Ayushman Bharat also known as Pradhan Mantri Jan Arogya Yojana (PM JAY) is the health insurance scheme launched by the Indian government on September 23, 2018 to help the poor and lower middle-class people to get cashless treatment in empanelled private and public hospitals. This Scheme is government provided insurance or health card; it covers the major hospital bills. So that poor people do not need to worry about their medical expenses. It covers 5 Lakhs of insurance per year as health benefits for a family who holds this insurance card.
This scheme is mainly to those people who have unstable jobs with irregular salaries. There is no need for paying premium by the insurance card holders. As this is funded by the government, it is free of cost.
What’s new in 2025?
This year on the 2025 budget, the Indian government has decided to include the gig workers. These are the people who works as freelancers, delivery person, part time jobs and short-term workers.
Gig workers are the people who does their job on short term. They are also called as Platform workers who gets paid for a task. They lack in protection such as health insurance and employee provident fund as they work independently and don’t work under any organization.
Also, apart from PMJAY, the gig workers will also get the E-shram card, as they are unorganized workers who don’t work under any organization.
Let us discuss further about the eligibility, key benefits, insurance coverage, and lot more about the Pradhan Mantri Jan Arogya Yojana in this article.
Who is it for?
The target of Ayushman Bharat is mainly for the daily wagers, laborers, people from low-income backgrounds, and rural areas. As they have a very low income they can’t afford for medical expenses. To reduce the burden of hospital bill and overcome the fear of poor people, our government has initiated this scheme.
All senior citizens above the age of 70 years irrespective of their income. They get a separate 5 Lakhs as top up coverage.
On union budget of 2025, Indian government has decided to add gig workers like delivery workers, app-based cab drivers, freelancers and part time digital workers.
Senior citizens
Senior citizens above the age of 70 years are eligible for AB-PMJAY. The get 5,00,000 of health coverage under this scheme.
If a senior citizen is already added in existing PMJAY , they get the additional coverage of 5 lakhs per year only for themselves.
All senior citizen irrespective of their financial status including the ex government staff can avail this scheme. There is no income limit.
Gig workers to avail PMJAY
Firstly, they need to check for their eligibility.
Then, they need to register their identity on e-shram, a website launched by the Indian government for unorganized workers.
Once they are registered, they will get the Universal Account Number UAN and an ID Card. This ID card helps the gig workers to get the benefits of the government like Ayushman Bharat.
Also, gig workers after getting the shram ID card gets the health benefits coverage under AM-PMJAY.
Benefits for Ayushman Bharat
There are wide variety of key benefits on this health care scheme. Let’s unleash it one by one.
Free Medical treatment: A family gets a health insurance coverage of 5 Lakhs for each year for secondary and tertiary care hospitalization. They can avail it for the serious treatment in the empanelled hospitals.
Paperless and Cashless: AB-PMJAYInsurance holder does not need to do pay any cash or doesn’t need to carry any papers means it is a digital process.
Nationwide coverage: This card can be used in all empanelled private and public hospital anywhere in India.
No age Limit: There is no age constraints. All beneficiaries from children, adult to senior citizens in the household are eligible to avail.
Prevent from debt: Many people fall into debt because of the medical expenses. This scheme prevents poor people from debts.
Pre and post hospitalization coverage: It covers the expenses of 3 days before and 15 days after hospitalization including diagnostics, treatment and medicines.
Pre Existing disease coverage: On going health issues are being covered from the very first day of enrolment to this policy.
Where to use the Ayushman Bharat card?
You can use the Ayushman Bharat card at
- All Government hospitals like health care centers.
- In the empanelled private hospitals.
To know the approved list of hospitals for AB-PMJAY. Visit the website hospital list
Benefits covered?
Eligible family are covered up to 5 Lakhs for secondary and tertiary care conditions such as
- Consultation, medical examination, Treatment
- Laboratory and diagnostic investigation
- Medicines and consumable medicines.
- Accommodation charges
- Intensive and non-intensive care charges
- Food expenses
- Medical implantation services
- Any complication charges on treatment
- Pre hospitalization charges for 3 days before
- Post hospitalization charges 15 days after.
Benefits not covered?
These are the following exclusions on benefits.
- Transplantation of Organ
- Out Patient bills and expenses
- Fertility treatment
- Surgeries related to cosmetics
- Drug Rehabilitation
Eligibility for Ayushman Bharat
Rural beneficiary
- Households belong to Scheduled class/Scheduled tribe (SC/ST)
- Family with disabled member and not a single abled person to financially support them.
- Household with no adult within the age limit of 16 to 59 years.
- Moreover, Family with no adult men within the age limit of 16 to 59 years to support.
- Family living in a single room with Kucha wall and roof.
- Also, Landless manual casual labors
Urban beneficiary
- Electrician, assembler, mechanic, and repair workers.
- Washerman
- Domestic workers
- Beggars
- Rag pickers
- Sanitation workers and sweepers
- All construction workers like mason, cookies, painter, plumber, labors, welders and load workers.
- Security guard
- Transport workers like driver, conductor, helpers, cart pullers, and rickshaw pullers.
- Hawkers, cobblers, street vendors and also others who works on street.
- Waiter, peon, delivery man, shop workers, assistant and helpers.
- Tailors, handicrafts workers, artisans and household workers.
Senior citizens for Ayushman Bharat
- 70 years and above senior citizen in families who are already covered by AB-PMJAY gets additional coverage of 5 lakhs as medical insurance only for themselves.
- If the 70 year old has no coverage under AB-PMJAY, they get the coverage of 5 lakhs separately.
- Senior citizens who are already covered by private insurance or state employee insurance are also eligible for AB-PMJAY.
- Person covered under other public health insurance like Central Government health scheme – CGHS, Ex-servicemen contributory health scheme – ECHS or Ayushman central armed police force can either opt for AB-PMJAY or continue with there existing scheme.
Gig workers for Ayushman Bharat
- App based cab drivers like ola, uber, etc.
- Freelancers
- Part time digital workers
- Delivery person who works in Zomato, Swiggy, amazon, etc.
- People who do short term tasks (e.g. working in platform like urban company)
Documents required
- Proof of address
- Identity Proof such as Aadhar card, PAN Card
- Income Certificate
- Caste Certificate
- Ration card.
Application process
Visit the official PMJAY Website and click on ‘Am I Eligible’ to know whether you are eligible for health insurance coverage.
Choose the option Beneficiary and enter the CAPTCHA, mobile number, OTP and login.
Select the STATE, SUB SCHEME, DISTRICT, SEARCH BY. Search by has the option of Family ID, Aadhar card, PMJAY ID. Based on the selection enter the required data and click search.
In case eligible, your data will appear on the screen with the status ‘Identified’
If the status is Unidentified, Click on ‘Action’.
Your Aadhar number with the last four digit will be visible. Enter the OTP you received and read the consent form and verify it.
It will redirect to e-KYC, you can do it using Aadhar OTP, Fingerprint or IRIS Scan.
A consent form appears, read the instruction and click on Allow
Capture the photograph and enter all the information needed and submit it. If your match score is 80% it will be automatically approved. If less than 80% it will be sent to approval.
You can download the Ayushman card after 20 minutes.
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