Ayushman Bharat Eligibility: Who Is Eligible for Ayushman Card and ₹5 Lakh Health Cover?
Ayushman Bharat Eligibility 2026: Who Is Eligible for Ayushman Card and ₹5 Lakh Health Cover?
Introduction
Ayushman Bharat Eligibility 2026 is an important topic for families who want to know whether they can receive healthcare benefits under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
Ayushman Bharat PM-JAY is a Government of India health assurance scheme designed to provide financial protection for eligible beneficiaries against healthcare expenses, particularly for covered secondary and tertiary hospitalisation.
Under the scheme, eligible families can receive health cover of up to ₹5 lakh per family per year for covered services at empanelled hospitals. The benefit is designed on a family-floater basis for the eligible beneficiary population.
There is also an important expansion for senior citizens. All Indian citizens aged 70 years and above are eligible for AB PM-JAY benefits irrespective of their income or economic status, subject to the scheme’s applicable rules. The National Health Authority states that Aadhaar-based e-KYC is required for enrolment and issuance of the Ayushman card for eligible senior citizens.
This article explains Ayushman Bharat eligibility, who can get an Ayushman Card, the 70+ senior citizen rule, benefits, documents, how to check eligibility, how to get a card, hospital treatment, exclusions, FAQs and official links.
Important: Eligibility rules and state-level implementation can change. Always verify your current eligibility through the official Government of India/National Health Authority channels before relying on information for treatment.
What Is Ayushman Bharat PM-JAY?
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is a major government health assurance programme implemented nationally by the National Health Authority (NHA) along with State Health Agencies.
The scheme was created to provide financial protection to eligible people for covered healthcare services.
The scheme provides benefits through a network of empanelled public and private hospitals.
According to NHA information, PM-JAY provides coverage of up to ₹5 lakh per family per year for eligible beneficiaries for covered secondary and tertiary care hospitalisation. Benefits are portable across India, allowing eligible beneficiaries to use the scheme at empanelled hospitals outside their home state as well.
Official Ayushman Bharat Website
National Health Authority – Official Website
PM-JAY Official Website
What Is Ayushman Bharat Eligibility?
Ayushman Bharat eligibility means whether a person or family meets the conditions required to receive benefits under AB PM-JAY.
The eligibility process is not exactly the same for everyone.
There are two important areas to understand:
- Existing PM-JAY eligible families identified through the scheme’s beneficiary databases and applicable state arrangements
- Senior citizens aged 70 years and above, who are now eligible irrespective of income
This distinction is important because a person under 70 should not assume that simply being an Indian citizen automatically makes them eligible for the original PM-JAY beneficiary category.
At the same time, the 70+ expansion has changed eligibility significantly for senior citizens.
Who Is Eligible for Ayushman Bharat?
1. Senior Citizens Aged 70 Years and Above
One of the most important current eligibility rules is for senior citizens.
All Indian citizens aged 70 years or above are eligible for AB PM-JAY, regardless of their income or economic status.
This means that income is not used as an eligibility condition for this 70+ category.
The age is determined using the information recorded in Aadhaar.
For eligible senior citizens, Aadhaar-based e-KYC is mandatory for enrolment and issuance of the Ayushman card. The NHA FAQ states that Aadhaar is the only document needed for enrolment under the senior citizen scheme.
Example
Suppose a person is:
- 72 years old
- Retired
- Receiving a pension
- Earning additional income
- Covered by private health insurance
They can still be eligible for AB PM-JAY because the 70+ eligibility expansion does not impose an income limit. The NHA specifically states that senior citizens aged 70+ remain eligible even if they have private health insurance.
2. Existing Eligible PM-JAY Families
For beneficiaries who fall outside the 70+ senior-citizen expansion, PM-JAY eligibility is based on the applicable beneficiary database and eligibility criteria rather than simply being an Indian citizen.
The original PM-JAY design targeted poor and vulnerable households identified using government databases and defined deprivation and occupational criteria.
For example, the NHA’s beneficiary categories include certain rural households meeting specified deprivation criteria and certain occupational groups in urban areas.
