10 March 2026·PIB

Update on AB-PMJAY

In this note

1. At a Glance

AB-PMJAY is the health-assurance arm of Ayushman Bharat, providing ₹5 lakh/family/year cashless cover for secondary & tertiary hospitalisation; world's largest publicly-funded health insurance scheme [1][3].
Latest PIB update (10 Mar 2026): 43.52 crore Ayushman cards created as on 28.02.2026 [1].
Examinable as a flagship welfare scheme touching GS-II (Health/Governance) and GS-III (Inclusive growth, OOP expenditure).

10 March 2026 Rajya Sabha written reply by MoS Health Shri Prataprao Jadhav: 43.52 crore Ayushman cards issued under AB-PMJAY [1].
Earlier expansion (29 Oct 2024): Cabinet approved free ₹5 lakh cover to all citizens aged 70+, irrespective of income — branded Ayushman Vay Vandana card [2][4].
Delhi became the 35th State/UT to implement AB-PMJAY (2025); Odisha had become the 34th earlier [5][6].

Recommended by National Health Policy 2017; launched by PM Modi on 23 September 2018 at Ranchi, Jharkhand [3].
Subsumed earlier Rashtriya Swasthya Bima Yojana (RSBY, 2008) and Senior Citizen Health Insurance Scheme (SCHIS).
Two pillars of Ayushman Bharat: (i) Health & Wellness Centres / Ayushman Arogya Mandirs, (ii) PM-JAY insurance arm [3].
2024 milestone: Vay Vandana expansion to seniors 70+ regardless of income [2].

Nodal Ministry: Ministry of Health & Family Welfare; implementing body National Health Authority (NHA) at Centre, State Health Agencies (SHA) at State level [7].
Cover: ₹5 lakh per family per year, cashless & paperless, portable across India.
Original beneficiary base: ~10.74 crore poor & vulnerable families (~55 crore individuals) = bottom 40% identified via SECC 2011 (6 rural deprivation + 11 urban occupational criteria) [7].
Cards issued: 43.52 crore as on 28.02.2026 [1].
Empanelled hospitals: 30,745 (17,084 public + 13,661 private) per recent PIB data [7].
Funding share: Centre:State = 60:40 (90:10 for NE & special-category States; 100% for UTs without legislature).
Senior citizen extension (2024): ~6 crore seniors / 4.5 crore families; existing PMJAY families above 70 get top-up ₹5 lakh exclusive to seniors [2][4].
OOP savings: ₹1.25 lakh crore saved in out-of-pocket expenditure per Economic Survey 2024-25 [3].

Economic

Cuts catastrophic health expenditure — a key driver of poverty (≈ 7% pushed below poverty line annually pre-PMJAY).
Crowds-in private hospital capacity in Tier-2/3 towns via empanelment [7].

Social

Targets bottom 40% via SECC 2011; gender-neutral, no family-size cap, no age cap [3].
2024 expansion universalises cover for 70+ seniors — addresses ageing-population vulnerability [2].

Administrative / Federal

Opt-in scheme: West Bengal still outside; Delhi (35th) and Odisha (34th) joined recently [5][6].
SHA-led empanelment, package rates set by NHA; portability enabled via Aadhaar-based eKYC.

Ethical / Governance

Concerns of fraudulent claims, ghost beneficiaries, upcoding — CAG (2023) flagged data integrity issues.
NHA's National Anti-Fraud Unit (NAFU) uses AI-based triggers.

Technological

Integrated with Ayushman Bharat Digital Mission (ABDM) — ABHA IDs, Health Claims Exchange (HCX).

29 Oct 2024: Cabinet approval for 70+ universal cover (Vay Vandana) [2].
2025: Odisha joins as 34th State [6]; Delhi joins as 35th State/UT [5].
2025: Enrolment for Ayushman Vay Vandana Cards crosses 25 lakh within months of launch [related PIB].
28 Feb 2026: Total Ayushman cards reach 43.52 crore [1].

Launched on 23 September 2018 at Ranchi, Jharkhand [3].
Nodal implementing agency: National Health Authority under MoHFW [7].
Cover: ₹5 lakh per family per year, no cap on family size/age [3].
Beneficiary identification basis: SECC 2011 (6 rural deprivation + 11 urban occupational criteria) [7].
Funding ratio: 60:40 (90:10 NE/special category).
Cards issued as on 28.02.2026: 43.52 crore [1].
Empanelled hospitals: 30,745 (17,084 public + 13,661 private) [7].
Delhi = 35th State/UT to implement AB-PMJAY [5]; Odisha = 34th [6].
Ayushman Vay Vandana Card: for all citizens aged 70+ irrespective of income, approved 29 Oct 2024 [2].
Top-up of ₹5 lakh exclusive to seniors in already-enrolled PMJAY families [2].
Estimated senior-citizen beneficiaries: ~6 crore individuals / 4.5 crore families [2].
AB-PMJAY is the insurance pillar; the other pillar is Ayushman Arogya Mandirs (renamed HWCs).
Predecessor scheme it subsumed: RSBY (2008).

GS-II: Welfare schemes for vulnerable sections; Issues relating to development and management of Social Sector/Services – Health.
GS-III: Inclusive growth; Government Budgeting (health expenditure).
Possible question stems: 1. "Examine how the 2024 expansion of AB-PMJAY to senior citizens above 70 addresses the challenges of an ageing India." (GS-II, 15M) 2. "AB-PMJAY has reduced catastrophic out-of-pocket health expenditure but raises concerns of moral hazard and fraud. Discuss." (GS-II, 10M) 3. "Evaluate the federal challenges in universalising AB-PMJAY across all States." (GS-II, 15M)

Ayushman Bharat Digital Mission (ABDM) — digital backbone (ABHA ID, HCX).
Ayushman Arogya Mandirs (erstwhile HWCs) — preventive/primary care pillar.
National Health Policy 2017 — parent policy framework.
Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) — affordable generics complement.
PM-ABHIM (PM Ayushman Bharat Health Infrastructure Mission) — supply-side investment.
National Health Authority — institutional setup, contrast with IRDAI.
SECC 2011 — beneficiary identification basis across welfare schemes.
Economic Survey 2024-25 — Health chapter — OOP, health expenditure as % of GDP.

Cover is per family, not per individual (except the new Vay Vandana top-up for seniors which is per-senior).
PMJAY ≠ entire Ayushman Bharat; AB has TWO pillars — Arogya Mandirs (primary) + PMJAY (secondary/tertiary).
Nodal authority is National Health Authority (NHA), NOT IRDAI or NITI Aayog.
Beneficiary list from SECC 2011, not Census 2011.
West Bengal has NOT implemented PMJAY; assume "all-India" only with caveat. Delhi joined as the 35th in 2025 [5].
70+ universal cover started 29 Oct 2024, not at original 2018 launch [2].