Ayushman Bharat Yojana – 5 lakh health Insurance: Who is eligible?

Ayushman Bharat Yojana is a government health insurance scheme for five lakh. We consider the features of the scheme and who is eligible.

Published: January 23, 2020 at 1:57 pm

Last Updated on August 30, 2021 at 9:07 am

Ayushman Bharat Yojana is a government health insurance scheme for five lakh. In this article, we discuss who is eligible for the scheme and what the features and facilities available. This is a guest post by Pratik Jain.

Before we begin, you can now watch for free the first lecture of the goal-based portfolio management lecture series. The contents of the course and FAQ can also be found there.

What is Ayushman Bharat Yojana? 

Join over 32,000 readers and get free money management solutions delivered to your inbox! Subscribe to get posts via email!
🔥Enjoy massive discounts on our robo-advisory tool & courses! 🔥

Ayushman Bharat Yojana(ABY) also known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana(PM-JAY) also known as National Health Protection Scheme, is a scheme rolled by the government on 23 September 2018. It aims to provide healthcare facilities to 10.74 Crore economically weak families (approximately 50 crore Beneficiaries). PM-JAY is a Health Insurance Scheme fully funded by the government without any contribution from the beneficiary.

What are the benefits of Ayushman Bharat Yojana? 

The key benefits are, 5 Lakh Cover per family per year, All Pre-existing Diseases are Covered, cashless benefit, no restriction on Family Size, no waiting period for pre-existing diseases. These are explained below.


  • 5 Lakh Cover per family per year – Family will get free 5 lakh healthcare cover per year for hospitalization across all public hospitals and private empanelled Hospitals in India. As of now, 19,871 Hospitals have been empanelled in this scheme.


  • All Pre-existing Diseases are Covered – Unlike most Health-Insurance covers this scheme covers all pre-existing illnesses.
  • Cashless – Ayushman Bharat Yojana aims to provide a cashless process to avoid the burden of paying for healthcare facility upfront. Insured family can get the treatment from all over India.
  • Fewer restrictions – There is no restriction on Family Size, Age of person or Gender. It covers all types of people. It covers up to 1393 Procedures and both Medical and Surgical expenses. However If Multiple Surgeries are required then the highest amount is paid in full and 50% waiver on second followed by 25% on third surgical operation cost. Multiple Surgeries cannot be claimed in full simultaneously.
  • No waiting period – As said above all the pre-existing diseases are covered under this scheme. There is no waiting period for pre-existing diseases which means they are covered from the very first day.
  • Cover – This covers up to 3 days of pre-hospitalization and 15 days of post-hospitalization expenses including but not limited to diagnostics, medicine Food Services, Complications arising during treatment, Accommodation benefits, medical examination and consultation.



Ayushman Bharat Yojana Eligibility

Who is Eligible under this scheme?

The inclusion of households is based on the deprivation and occupational criteria of the Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas, respectively. This number also includes families that were covered in the RSBY but were not present in the SECC 2011 database.

For Rural Parts of India, Out of 7 Deprivation categories It covers 6 (D1 to D5and D7):

  • D1- Only one room with kucha walls and kucha roof
  • D2- No adult member between ages 16 to 59
  • D3- Households with no adult male member between ages 16 to 59
  • D4- Disabled member and no able-bodied adult member
  • D5- SC/ST households
  • D7- Landless households deriving a major part of their income from manual casual labour

For Urban Parts of India following 11 occupational category workers are Eligible:

  • Ragpicker
  • Beggar
  • Domestic worker
  • Street vendor/ Cobbler/hawker / other service provider working on streets
  • Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/ Coolie and other head-load worker
  • Sweeper/ Sanitation worker/ Mali
  • Home-based worker/ Artisan/ Handicrafts worker/ Tailor
  • Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ cart puller/ Rickshaw puller
  • Shop worker/ Assistant/ Peon in small establishment/ Helper/Delivery assistant / Attendant/ Waiter
  • Electrician/ Mechanic/ Assembler/ Repair worker
  • Washer-man/ Chowkidar

How to Check Eligibility?

You need to follow the following steps to check your eligibility for this scheme:

  1. Visit https://pmjay.gov.in and click on “Am I Eligible”.
  2. You will be asked to log in. To log in enter your Mobile Number and captcha shown in the image.
  3. Click on “Generate OTP” button.
  4. An OTP will be sent to your mobile number, which you need to enter in order to get your mobile number verified.
  5. On Next Page Enter Your State and wait for the page to reload.
  6. You will have four ways to search,  By Name, By RationCard Number, By Mobile number or HHD Number.
  7. Alternatively, to check your Eligibility you can call there call centre at 14555 or 1800-111-565.

These are the steps to know your eligibility, if you are eligible you need to visit nearest empanelled hospital or Community Service Center(CSC) to get E-Card.


Ayushman Bharat Pradhan Mantri Jan Arogya Yojana aims at bottom 40% of the vulnerable population. This is indeed a good step towards increasing the quality of life and health of the Economically weak population.

Do share this article with your friends using the buttons below.