Therefore, people below 70 should check their eligibility through the official beneficiary system rather than assuming that they qualify or do not qualify based only on income.
Ayushman Bharat Eligibility for Rural Families
The original PM-JAY identification system uses specified deprivation and occupational criteria.
Some rural beneficiary categories include households meeting certain deprivation conditions.
Examples include households with:
- Only one room with kucha walls and kucha roof
- No adult member between 16 and 59 years
- No adult male member between 16 and 59 years
- A disabled member and no able-bodied adult member
- Certain Scheduled Caste or Scheduled Tribe households
- Landless households whose major income comes from manual casual labour
The scheme also included certain automatically included vulnerable categories, as defined in the applicable beneficiary database.
These criteria come from the scheme’s beneficiary identification framework. Individual eligibility should still be checked through the official system.
Ayushman Bharat Eligibility for Urban Families
For urban areas, PM-JAY identification includes certain occupational categories.
Examples listed in the NHA beneficiary framework include:
- Ragpickers
- Beggars
- Domestic workers
- Street vendors
- Construction workers
- Plumbers
- Masons
- Labourers
- Painters
- Welders
- Security guards
- Sanitation workers
- Garden workers
- Tailors
- Artisans
- Transport workers
- Drivers
- Conductors
- Shop workers
- Delivery assistants
- Electricians
- Mechanics
- Repair workers
- Washer-men
- Chowkidars
The complete eligibility process depends on the applicable government database and state implementation.
Is There an Income Limit for Ayushman Bharat?
The answer depends on which eligibility category applies.
For citizens aged 70 years and above:
No income limit applies.
The NHA states that all senior citizens aged 70 years and above are eligible irrespective of economic status.
For other beneficiaries:
Eligibility under the original PM-JAY framework is based on the applicable beneficiary identification criteria and database, not simply on a universal income test.
Therefore, a person should use the official eligibility-checking system instead of making a decision based only on annual income.
What Is the Ayushman Card?
The Ayushman Card is used by eligible beneficiaries to access benefits under AB PM-JAY.
The card helps identify the beneficiary within the scheme.
For eligible senior citizens aged 70 and above, the NHA says a distinct Ayushman card is issued after the required enrolment and e-KYC process.
The card should be kept safely and presented according to the requirements of the empanelled hospital.
How to Check Ayushman Bharat Eligibility Online
Checking eligibility is an important step before planning treatment.
A beneficiary can use official government channels.
Step 1: Visit the Official Beneficiary Portal
Use the official National Health Authority beneficiary platform.
Ayushman Bharat Beneficiary Portal
Step 2: Follow the Login or Beneficiary Instructions
Enter the information requested by the official portal.
Step 3: Complete Verification
Depending on the category and service, the system may require identity verification or Aadhaar-based e-KYC.
Step 4: Check Beneficiary Status
The system can indicate whether the person is eligible and whether an Ayushman card can be generated or accessed.
Step 5: Generate or Access the Card
Follow the official instructions provided on the portal.
Do not give your Aadhaar OTP or other sensitive information to unknown people claiming that they can create an Ayushman card.
Ayushman Card Eligibility Through the Ayushman App
Eligible senior citizens can also use the official Ayushman ecosystem and app-based services.
The NHA’s senior citizen FAQ states that people aged 70 years and above can apply through the beneficiary portal and the Ayushman App.
Always download applications only through official sources and verify the developer information before entering personal details.
Can You Check Eligibility Offline?
Yes.
People can also seek assistance through:
- Common Service Centres (CSCs)
- PM-JAY empanelled hospitals
- Ayushman Mitras
- Official PM-JAY helpline
The NHA has advised beneficiaries to use official channels for eligibility and card-related assistance.
Ayushman Bharat Helpline Number
For PM-JAY-related information, the National Health Authority has provided the toll-free helpline:
14555
The NHA identifies 14555 as the national PM-JAY call-centre number for beneficiary queries, access to services and grievance-related assistance.
Before calling, keep basic information available if required, but do not share OTPs or passwords with anyone.
What Benefits Are Available Under Ayushman Bharat?
