What is Ayushman Bharat Health Insurance?

Ayushman Bharat health insurance provides free hospitalization for poor families across the country. Led by the National Health Authority (NHA), it has two key components. 

First, over 1.5 lakh Primary Health Centres were upgraded into Health and Wellness Centres (HWCs) offering preventive, primary, and rehabilitative care. Second, the Pradhan Mantri Jan Arogya Yojana (PM-JAY) provides cashless hospitalization to around 10.74 crore poor families, reducing medical expenses and improving access to quality treatment. 

This comprehensive guide covers the scheme’s benefits and eligibility, what is included and excluded, how to check your enrollment, and how to apply for and download your ABHA card.

Eligibility Criteria for the Ayushman Bharat Health Insurance Scheme

Eligibility generally depends on the Socio-Economic Caste Census (SECC 2011) data. Households listed as deprived or vulnerable in the government database qualify automatically.

Who Are Excluded from the Ayushman Bharat Health Scheme?

While the Ayushman Bharat scheme offers wide medical coverage, certain groups are not eligible. Here are the families/individuals who cannot access the scheme.

• If you own a two, three or four-wheeler or a motorised fishing boat
• If you own mechanised farming equipment
• If you have Kisan cards with a credit limit of ₹ 50k
• If you are employed by the government
• If you work in government-managed non-agricultural enterprises
• If you earn a monthly income above ₹ 10k
• Households with refrigerators and landlines
• Households with a decent, well-built house
• If you own 5 acres or more of agricultural land

Inclusions and Exclusions in Ayushman Bharat Health Insurance Scheme

How to Check your Name on the PMJAY Ayushman Bharat Scheme? 

You can follow these steps to check your enrollment status: 

Step 1:  Visit the official PMJAY website and tap the 'Am I Eligible' tab on the top right menu.

Step 2: Enter the displayed captcha code, your mobile number and OTP to verify.

Step 3: Next, type in the captcha code again and click the 'Login' button.

Step 4: Select the relevant option under the 'Scheme', 'State', ‘Sub Scheme’, 'District' and 'Search By' columns and provide the required details.

Steps for Unregistered Ayushman Bharat Users

01

Submit Basic Details

Visit a Hospital or a Common Service Centre (CSC). Share your PM letter, Rashtriya Swasthya Bima Yojana (RSBY) unique reference number, ration card number, mobile number, or any ID. The Arogya Mitra(operator) searches your name in the beneficiary list.

02

Database Verification

The operator checks your details in all official databases such as SECC, RSBY, State Health Scheme, and other approved records.

03

Individual ID Verification

If your name appears in the list, you must show Aadhaar or any government ID along with your ration card or family ID. The operator scans and uploads these documents.

04

Family Verification

Your family details are matched using the ration card. Scanned family documents are uploaded for confirmation.

05

Approval Process

The insurance company or state trust reviews your application. The State Health Agency (SHA) gives final approval or rejection.

06

Get Your e-card

Once approved, your Ayushman Bharat e-card is generated. You can use it to get cashless treatment at any empanelled hospital.

If you want to enrol your parents above 70 years of age or you are a senior citizen over 70, go to the Ayushman PM-JAY portal and click the beneficiary registration banner. Then, follow the same steps as earlier to complete the registration.

Here are some commonly asked questions about the benefits available to senior citizens under the AB-PMJAY scheme.

How to Apply for an ABHA Health ID Card Online?

The ABHA Card is a special 14-digit ID introduced as part of India’s Ayushman Bharat Digital Mission (

ABDM) and helps you keep all your medical records in one place. To create one:

1. Visit the official ABHA portal.
2. Click 'Create your ABHA now' and choose 'Generate via Aadhaar.'
3. Enter your Aadhaar number and verify using the OTP sent to your registered mobile.
4. After this, you must enter your details and create your ABHA address.

5. Download your ABHA card for use.

Take note: You will need a few basic documents for ABHA card registration. These include your Aadhaar or PAN for identity, proof of address, and your mobile number. You may also need documents that confirm whether your family is joint or nuclear.

How to Apply for an ABHA Health ID Card Offline?

For in-person assistance, follow the listed steps:

1: Visit a registered medical facility or an Ayushman Bharat CSC.

2: Bring your Aadhaar card or another valid ID for verification.

3: Fill out the registration form with your personal details.

4: Confirm your Aadhaar information using an OTP or biometric verification.

5: Hand in the completed form along with your documents to the facility representative.

Here’s a guide to creating ABHA (number) using digital devices in offline mode.

How to Download the Ayushman Bharat Card (PMJAY Card) Online?

You can download your card via the PMJAY website, ABHA website or the Ayushman Bharat mobile app.

Since each platform uses the same verification steps (OTP login + Aadhaar-based e-KYC), here’s the unified process:

1. PMJAY Website

• Click “Am I Eligible” in the top menu and log in using your mobile number + OTP.
• Search your beneficiary record using State, District and Scheme details.
• Complete Aadhaar-based e-KYC once (if not already done).
• After successful verification, use the download card option.

2. ABHA Website

• Log in using your mobile number, Aadhaar number or ABHA ID.
• Go to “View Health Card” and download the PDF.

3. Ayushman Bharat Mobile App

• Install the Ayushman App on your smartphone.
• Next, follow the same download steps mentioned earlier via the PMJAY website.
• Open your profile and tap Download Card.

Note: Aadhaar OTP verification is required once to activate/download the card.

How to Download the Ayushman Bharat Card (PMJAY Card) Offline?

If you want in-person help, visit your nearest CSC and request the Ayushman Bharat card. Next, verify your mobile number, and submit your documents. After verification, the staff will process your card, and you can collect it in a few days.

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Ditto’s Take on Ayushman Bharat Health Insurance

Government-backed schemes like Ayushman Bharat support low-income workers in the informal/unorganised sector. However, many hospitals hesitate to accept them due to delayed government payments. These schemes also offer lower coverage limits, fewer empanelled private hospitals, and slower claim processing compared to private health insurance.

At Ditto, we recommend plans like HDFC Ergo Optima Secure and Care Supreme. We assess them through our 6-point evaluation framework to ensure strong coverage, clear features, and long-term value.