🔥Enjoy massive discounts on our courses, robo-advisory tool and exclusive investor circle! 🔥& join our community of 5000+ users!
Use our Robo-advisory Tool for a start-to-finish financial plan! More than 1,000 investors and advisors use this!
New Tool! => Track your mutual funds and stock investments with this Google Sheet!
We also publish monthly equity mutual funds, debt and hybrid mutual funds, index funds and ETF screeners and momentum, low-volatility stock screeners.
Follow Freefincal on Google News
Follow Freefincal on Google News
Subscribe to the freefincal Youtube Channel. Subscribe button courtesy: Vecteezy.
Subscribe to the freefincal Youtube Channel.
Follow freefincal on WhatsApp Channel
Follow freefincal on WhatsApp
Podcast: Let's Get RICH With PATTU! Every single Indian CAN grow their wealth! 
Listen to the Lets Get Rich with Pattu Podcast
Listen to the Let's Get Rich with Pattu Podcast
You can watch podcast episodes on the OfSpin Media Friends YouTube Channel.
Lets Get RICH With PATTU podcast on YouTube
Let's Get RICH With PATTU podcast on YouTube.
🔥Now Watch Let's Get Rich With Pattu தமிழில் (in Tamil)! 🔥
  • Do you have a comment about the above article? Reach out to us on Twitter: @freefincal or @pattufreefincal
  • Have a question? Subscribe to our newsletter using the form below.
  • Hit 'reply' to any email from us! We do not offer personalized investment advice. We can write a detailed article without mentioning your name if you have a generic question.

Join over 32,000 readers and get free money management solutions delivered to your inbox! Subscribe to get posts via email!

About The Author

Pattabiraman editor freefincalDr M. Pattabiraman(PhD) is the founder, managing editor and primary author of freefincal. He is an associate professor at the Indian Institute of Technology, Madras. He has over ten years of experience publishing news analysis, research and financial product development. Connect with him via Twitter(X), Linkedin, or YouTube. Pattabiraman has co-authored three print books: (1) You can be rich too with goal-based investing (CNBC TV18) for DIY investors. (2) Gamechanger for young earners. (3) Chinchu Gets a Superpower! for kids. He has also written seven other free e-books on various money management topics. He is a patron and co-founder of “Fee-only India,” an organisation promoting unbiased, commission-free investment advice.
Our flagship course! Learn to manage your portfolio like a pro to achieve your goals regardless of market conditions! More than 3,000 investors and advisors are part of our exclusive community! Get clarity on how to plan for your goals and achieve the necessary corpus no matter the market condition is!! Watch the first lecture for free!  One-time payment! No recurring fees! Life-long access to videos! Reduce fear, uncertainty and doubt while investing! Learn how to plan for your goals before and after retirement with confidence.
Our new course!  Increase your income by getting people to pay for your skills! More than 700 salaried employees, entrepreneurs and financial advisors are part of our exclusive community! Learn how to get people to pay for your skills! Whether you are a professional or small business owner who wants more clients via online visibility or a salaried person wanting a side income or passive income, we will show you how to achieve this by showcasing your skills and building a community that trusts and pays you! (watch 1st lecture for free). One-time payment! No recurring fees! Life-long access to videos!   
Our new book for kids: “Chinchu Gets a Superpower!” is now available!
Both boy and girl version covers of Chinchu gets a superpower
Both the boy and girl-version covers of "Chinchu Gets a superpower".
Most investor problems can be traced to a lack of informed decision-making. We made bad decisions and money mistakes when we started earning and spent years undoing these mistakes. Why should our children go through the same pain? What is this book about? As parents, what would it be if we had to groom one ability in our children that is key not only to money management and investing but to any aspect of life? My answer: Sound Decision Making. So, in this book, we meet Chinchu, who is about to turn 10. What he wants for his birthday and how his parents plan for it, as well as teaching him several key ideas of decision-making and money management, is the narrative. What readers say!
Feedback from a young reader after reading Chinchu gets a Superpower (small version)
Feedback from a young reader after reading Chinchu gets a Superpower!
Must-read book even for adults! This is something that every parent should teach their kids right from their young age. The importance of money management and decision making based on their wants and needs. Very nicely written in simple terms. - Arun.
Buy the book: Chinchu gets a superpower for your child!
How to profit from content writing: Our new ebook is for those interested in getting side income via content writing. It is available at a 50% discount for Rs. 500 only!
Do you want to check if the market is overvalued or undervalued? Use our market valuation tool (it will work with any index!), or get the Tactical Buy/Sell timing tool!
We publish monthly mutual fund screeners and momentum, low-volatility stock screeners.
About freefincal & its content policy. Freefincal is a News Media Organization dedicated to providing original analysis, reports, reviews and insights on mutual funds, stocks, investing, retirement and personal finance developments. We do so without conflict of interest and bias. Follow us on Google News. Freefincal serves more than three million readers a year (5 million page views) with articles based only on factual information and detailed analysis by its authors. All statements made will be verified with credible and knowledgeable sources before publication. Freefincal does not publish paid articles, promotions, PR, satire or opinions without data. All opinions will be inferences backed by verifiable, reproducible evidence/data. Contact information: letters {at} freefincal {dot} com (sponsored posts or paid collaborations will not be entertained)
Connect with us on social media
Our publications

You Can Be Rich Too with Goal-Based Investing

You can be rich too with goal based investingPublished by CNBC TV18, this book is meant to help you ask the right questions and seek the correct answers, and since it comes with nine online calculators, you can also create custom solutions for your lifestyle! Get it now.
Gamechanger: Forget Startups, Join Corporate & Still Live the Rich Life You Want Gamechanger: Forget Start-ups, Join Corporate and Still Live the Rich Life you wantThis book is meant for young earners to get their basics right from day one! It will also help you travel to exotic places at a low cost! Get it or gift it to a young earner.

Your Ultimate Guide to Travel

Travel-Training-Kit-Cover-new This is an in-depth dive into vacation planning, finding cheap flights, budget accommodation, what to do when travelling, and how travelling slowly is better financially and psychologically, with links to the web pages and hand-holding at every step. Get the pdf for Rs 300 (instant download)