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A complete guide to eligibility, coverage, recent state rollouts and the numbers behind India's flagship public health insurance program
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is India's flagship public health insurance scheme, designed to give economically vulnerable families access to free, cashless secondary and tertiary medical care. Launched on September 23, 2018, in Ranchi, Jharkhand, the scheme is administered by the National Health Authority under the Ministry of Health and Family Welfare.
At its core, PM-JAY provides ₹5 lakh (roughly $5,900) in annual health coverage per family for treatment at empaneled public and private hospitals, with no restrictions on family size, age, or gender among eligible beneficiaries.
PM-JAY's eligibility was originally based on the Socio Economic and Caste Census (SECC) 2011, targeting the bottom 50% of India's population by economic status — approximately 10 crore households, or around 500 million people.
In September 2024, the scheme was significantly expanded to include all Indian citizens aged 70 and above, regardless of their income or existing economic eligibility, with an additional ₹5 lakh individual cover for senior citizens on top of existing family coverage. This made India's elderly population, one of the country's most healthcare-vulnerable groups, universally eligible for the scheme for the first time.
Unlike traditional insurance, PM-JAY beneficiaries do not pay premiums or file reimbursement claims. Coverage works as follows:
Since its 2018 launch, PM-JAY has become one of the largest publicly funded health insurance programs in the world by number of eligible beneficiaries:
| Metric | Figure |
|---|---|
| Target beneficiaries | ~50 crore (500 million) Indians |
| Hospital admissions recorded | Over 116.9 million |
| Value of treatments sanctioned | ₹1.73 lakh crore |
| Annual cover per family | ₹5 lakh |
| Additional senior citizen cover | ₹5 lakh (individual, 70+) |
State-level data has also highlighted the scheme's financial impact on households: in Bihar, for example, official figures cite savings of over ₹1,000 crore for beneficiaries in a single year who would otherwise have paid out of pocket for hospital care.
PM-JAY implementation is a joint effort between the central government and individual states, and several states have joined or formally launched the scheme only in the past two years:
These rollouts matter because PM-JAY's reach has historically depended on individual state governments opting in and co-funding the program — meaning coverage on paper does not always translate to coverage on the ground until a state formally implements it.
Healthcare costs are one of the leading causes of household debt and impoverishment in India, particularly for families without access to employer-provided or private health insurance. By removing the premium and upfront-payment barriers that keep many low-income families from seeking hospital care, PM-JAY is designed to prevent medical expenses from pushing vulnerable households into poverty — a phenomenon health economists often call "catastrophic health expenditure."
The 2024 expansion to all senior citizens also reflects a policy shift toward recognizing age, not just income, as a health-vulnerability factor worth covering universally.
Is Ayushman Bharat PM-JAY free?
Yes. Eligible beneficiaries do not pay premiums, and treatment at empaneled hospitals is cashless up to the ₹5 lakh annual family limit.
Who is eligible for Ayushman Bharat?
Families identified as economically vulnerable under the SECC 2011 census are eligible, along with, since September 2024, all Indian citizens aged 70 and above regardless of income.
Does PM-JAY cover private hospitals?
Yes, treatment is available at both empaneled public and private hospitals across India, not limited to government facilities.
Which states recently joined the scheme?
Delhi and Odisha implemented PM-JAY in April 2025, and West Bengal formally launched the scheme on August 16, 2026.
How is PM-JAY different from regular health insurance?
There are no premiums to pay and no reimbursement claims to file — the government settles bills directly with empaneled hospitals, making it cashless for eligible beneficiaries.
Nearly eight years after its launch, Ayushman Bharat PM-JAY has grown into one of the world's largest public health coverage programs by eligible population, with continued expansion — most recently to senior citizens nationwide and to new states like West Bengal in 2026 — steadily closing gaps in India's healthcare safety net. Its scale makes it a central pillar of India's public health policy, even as coverage in practice still depends on state-level implementation and hospital participation.
