Indian Political CompassGovernment Scheme · Active
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
Provides health insurance cover of Rs 5 lakh per family per year for secondary and tertiary hospitalisation, targeting the bottom 40% of India's population by socio-economic status.
What it does
AB-PMJAY is a cashless, paperless health insurance scheme. Beneficiaries can get treatment at any empanelled public or private hospital across India without paying upfront. The scheme covers over 1,929 medical procedures including surgery, chemotherapy, and ICU care. Beneficiaries are identified from the Socio-Economic Caste Census (SECC) 2011 data.
Who it covers
Families listed in SECC 2011 as deprived or belonging to specified occupational categories of rural and urban workers. There is no cap on family size. The scheme covers approximately 500 million individuals.
Funding
Centrally sponsored with a 60:40 Centre-State cost-sharing ratio (90:10 for northeastern and hill states). Annual central allocation is approximately Rs 7,000–9,000 crore; premium per family is around Rs 1,000–1,200 per year paid by the government to insurance companies or trusts.
Scale
Over 550 million beneficiaries enrolled. More than 60 million hospital admissions authorised since launch through 2024, worth over Rs 80,000 crore in claims.
Criticism and debate
Several states — Delhi, West Bengal, Odisha — initially declined to join due to disputes over funding share and design. Private hospitals have been found to conduct unnecessary procedures to inflate claims. Coverage of Rs 5 lakh is often insufficient for serious illnesses in metropolitan hospitals. The SECC 2011 list is outdated and excludes many genuinely poor households formed after 2011.
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Content is editorial draft pending verification against official scheme guidelines, ministry press releases, and independent evaluations. Last reviewed: 2026-07-02.