AB-PMJAY Puducherry Eligibility, Benefits, & Hospitals

Overview

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in Puducherry operates through the AB-PMJAY Convergence Scheme, created after the Pondicherry Medical Relief Society medical assistance scheme was merged with AB-PMJAY in 2021. The scheme provides cashless access to secondary and tertiary hospitalization at empaneled hospitals for eligible beneficiaries.

Key Details of AB-PMJAY Puducherry

Coverage Limit: Up to ₹5 lakh per family per year for hospitalization and treatment packages.
Implementation: The State Health Agency implements the AB-PMJAY Convergence Scheme in trust mode under Puducherry’s health insurance framework.
Senior Citizen Extension: Puducherry implemented the AB-PMJAY expansion for citizens aged 70 years and above in 2025, with coverage available regardless of income.
Check Eligibility & Registration: Eligible beneficiaries can verify their beneficiary status, complete e-KYC, and generate an Ayushman card through the beneficiary portal, Ayushman App, empaneled hospitals, or Common Service Centres.

Healthcare costs can be unpredictable, and government-backed health schemes can play an important role in making hospital treatment more accessible. For eligible families in Puducherry, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides financial protection through cashless treatment at empaneled hospitals.

This guide covers eligibility, benefits, treatments covered, AB-PMJAY registration, card download, empaneled hospitals, and whether you still need private health insurance.

What Is AB-PMJAY Puducherry?

AB-PMJAY is a government-funded health assurance scheme that provides eligible families in Puducherry with up to ₹5 lakh in coverage per year on a family floater basis. The cover is intended for secondary and tertiary hospitalization at empaneled public and private hospitals.

Want to understand how government health insurance schemes work in India? Watch our detailed video covering PM-JAY, CGHS, ESIC, and other major government-backed schemes before exploring the Puducherry-specific details.

Government Health Insurance Schemes in India: PM-JAY, CGHS, ESIC & More Explained | Ditto

Important Note

According to the Puducherry government notification, the Pondicherry Medical Relief Society medical assistance scheme was merged with AB-PMJAY, and the resulting AB-PMJAY Convergence Scheme was to be implemented by the State Health Agency in trust mode.

According to the AB-PMJAY dashboard, around 5.7 lakh Ayushman cards have been created in Puducherry.

Who Is Eligible for AB-PMJAY Puducherry?

Living in Puducherry does not automatically make you eligible for AB-PMJAY. Eligibility depends on whether you belong to an identified beneficiary category under the scheme.

AB-PMJAY Beneficiaries and BPL Ration Card Holders

Under Puducherry's AB-PMJAY Convergence Scheme, all eligible AB-PMJAY beneficiaries and non-AB-PMJAY beneficiaries among BPL households holding Antyodaya Anna Yojana (AAY) or Priority Household (PHH) ration cards are covered. This convergence was introduced after Puducherry merged the Pondicherry Medical Relief Society's medical assistance scheme with AB-PMJAY.

ASHA and Anganwadi Workers

The Government of India later added ASHA workers, Anganwadi Workers (AWWs), Anganwadi Helpers (AWHs), and their families to AB-PMJAY through a national expansion. Eligible workers and their families in Puducherry can also receive coverage under this category.

Citizens Aged 70 Years and Above

Puducherry implemented the AB-PMJAY senior-citizen expansion in 2025, extending coverage to citizens aged 70 years and above under the Union Territory's health insurance framework. The expansion provides eligible senior citizens with an Ayushman Vay Vandana Card and up to ₹5 lakh in health coverage per year.

If a senior citizen aged 70 years or above already belongs to a family covered under AB-PMJAY, they receive an additional top-up cover of up to ₹5 lakh per year.

What About Other Residents of Puducherry?

The 2021 AB-PMJAY Convergence Scheme also provides government funding for non-SECC BPL families who are not covered under the regular AB-PMJAY beneficiary database. The Puducherry government notification states that the Union Territory Government funds these beneficiaries.

