Ayushman Bharat Health Insurance Scheme (AB-PMJAY): Features and Impact

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Key takeaways

AB-PMJAY was launched on September 23, 2018, to offer health protection to the bottom 40% of India's low-income population.
The scheme provides an annual cover of ₹5 lakh per family for secondary and tertiary hospital care across empaneled hospitals.
It covers over 1,900+ medical treatments along with 3 days of pre-hospitalization and 15 days of post-hospitalization costs from day one.
The Central Government expanded benefits to cover all senior citizens aged 70 years and above with an additional ₹5 lakh annual cover.

The Central Government's Ayushman Bharat scheme and West Bengal's Mukhyamantri Swasthya Bima Yojana were rolled out together in West Bengal to deliver cashless medical treatment in empaneled hospitals.

The Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) stands as the world's largest government-funded health assurance initiative.
The National Health Authority (NHA) under the Ministry of Health and Family Welfare oversees the implementation of this scheme.
It delivers strong financial security for secondary and tertiary hospital care to the bottom 40% of India's low-income households.

The government officially launched the scheme on September 23, 2018.
The initiative directly follows the goals of the National Health Policy 2017 to achieve Universal Health Coverage and Sustainable Development Goal 3.

The AB-PMJAY component handles secondary and tertiary hospital treatment coverage.
The Ayushman Arogya Mandirs (AAMs) deliver decentralized primary healthcare services directly to local communities.
The Ayushman Bharat Digital Mission (ABDM) builds integrated digital health systems and creates individual ABHA IDs.
The PM-ABHIM upgrades healthcare buildings and facilities across both rural and urban areas.

The main target is to protect vulnerable families from high medical costs by offering free, quality inpatient treatment in public and empaneled private hospitals.

Families receive a health cover of ₹5 lakh per family per year for secondary and tertiary medical treatments across network hospitals.
All pre-existing medical conditions are covered from day one, spanning over 1,900+ medical and surgical packages, including 3 days of pre-hospital care and 15 days of post-hospital treatment expenses.
The scheme places no restrictions on family size, gender, or age, ensuring full access for women, children, and elderly family members.
It offers an additional ₹5 lakh annual health cover to all senior citizens aged 70 years and above, regardless of family income.
Beneficiaries use an Ayushman Card to get completely cashless, paperless, and nationally portable treatment anywhere in India.

It cuts direct medical expenses for poor families, saving households from falling into deep debt or poverty.
It connects government and private hospitals using standardized package rates, clear quality standards, and digital claim settlements.