Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana: Expanding Health Coverage for Millions
Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a key initiative by the Government of India aimed at providing comprehensive health coverage of up to ₹5 lakh per eligible beneficiary family each year. This scheme facilitates secondary and tertiary care hospitalization across 27 medical specialties, encompassing a total of 1,961 procedures.
Since January 2022, the scheme’s eligibility criteria have been broadened, increasing the beneficiary base from 10.74 crore families to 12 crore families. This expansion integrates various databases, including the Socio-Economic Caste Census (SECC), Antyoday Anna Yojana (AAY), and the National Food Security Act (NFSA).
In March 2024, the program further extended its reach to include 37 lakh Accredited Social Health Activists (ASHAs), Anganwadi Workers (AWWs), Anganwadi Helpers (AWHs), and their families. Additionally, it now covers 6 crore senior citizens aged 70 and above from 4.5 crore families, regardless of socio-economic status, through the issuance of Ayushman Vay Vandana cards.
Many states and Union Territories (UTs) implementing AB-PMJAY have also utilized non-SECC data sources, including state-specific datasets and the National Food Security Act, to enhance the beneficiary pool. This ongoing evolution reflects the government’s commitment to improving healthcare access for vulnerable populations across the country.
GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE
LOK SABHA STARRED QUESTION NO. 486
TO BE ANSWERED ON THE 4TH APRIL, 2025
AYUSHMAN BHARAT PRADHAN MANTRI JAN AROGYA YOJANA
Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:
(a) the eligibility criteria and norms prescribed for availing the benefits under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana; and
(b) the amount of health insurance cover fixed by the Government for availing medical treatment under the said scheme?
ANSWER
THE MINISTER OF HEALTH AND FAMILY WELFARE
(SHRI JAGAT PRAKASH NADDA)
STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 486 FOR 4TH APRIL, 2025
Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a flagship scheme of the Government which provides health cover of Rs. 5 lakh per eligible beneficiary family per year for secondary and tertiary care hospitalization in 27 different medical specialties corresponding to 1961 procedures.
The eligibility criteria under AB-PMJAY have evolved over time. Since January 2022, the beneficiary base of AB-PMJAY has been expanded from 10.74 crore families to 12 crore families, incorporating various databases such as Socio-Economic Caste Census (SECC), Antyoday Anna Yojana (AAY), National Food Security Act (NFSA) etc.
In March 2024, the eligibility criteria under the scheme were expanded to include 37 lakh Accredited Social Health Activists (ASHAs), Anganwadi Workers (AWWs), Anganwadi Helpers (AWHs) and their families. Recently, the scheme has been expanded to cover 6 crore senior citizens of age 70 years and above belonging to 4.5 crore families irrespective of their socio-economic status through Ayushman Vay Vandana cards.
Many of the States and Union Territories (UTs) implementing AB-PMJAY have further expanded the beneficiary base under the scheme using non-SECC data sources (including National Food Security Act, State specific datasets).
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