Eligible beneficiaries can receive covered healthcare services under the scheme at empanelled hospitals.
The scheme provides coverage of up to ₹5 lakh per family per year for eligible beneficiaries for covered services.
The benefits can include expenses associated with covered hospitalisation packages.
According to the NHA beneficiary rights document, covered benefits include:
- Treatment of pre-existing illnesses
- Medicines and drugs included in covered treatment
- Implants where included in the package
- Food during treatment
- Nursing
- General ward bed charges
- Applicable pre-hospitalisation expenses
- Applicable post-hospitalisation expenses
The NHA document specifies coverage of up to three days of pre-hospitalisation and up to 15 days of post-hospitalisation expenses for applicable covered treatment.
Is Treatment Cashless Under Ayushman Bharat?
PM-JAY is designed to provide cashless access to covered services at empanelled hospitals.
An eligible beneficiary can receive covered treatment without paying the covered package amount directly, subject to scheme rules and the hospital’s empanelment.
The scheme also provides portability across India.
This means an eligible beneficiary can seek covered treatment at an empanelled hospital outside their home state.
Can You Use Ayushman Bharat in Another State?
Yes.
One important feature of PM-JAY is national portability.
An eligible beneficiary from one state can receive covered treatment at an empanelled hospital in another state.
The NHA states that beneficiaries can obtain treatment outside their home state at empanelled hospitals through the cashless process.
This can be especially useful for families who travel for work or need specialised treatment that is available in another city or state.
Does Ayushman Bharat Cover Pre-Existing Diseases?
Yes.
The NHA’s beneficiary rights document states that pre-existing illnesses are covered under PM-JAY, subject to the applicable scheme packages and rules.
This is an important difference from some private health insurance products that may impose waiting periods for certain pre-existing conditions.
However, beneficiaries should remember that PM-JAY covers services according to its defined health benefit packages. Not every medical expense automatically becomes payable under the scheme.
Is There a Waiting Period?
For eligible senior citizens under the 70+ expansion, the NHA states that beneficiaries can begin accessing treatment from the first day of enrolment and there is no waiting period for diseases or treatment.
For treatment generally, coverage remains subject to the scheme’s applicable packages, hospital empanelment and authorisation requirements.
Is There a Family Size Limit?
PM-JAY does not generally impose a family-size limit in the original beneficiary framework.
The NHA’s FAQ states that if a family already has five members who have used PM-JAY benefits, a newborn can also receive care provided the benefit limit has not been exhausted.
However, beneficiary identification and family addition must follow the applicable rules and verification process.
What Documents Are Required for Ayushman Card?
Documents can vary according to the beneficiary category and state process.
For senior citizens aged 70 years and above, the NHA states that:
Aadhaar is the only document required for enrolment, and Aadhaar-based e-KYC is mandatory.
For other beneficiary identification processes, the required identity and family documents can depend on the applicable state and verification process.
Documents may include:
- Aadhaar
- Ration card
- Government-issued identity document
- Family identification document
- Other documents accepted under the applicable process
Do not submit documents to unofficial websites or agents unless you have verified their authority.
What If Only the Birth Year Is on Aadhaar?
This is an important question for senior citizens.
The NHA’s official FAQ states that if only the birth year is recorded in Aadhaar, January 1 of the year following the recorded birth year is considered as the date of birth for determining eligibility.
Because this can affect eligibility, senior citizens should ensure that their Aadhaar information is accurate where possible.
Can Both Husband and Wife Above 70 Get Ayushman Benefits?
Yes, eligible senior citizens aged 70 and above can be enrolled under the scheme.
The NHA states that separate enrolments are not necessarily required for every family member: after enrolling the first eligible family member, other eligible members aged 70+ can be added through the applicable “Add Member” facility.
What If a Family Already Has Ayushman Bharat?
If a family is already covered under PM-JAY and a family member is aged 70 or above, the senior citizen can receive the applicable additional benefit under the 70+ expansion.
The government has explained that senior citizens aged 70+ in already-covered families receive an additional top-up cover of up to ₹5 lakh per year for themselves, which is not shared with family members below age 70.
This is an important distinction.
