Part 1: Ayushman Bharat (PM-JAY) — India’s Biggest Health Insurance

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is the world’s largest government-funded health insurance scheme. It provides ₹5 Lakh per family per year for free, cashless treatment at any empanelled hospital in India.

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1. Coverage at a Glance

Feature	Details
Annual Coverage	₹5,00,000 per family
Premium	₹0 (Government pays)
Beneficiaries	~55 Crore Indians (~40% of population)
Hospitals	30,000+ empanelled (govt + private)
Packages	1,900+ medical/surgical procedures
Pre-existing Diseases	Covered from Day 1
Family Size Limit	No limit
Age Limit	No limit
Portability	Can use in any state

2. What’s Covered?

• All surgeries — Cardiac bypass, joint replacement, cancer surgery, brain surgery, kidney transplant.
• Cancer treatment — Chemotherapy, radiation therapy, surgical oncology.
• Cardiac care — Angioplasty, pacemaker, valve replacement.
• Dialysis — Kidney dialysis sessions.
• Maternity — Normal delivery, C-section.
• Mental health — Inpatient psychiatric care (select packages).
• Pre-hospitalization — 3 days before admission (tests, medicines).
• Post-hospitalization — 15 days after discharge (follow-up, medicines).
• Day-care procedures — Cataract surgery, chemotherapy sessions, dialysis.

3. Who is Eligible?

Automatically Eligible:

• Families identified in the SECC 2011 (Socio-Economic Caste Census) database.
• Rural criteria: Families with kutcha house, no adult earning member, female-headed households, SC/ST families, landless labourers, manual scavengers, destitute, beggars.
• Urban criteria: Rag pickers, street vendors, domestic workers, construction workers, plumbers, painters, security guards, coolies, rickshaw pullers, sweepers, etc.

Special Category (2024 Expansion):

• ALL citizens aged 70+ years are now eligible regardless of income or existing insurance.

NOT Eligible:

• Income-tax payers, government employees (CGHS/ESI covers them), families not in the SECC database.

4. How to Check Eligibility & Get Your Card

Step 1: Check Online

• Go to beneficiary.nha.gov.in
• Enter your mobile number → OTP → Search by Aadhaar, ration card, or name.

Step 2: Get Your Golden Card

• Online: Complete e-KYC on the portal using Aadhaar OTP or face authentication. Download instantly.
• Offline: Visit any Common Service Centre (CSC) or the Ayushman Mitra desk at empanelled hospitals. Carry Aadhaar + ration card.

Step 3: Use It

• Walk into any empanelled hospital → Show your Ayushman card + Aadhaar → Treatment is cashless.

5. Helplines

• National Helpline: 14555 (24/7)
• Toll-Free: 1800-111-565
• Website: pmjay.gov.in

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Next: Part 2 — Central Government Hospitals