-JAY beneficiary, the 70+ member gets an extra top-up of up to ₹5 lakh a year. That top-up is theirs alone. They do not share it with members under 70.

If the family was not covered before, the 70+ household gets ₹5 lakh a year on a family basis. The card issued is a distinct one, known as the Ayushman Vay Vandana card.

There is a choice to make if you already have government cover. Senior citizens under CGHS, ECHS or the Ayushman CAPF scheme must pick one — their existing scheme or PM-JAY. You cannot hold both. But a private health policy is no bar. The Cabinet clarified that people aged 70 and above who hold private insurance or ESI cover remain eligible for PM-JAY.

How do you check if your family is on the list?

Use the official beneficiary portal or an Ayushman Mitra help desk at an empanelled hospital. You will need a ration card or an Aadhaar-linked identity to be matched against the database. Common service centres also do the check and the card printing.

Do not pay an agent for this. The check is free and the card is free. Anyone charging you a fee to “get you an Ayushman card” is selling you something the state gives away.

Where can you use the card?

Only at an empanelled hospital, public or private. Treatment is cashless and portable, so a beneficiary from Bihar can be treated in Delhi. Thirty-five states and union territories were implementing the scheme after Delhi signed its agreement on 5 April 2025.

Check empanelment before admission, not after. A hospital that is not on the list will bill you in full, and PM-JAY does not reimburse a bill you have already paid. This is an assurance scheme funded by the government, as the health ministry stresses, not an insurance policy with a claims counter.

What PM-JAY does not do

This is where honest advice matters. PM-JAY is hospitalisation cover. It does not pay for outpatient consultations, routine medicines or diagnostics outside an admission. It does not give you a private room by right. And your ₹5 lakh is a family pool — one serious illness can exhaust it for everyone.

If you have PM-JAY and can afford a premium, a top-up policy alongside is worth considering. If you are not eligible at all, PM-JAY is not a plan you can wait for. Read our guides to health insurance, senior citizen health plans and room rent limits instead.

The scheme is doing real work. The health minister said in April 2025 that out-of-pocket health spending had fallen from 62% in 2014 to 38%. That is his figure, not ours. It still leaves a lot for a family to fund.