AB PM-JAY at 8 years: 13.25 crore admissions worth ₹2.03 lakh crore

AB PM-JAY: what happened?

One big hospital bill can push a poor family into debt. PM-JAY is the Government’s answer to that risk. On its eighth birthday, PIB put out a backgrounder with the latest numbers. Read it as a report card on India’s march towards universal health coverage.

• PM-JAY has funded about 13.25 crore hospital admissions worth up to ₹2.03 lakh crore.
• Over 48.51 crore people hold Ayushman cards (as of 21 September 2026).
• It covers 1,961 procedures across 27 medical specialties.
• Over 1.36 crore senior citizens now hold Ayushman Vay Vandana cards.

What is AB PM-JAY?

• A public health assurance scheme for secondary and tertiary care, that is, hospital stays.
• It is one of the world’s largest public health schemes.
• It is cashless: the family pays nothing at the empanelled hospital for covered treatment.
• It also absorbed families earlier covered under the Rashtriya Swasthya Bima Yojana (RSBY).

Who is eligible?

• Rural families: picked from the Socio-Economic Caste Census (SECC) 2011 on deprivation criteria D1, D2, D3, D4, D5 and D7.
• D1 is a one-room kucha house; D5 is an SC/ST household; D7 is a landless household living on manual casual labour.
• Urban families: 11 occupational groups, such as ragpickers, domestic workers, street vendors, construction workers and rickshaw pullers.
• March 2024: about 37 lakh families of ASHAs, anganwadi workers and helpers added.
• 11 September 2024: all senior citizens aged 70 and above added, about 6 crore people, regardless of income.
• Others added through schemes: BOCW workers, road accident victims under PM-RAHAT, transgender persons under SMILE, children under PM CARES for Children, sanitation workers under NAMASTE, and PVTGs under PM-JANMAN.

What are the four pillars of Ayushman Bharat?

Which constitutional provisions back health schemes?

• Article 47 (Directive Principle): the State shall regard the raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties.
• Seventh Schedule, List II (State List), entry 6: public health and sanitation; hospitals and dispensaries.
• So health is a State subject. That is why PM-JAY runs as a centrally sponsored scheme with cost sharing.

How is PM-JAY funded?

Union budget estimate for 2026-27: ₹9,500 crore.

What do the numbers show?

How does a patient use PM-JAY?

1. Family is found eligible (SECC 2011, occupation, or an added group)
2. Member gets an Ayushman card
3. Patient goes to any of the 38,000-plus empanelled hospitals
4. Treatment from the 1,961-procedure list, cashless
5. Claim is settled with the hospital, not the patient

Why does AB PM-JAY matter?

What are the challenges in AB PM-JAY?

• Of about 6 crore senior citizens made eligible, only over 1.36 crore hold Vay Vandana cards so far.
• About 33% of Indians hold Ayushman cards, so the scheme reaches the poorer third; the middle group must still pay on its own.
• Rural eligibility still rests on SECC 2011 data, now 15 years old.
• The scheme pays for hospital care; prevention depends on the Arogya Mandirs doing their job.

What should be done next on AB PM-JAY?

• Push enrolment of the 70-plus group through camps and ASHAs.
• Refresh the beneficiary base beyond SECC 2011.
• Keep growing primary care so fewer people need hospital stays.
• Use ABHA records to track quality and stop misuse of claims.

What can Prelims ask on AB PM-JAY?

• AB PM-JAY launched on 23 September 2018.
• Cover: up to ₹5 lakh per family per year, secondary and tertiary care.
• Rural eligibility: SECC 2011 criteria D1 to D5 and D7; urban: 11 occupational groups.
• Seniors 70+ added on 11 September 2024 (Ayushman Vay Vandana card).
• Fund sharing 60:40; 90:10 for NE States, Himachal Pradesh, Uttarakhand and J&K.
• PM-ABHIM launched 25 October 2021 with ₹64,180 crore.

How to write about AB PM-JAY in Mains

Practice question (15 marks, 250 words): Ayushman Bharat PM-JAY has widened access to hospital care, but universal health coverage needs more. Critically examine.

• Intro: launch, ₹5 lakh cover, 13.25 crore admissions.
• Gains: cashless care, new groups (70+, ASHAs), digital IDs.
• Gaps: SECC base, low Vay Vandana uptake, focus on hospital care.
• Link with the other three pillars: AAM, ABDM, PM-ABHIM.
• Way forward and Article 47.