Ayushman Bharat PM-JAY: Coverage, Hospital Admissions, And Number Of Beneficiaries Explained

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) provides health insurance of Rs 5 lakh to beneficiaries at empanelled hospitals across India. This PAN India public health scheme is applicable for over 1900 medical treatments; however, state governments can further add to these procedures for inhabitants of their states.

Healthcare Coverage And Hospital Admissions

When a few parliamentarians in the Rajya Sabha asked about the progress of the scheme in terms of the beneficiaries covered and hospital admissions, the government replied that as of June 30, 2026, a total of 127 million (12.69 crore) hospital admissions have been authorised under the scheme.

The Minister of State in the Ministry of Health and Family Welfare, Prataprao Jadhav, replied that the government has approved claims of over Rs 1.92 lakh crore as of June 30, 2026, under the scheme.

Besides the health coverage through PM-JAY, the government also runs Ayushman Arogya Mandir (AAM), the healthcare centres to provide primary healthcare. Per the reply, there are approximately 1.86 lakh AAMs in the country, including Sub Health Centres (SHCs) and Primary Health Centres (PHCs), among others. According to a written reply by the Minister in the Lok Sabha on July 24, 2026, the highest number of AAMs is in Uttar Pradesh (23,646), followed by Rajasthan (14,494), Maharashtra (13,457), Madhya Pradesh (12,775), and Bihar (12,444).

Under another initiative, the Ayushman Bharat Digital Mission (ABDM), which was launched in 2021 to develop an integrated digital health ecosystem, the government integrates the central and state-level health programs with the scheme, including AB PM-JAY, Nikshay, and various hospital management information systems.

Scheme Beneficiaries

The healthcare scheme was initially launched only for people from weaker economic backgrounds under the Socio-Economic Caste Census, 2011. The PM-Jay was launched in 2018 and covered around 10.74 crore families (bottom 40 per cent of the population) based on the 2011 census data, but later it was expanded to include other beneficiaries, too.

In 2023, the beneficiary base was revised from 10.74 crore to 12 crore families, considering the population growth in the decade. In the first half of 2024, PM-JAY benefits were extended to accredited social health activists, anganwadi workers and anganwadi helpers, and thus, 37 lakh additional families have been included as beneficiaries under the scheme.  

In the second half of 2024 (in October 2024), the scheme was extended further to include all senior citizens aged 70 years and above, irrespective of their socio-economic background. So the beneficiary base grew by around 4.5 crore families, having six crore elderly citizens.

Per the National Health Accounts Estimates 2022-23, the out-of-pocket expenditure (OOPE) has declined over the years from 62.6 per cent in 2014-15 to 43.4 per cent in 2022-23, reads the reply.