The Ayushman card & PM-JAY, explained
Ayushman Bharat PM-JAY (Pradhan Mantri Jan Arogya Yojana) gives eligible families health cover of up to ₹5 lakh a year for cashless hospital treatment. Here is what the scheme covers, who qualifies, and how it differs from your free ABHA health ID.
Ayushman Bharat explainer
What is Ayushman Bharat PM-JAY?
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a government health-insurance scheme that provides eligible families with health cover of up to ₹5 lakh per family, per year for secondary and tertiary hospitalisation. It is run by the National Health Authority.
The scheme is designed to be cashless and paperless for the beneficiary — when a covered treatment is needed at an empanelled hospital, the patient does not pay for it out of pocket at the point of care, up to the family cover limit.
The cover applies to a defined set of treatment packages across surgical, medical and day-care procedures. It is meant to protect families from the high cost of hospital treatment, so a serious illness does not become a financial crisis.
What the Ayushman card gives you
The Ayushman card identifies you as a PM-JAY beneficiary so you can access the scheme’s benefits.
Up to ₹5 lakh a year
Health cover of up to ₹5 lakh per eligible family, per year, for secondary and tertiary hospitalisation — shared across all family members.
Cashless treatment
Covered treatment at empanelled hospitals is cashless and paperless for the beneficiary at the point of care.
Empanelled hospitals
Use the cover at public and empanelled private hospitals across India that are part of the PM-JAY network.
Covers many procedures
The scheme includes a wide range of defined treatment packages spanning surgery, medical care and day-care procedures.
Who is eligible for the Ayushman card?
Eligibility for PM-JAY is decided by the government, not by the beneficiary. It is based on the deprivation and occupational criteria drawn from the Socio-Economic Caste Census (SECC) 2011 — specified deprivation categories for rural households, and identified occupational categories for urban households.
Many states also extend the scheme to additional groups beyond the central criteria, so exact coverage can vary by state. Because of this, the reliable way to know your status is to check the official beneficiary list rather than assume.
How to check if you are eligible
- Check your name in the official PM-JAY beneficiary list through the government’s channels.
- Use the official Ayushman app to search for your family’s eligibility.
- Ask at the Ayushman Mitra / help desk of an empanelled hospital, who can verify your status.
ExaHealth does not determine eligibility or issue Ayushman cards. Eligibility is set by the government and the National Health Authority — always confirm through official channels.
ABHA card vs Ayushman card — what’s the difference?
They sound similar and are both part of India’s health system, but they do completely different jobs. One organises your records; the other pays for your treatment.
| ABHA (Health ID) | Ayushman / PM-JAY | |
|---|---|---|
| What it is | A digital health ID for your medical records under the Ayushman Bharat Digital Mission (ABDM). | A health-insurance entitlement under the PM-JAY scheme for eligible families. |
| What it gives you | A 14-digit number and address to link and share lab reports, prescriptions and hospital records. | Up to ₹5 lakh a year of cashless hospital cover at empanelled hospitals. |
| Who can get it | Everyone in India — no eligibility criteria. | Only families that meet the scheme’s eligibility criteria (see below). |
| Cost | Free to create and use. | Free for eligible beneficiaries — no premium is paid by the family. |
| Run by | National Health Authority (ABDM). | National Health Authority (PM-JAY). |
| Main purpose | Organise and carry your health records digitally. | Pay for hospital treatment when you need it. |
In short: everyone can create a free ABHA to manage their records, while the Ayushman card is a health-insurance entitlement for eligible families only.
How to use your Ayushman card at hospitals
- 1
Confirm you are a beneficiary
Your family must appear in the PM-JAY beneficiary list based on the scheme’s eligibility criteria.
- 2
Get your Ayushman card
Eligible beneficiaries can be verified and issued an Ayushman card through official channels such as an empanelled hospital or the government’s Ayushman app.
- 3
Go to an empanelled hospital
Visit a hospital that participates in PM-JAY and approach the Ayushman Mitra / help desk.
- 4
Verify and get cashless care
Staff verify your identity against the beneficiary list; covered treatment is then provided cashless up to the family cover limit.
Where ExaHealth fits in
ExaHealth is not a government body. We do not issue Ayushman (PM-JAY) cards and we do not decide who is eligible — that is entirely the government and the National Health Authority.
What we do help with is the digital records side of India’s health ecosystem. ExaHealth helps you understand the Ayushman Bharat Digital Mission (ABDM) and create your free ABHA health ID, so your lab reports, prescriptions and hospital records live in one secure, consent-controlled place.
Whether or not you are eligible for PM-JAY, an ABHA is free and useful for everyone. Learn more about ABDM.
Ayushman card — frequently asked questions
Is the Ayushman card the same as ABHA?
No. They are different things run under the same National Health Authority. The Ayushman (PM-JAY) card is a health-insurance entitlement that can pay for hospital treatment up to ₹5 lakh a year for eligible families. ABHA is a free digital health ID that anyone can create to link and share their medical records. You can have an ABHA even if you are not eligible for PM-JAY.
Who is eligible for Ayushman Bharat PM-JAY?
Eligibility is decided by the government based on deprivation and occupational criteria from the SECC 2011 data — rural households in specified deprivation categories and workers in identified urban occupational categories. Several states also extend the scheme to additional groups. Eligibility is not something you set yourself; it is determined by the scheme and can be checked against the official beneficiary list.
How much cover does PM-JAY give?
PM-JAY provides health cover of up to ₹5 lakh per eligible family, per year, for secondary and tertiary hospitalisation. The amount is shared across the whole family rather than per person.
Is the Ayushman card free?
Yes. For eligible beneficiaries the scheme is free — there is no premium, and covered treatment at empanelled hospitals is cashless at the point of care.
How do I check if I am eligible for the Ayushman card?
You can check whether your family is in the beneficiary list through official government channels — for example the Ayushman app, the scheme’s official website, or the Ayushman Mitra help desk at an empanelled hospital. ExaHealth does not determine PM-JAY eligibility; that is decided by the government and National Health Authority.
Does ExaHealth issue Ayushman cards?
No. ExaHealth is not a government body and does not issue Ayushman (PM-JAY) cards or decide eligibility. We help you understand India’s digital health ecosystem (ABDM) and create your free ABHA health ID so your records stay organised in one place.
Start with your free ABHA health ID
Whatever your PM-JAY status, create a free ABHA and bring every report into one secure place. It only takes a couple of minutes.
Create your free ABHA