Note

In May 2026, the Puducherry government approved extending health assurance coverage of up to ₹3 lakh to all Above Poverty Line (APL) ration-card holders under the Chief Minister’s Health Assurance Scheme. The coverage is intended to reimburse treatment in private or outside hospitals for procedures that are not available at government hospitals. This is separate from the standard AB-PMJAY entitlement.

Benefits, Coverage, and Treatments Covered Under AB-PMJAY Puducherry

Benefit	What AB-PMJAY Covers
Coverage Amount	Up to ₹5 lakh per family per year (shared by all members).
Treatment Packages	The health benefit package covers procedures across medical specialties, including general medicine, general surgery, orthopedics, cardiology, and oncology.
Pre-Existing Diseases	Eligible pre-existing diseases are covered from day one, with no waiting period.
Pre- and Post-Hospitalization	Covers eligible expenses incurred up to 3 days before and 15 days after hospitalization.
Room Entitlement	General ward accommodation is covered, subject to the applicable package terms.
Family and Beneficiary Restrictions	No restriction on the number of family members, age, or gender for beneficiaries who meet the scheme's eligibility criteria.
Day Care Treatment	Covers eligible day care procedures included under the scheme's treatment packages.

What Is Not Covered Under AB-PMJAY?

Routine Out-Patient Department (OPD) Treatment

Regular outpatient consultations and treatment are not covered under the PM-JAY hospitalization benefit.

Cosmetic Procedures

Cosmetic or aesthetic treatments that are not medically necessary are excluded.

Routine Dental Treatment

Dental procedures that do not require hospitalization are not covered.

Infertility Treatment

Fertility and assisted reproductive treatments are excluded.

Non-Medical Expenses

Expenses that are not part of the covered treatment package are not payable under PM-JAY.

Treatments Outside the Package

Procedures or treatments not included in the applicable health benefit package are not covered.

Talk to an expert
today and
find
the right
insurance for you.

How to Apply for AB-PMJAY Puducherry and Download Your Card

Eligible beneficiaries in Puducherry can get their AB-PMJAY card through the official beneficiary portal, Ayushman App, or by visiting an empaneled hospital or authorized service center.

Online: Use the official AB-PMJAY beneficiary portal or the Ayushman App, available on the Google Play Store for Android and the Apple App Store for iOS. Eligible beneficiaries can use these platforms for beneficiary verification and e-KYC.
Empaneled Hospitals: Visit an AB-PMJAY empaneled hospital and approach the Ayushman Mitra or authorized staff for beneficiary verification, e-KYC, and card generation.
Common Service Centres (CSCs): Eligible beneficiaries can also approach a CSC for assistance with beneficiary verification and Ayushman card generation.

Steps to Apply Online and Download Your Card

Visit the official AB-PMJAY beneficiary portal.
Log in using your mobile number and complete the required verification.
Search for your beneficiary record using the available identification details.
Complete Aadhaar-based e-KYC if required.
Follow the instructions to generate your Ayushman card.
Once the card is approved and generated, download the digital copy.

Documents Required for an AB-PMJAY Card

The documents required depend on the beneficiary category. Keep the following available for verification:

Aadhaar Card: Required for Aadhaar-based e-KYC and identity verification.
Ration Card: AAY or PHH ration card details can establish eligibility under Puducherry's convergence scheme.
Mobile Number: Required for OTP-based verification where applicable.
Other Identification Details: Additional information or documents can be required to locate and verify the beneficiary record.

Note

For beneficiaries aged 70 years and above, Aadhaar is the only document required for enrollment under Puducherry's 2025 extension of AB-PMJAY, and Aadhaar-based e-KYC is mandatory for issuing the Ayushman card.