It does not mean that every member of a family automatically receives ₹10 lakh.
The additional ₹5 lakh is specifically associated with eligible family members aged 70 and above.
What If a Senior Citizen Already Has Private Health Insurance?
A senior citizen aged 70 or above can still be eligible for AB PM-JAY even if they have private health insurance.
The NHA’s FAQ specifically confirms that private health insurance does not make an otherwise eligible 70+ senior citizen ineligible.
However, people covered by another government health scheme may have to choose between schemes according to the applicable government rules.
For example, the NHA states that a person receiving benefits from certain government schemes such as CGHS may need to choose between the existing government scheme and AB PM-JAY rather than receiving both simultaneously.
What Treatment Is Not Covered?
Ayushman Bharat is not a general-purpose payment programme for every healthcare expense.
PM-JAY has defined packages and exclusions.
The NHA’s technical FAQ states that certain services, including outpatient care, drug rehabilitation, cosmetic treatments, organ transplants and fertility treatment, are excluded under PM-JAY.
Coverage also depends on the treatment package and the hospital’s empanelment.
Therefore, before undergoing a procedure, ask the empanelled hospital whether the specific treatment is covered under the applicable PM-JAY package.
Does Ayushman Bharat Cover Cancer Treatment?
Cancer treatment can be covered under PM-JAY, subject to applicable packages and approval procedures.
The NHA explains that cancer care can involve a treatment-plan approval process and pre-authorisation for applicable cancer packages.
Patients should therefore speak with the PM-JAY desk or Ayushman Mitra at the empanelled hospital before treatment.
How to Find an Ayushman Bharat Empanelled Hospital
Beneficiaries should use official PM-JAY resources to locate an empanelled hospital.
You can also contact the PM-JAY helpline at 14555 for assistance.
When selecting a hospital, verify:
- Hospital name
- Empanelment status
- Available speciality
- Covered treatment package
- PM-JAY help desk
- Required documents
- Pre-authorisation requirements
Do not assume that every private hospital accepts PM-JAY.
What Is an Ayushman Mitra?
An Ayushman Mitra is a facilitator associated with the PM-JAY ecosystem who helps beneficiaries understand the scheme and access services.
Ayushman Mitras can assist with areas such as:
- Eligibility information
- Ayushman card generation
- Hospital location
- Beneficiary guidance
- Understanding rights under the scheme
The National Health Authority has described the Ayushman Mitra initiative as a way to help people understand and access PM-JAY services.
What Should You Do If an Eligible Beneficiary Faces a Problem?
If an eligible beneficiary faces difficulty at an empanelled hospital, the first step is to speak with the hospital’s Ayushman Mitra or PM-JAY help desk.
If the issue is not resolved, the beneficiary can contact the official PM-JAY helpline.
PM-JAY Helpline
14555
The NHA also provides grievance-related channels for beneficiaries.
Do not pay an unofficial person simply because they claim they can “activate” your Ayushman Card.
Important Safety Tips for Ayushman Card Applicants
Be careful when applying online.
Never share your OTP
Government services may use OTP verification, but you should not share OTPs with unknown callers.
Use official websites
Prefer official NHA and PM-JAY websites.
Avoid fake websites
Many websites may use words such as “Ayushman,” “PM-JAY,” or “Government Scheme” in their names.
Check the official domain before entering personal information.
Do not pay for a free eligibility check
Eligibility checking through official government channels should not require payment to an unofficial agent.
Verify hospital empanelment
Before treatment, confirm that the hospital is currently empanelled and that your specific treatment is covered.
Ayushman Bharat Eligibility 2026: Quick Summary
| Question | Answer |
|---|---|
| Scheme | Ayushman Bharat PM-JAY |
| Main benefit | Up to ₹5 lakh per family per year for covered services |
| 70+ eligibility | All Indian citizens aged 70+ irrespective of income |
| Income limit for 70+ | No |
| Aadhaar e-KYC for 70+ | Mandatory |
| 70+ enrolment document | Aadhaar |
| Hospital type | Empanelled public and private hospitals |
| Portability | Yes, across empanelled hospitals in India |
| Pre-existing diseases | Covered under applicable scheme packages |
| Family size | No general family-size limit under PM-JAY |
| Helpline | 14555 |
| Eligibility check | Official NHA/PM-JAY beneficiary channels |
| Certificate/Card | Ayushman Card for eligible beneficiaries |
The exact treatment package and beneficiary status should always be verified through official sources.