AB-PMJAY Puducherry Empaneled Hospital List Across Puducherry, Karaikal, Mahe, and Yanam

AB-PMJAY beneficiaries can receive cashless treatment at empaneled public and private hospitals across Puducherry. The empaneled hospital network can change, so check the latest list before seeking treatment. The Puducherry Health Department also maintains a list of government hospitals across Pondicherry, Karaikal, Mahe, and Yanam.

For example, beneficiaries in Pondicherry can find hospitals such as Indira Gandhi Medical College and Research Institute, while those in Karaikal can access General Hospital, Karaikal.

You can check the latest AB-PMJAY empaneled hospital list through the National Health Authority's Hospital Empanelment Module. Select "By District", choose Puducherry under the State/Union Territory field, and select the relevant district to view available hospitals.

AB-PMJAY Puducherry vs. Private Health Insurance: Do You Still Need Cover?

AB-PMJAY Puducherry provides valuable financial protection, but it may not cover all of a family's healthcare costs. A private health insurance policy can fill gaps in coverage, expand hospital choice, and cover expenses outside the AB-PMJAY package.

Higher Financial Protection: AB-PMJAY provides only up to ₹5 lakh per year. An expensive surgery or multiple hospitalizations in the same year can exhaust this amount. A private health insurance policy can provide a higher sum insured, along with features such as automatic restoration and cumulative bonuses, depending on the policy.
More Choice of Hospitals: Its portability allows beneficiaries to receive covered treatment at empaneled hospitals across India, but you still need to use a hospital within the scheme's network. On the other hand, a private health insurance policy can provide access to a wider network, depending on the insurer and policy.
Package Rates Decide the Room, Not You: AB-PMJAY pays fixed package rates based on the applicable bed category. Under the scheme, you do not choose the room or surgeon based on your preference. This is a fair trade for free treatment, but it is not the same as having a private health insurance policy that gives you greater control over your treating doctor and room choice, subject to policy terms.
AB-PMJAY Is Cashless Only: AB-PMJAY does not have a reimbursement route. If you pay the hospital bill yourself, you cannot claim that amount back under the scheme. Private health insurance provides a reimbursement option when you pay for an eligible treatment yourself, subject to the policy terms.
Protection Against Non-Medical Expenses: AB-PMJAY covers eligible medical treatments up to ₹5 lakh but excludes travel, accommodation, and lost wages for out-of-station referrals. Private health insurance can provide additional financial protection and may cover benefits such as dependent lodging, ambulance charges, and hospital cash.

Our Recommendation: If you are eligible for AB-PMJAY Puducherry, use it for covered treatments, as it provides healthcare coverage at no cost. However, do not treat the ₹5 lakh AB-PMJAY cover as a substitute for private health insurance. We recommend a private health insurance policy with at least ₹15 lakh sum insured, restoration benefits, and a network that includes hospitals you would consider for treatment.

Why Choose Ditto for Health Insurance?

At Ditto, we’ve assisted over 12,00,000 customers choose the right insurance policy. Why customers like Pallavi love us:

Pallavi Nayak LinkedIn Customer Testimonial

100% Free Consultation
No Spam. No Sales Pressure.
Rated 4.9/5 on Google Reviews by 30,000+ Happy Customers
Backed by Zerodha
Dedicated Claim Support Team
Compare Plans and Premiums with a Trusted Insurance Advisor

Confused about the right insurance? Speak to Ditto’s certified advisors for free, unbiased guidance. Book your call now or chat with us on WhatsApp. Slots fill up fast!

Conclusion

AB-PMJAY Puducherry provides eligible beneficiaries with up to ₹5 lakh of floater cover a year for covered hospitalization at empaneled hospitals, with pre-existing diseases covered from day one. However, the scheme works within defined beneficiary categories, treatment packages, and hospital networks.

If you want a higher sum insured, greater choice of rooms and doctors, reimbursement options, OPD or maternity coverage, restoration and bonus benefits, or protection beyond AB-PMJAY's package limits, you can compare some of the best health insurance plans in India for additional financial protection.