Frequently Asked Questions About Ayushman Bharat Eligibility
Who is eligible for Ayushman Bharat in 2026?
All Indian citizens aged 70 years and above are eligible irrespective of income. Other beneficiaries are covered according to the applicable PM-JAY beneficiary identification rules and databases.
Is Ayushman Bharat available to everyone?
Not every citizen below age 70 is automatically eligible under the original PM-JAY beneficiary category. Eligibility should be checked through the official beneficiary system.
However, the 70+ expansion makes all Indian citizens aged 70 or above eligible irrespective of income.
Is there an income limit for people aged 70+?
No. The government has stated that senior citizens aged 70 years and above are eligible irrespective of income.
How can I check my Ayushman eligibility?
Use the official beneficiary portal or contact the PM-JAY helpline at 14555. You can also seek assistance at a CSC or empanelled hospital.
Is Aadhaar required for people aged 70+?
Yes. The NHA states that Aadhaar-based e-KYC is mandatory for enrolment and issuance of the Ayushman card for eligible senior citizens.
How much health coverage is available?
PM-JAY provides coverage of up to ₹5 lakh per family per year for eligible beneficiaries for covered services.
Can I use Ayushman Bharat outside my state?
Yes. PM-JAY provides portability, allowing eligible beneficiaries to receive covered treatment at empanelled hospitals outside their home state.
Are pre-existing diseases covered?
Yes. The NHA beneficiary rights document states that pre-existing illnesses are covered, subject to applicable scheme packages.
Can someone with private health insurance get PM-JAY if they are 70+?
Yes. The NHA states that eligible senior citizens aged 70+ can receive PM-JAY benefits even if they have private health insurance.
Is the Ayushman Card free?
Eligible beneficiaries should use official government channels for card generation and verification. Avoid paying unofficial agents for eligibility or card services.
What is the Ayushman Bharat helpline number?
The PM-JAY national toll-free helpline is 14555.
Official Ayushman Bharat Links
For accurate and updated information, use official sources:
National Health Authority:
NHA Official Website
PM-JAY Official Website:
PM-JAY Official Website
Ayushman Bharat Beneficiary Portal:
Beneficiary Portal
PM-JAY Helpline:
14555
Final Words
Ayushman Bharat Eligibility 2026 is important for anyone who wants to understand whether they can access government-supported healthcare benefits.
The most important recent change is the expansion of AB PM-JAY to all Indian citizens aged 70 years and above, regardless of income. For this category, Aadhaar-based e-KYC is required, and eligible senior citizens can receive a distinct Ayushman Card.
For people below 70, eligibility should not be assumed simply from age, income or citizenship. The original PM-JAY beneficiary framework identifies eligible families through applicable government databases and criteria, including specified rural deprivation and urban occupational categories.
Eligible beneficiaries can receive covered treatment through empanelled hospitals, and PM-JAY provides portability across India. The scheme also covers pre-existing illnesses under its applicable packages.
If you or a family member may be eligible, the safest approach is to check through the official NHA beneficiary portal, PM-JAY website, CSC, or an empanelled hospital.
Do not rely on unofficial websites or social media posts for final eligibility confirmation.
For assistance, use the official PM-JAY helpline:
14555
Official beneficiary portal:
Check Ayushman Bharat Beneficiary Information
Official PM-JAY website:
Visit PM-JAY Official Website
Disclaimer
This article is intended for general educational and informational purposes. Ayushman Bharat PM-JAY eligibility, beneficiary databases, state-level implementation, hospital empanelment, treatment packages and government rules may change. Eligibility should be confirmed through the official National Health Authority/PM-JAY system before treatment or application. Hafiz Portal is not the Government of India and does not issue Ayushman Cards or approve PM-JAY benefits.