Frequently Asked Questions

Is the AB-PMJAY Puducherry enough cover on its own for a family?

No. AB-PMJAY Puducherry provides up to ₹5 lakh per family per year, which can be exhausted by an expensive surgery or multiple hospitalizations. It also covers only specified treatment packages and does not cover expenses such as travel, accommodation, or lost wages. A private health insurance policy with a higher sum insured can provide additional financial protection and greater flexibility in choosing hospitals and treatments.

How much premium does a family pay for AB-PMJAY Puducherry?

Eligible beneficiaries do not pay a premium for AB-PMJAY Puducherry. The scheme is government funded, with the Union Territory Government funding beneficiaries brought under the Puducherry convergence framework who are outside the regular AB-PMJAY database. This means eligible families receive the scheme's covered benefits without purchasing an insurance policy or paying a yearly premium. The same applies to eligible beneficiaries covered under the national AB-PMJAY framework.

Can an AB-PMJAY Puducherry card be used at a private hospital in Chennai or Bengaluru?

Yes. AB-PMJAY provides national portability, so beneficiaries can receive covered treatment at any AB-PMJAY-empaneled private hospital in Chennai, Bengaluru, or elsewhere in India. The hospital must be empaneled under the scheme, and the required treatment must be included in the applicable Health Benefit Package. A Puducherry card does not provide cashless treatment at every private hospital outside the Union Territory.

What income limit applies for a family to qualify for AB-PMJAY Puducherry?

No single income limit applies to every AB-PMJAY Puducherry beneficiary. Puducherry's convergence scheme covers eligible BPL households holding AAY or PHH ration cards, including families outside the regular AB-PMJAY database. Other beneficiary categories, such as ASHA and Anganwadi workers and citizens aged 70 years and above, have separate eligibility rules. Therefore, eligibility depends on the beneficiary category rather than a universal income ceiling.

Can a family hold both an AB-PMJAY Puducherry card and Tamil Nadu CMCHIS cover at the same time?

Tamil Nadu's Chief Minister Comprehensive Health Insurance Scheme (CMCHIS) has separate residency, ration-card, and eligibility requirements. Holding an AB-PMJAY Puducherry card does not itself make you eligible for CMCHIS. If you independently meet CMCHIS eligibility, confirm your current beneficiary status and any restrictions on concurrent scheme benefits with the CMCHIS authorities before relying on both.

Does AB-PMJAY Puducherry cover OPD consultations and diagnostic tests, or only hospitalization?

AB-PMJAY Puducherry primarily covers specified secondary and tertiary hospitalization and eligible day care procedures under its Health Benefit Packages. PM-JAY does not cover routine OPD consultations. Diagnostic tests are covered when they form part of an eligible hospitalization or treatment package. Standalone diagnostic tests or routine outpatient consultations are not covered simply because the beneficiary holds an AB-PMJAY card.

What is the full form of AB-PMJAY?

The AB-PMJAY full form is Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. It is a government health assurance scheme that provides eligible beneficiaries with financial protection for covered hospitalization expenses. The scheme offers up to ₹5 lakh per family per year and provides cashless treatment for eligible procedures at empaneled public and private hospitals. Coverage includes listed secondary and tertiary care treatments, such as appendix removal under secondary care and cancer treatment or organ transplant under tertiary care.

I am over 70 and already have other health cover. Can I still get an Ayushman card?

Yes, you can get an Ayushman card even if you already have other health cover. If you have the Central Government Health Scheme, Ex-Servicemen Contributory Health Scheme, or Ayushman CAPF coverage, you must choose only one of these schemes. If you have private health insurance or Employees’ State Insurance Corporation coverage, you can use AB-PMJAY alongside it. If your family already has AB-PMJAY, your ₹5 lakh senior citizen cover is an additional benefit.

Last updated on: 22 Aug, 2026

AB-PMJAY Puducherry: Cover, Hospitals & Card