Executive Summary:
The Ministry of Health and Family Welfare addresses questions regarding the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY). The scheme has been expanded to cover senior citizens and additional socio-economic groups, with revised health benefit packages. The government aims to ensure seamless enrollment and benefit delivery through various channels, including online portals and on-site assistance.
Key Points / Main Content:
* **ABPMJAY Overview:**
* Provides health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization.
* Targets 12 crore economically vulnerable families (bottom 40% of India's population).
* **Expansion to Senior Citizens:**
* In October 2024, the scheme expanded to cover 6 crore senior citizens (age 70+) from 4.5 crore families, regardless of socio-economic status, through VayVandanacard.
* **Health Benefit Package (HBP) 2022:**
* Comprises 1,961 procedures across 27 medical specialties.
* **Eligibility Criteria Evolution:**
* Since January 2022, expanded from 10.74 crore to 12 crore families.
* Flexibility given to States/UTs to use other aadhaar-seeded databases of similar socio-economic profiles.
* In March 2024, included 37 lakh ASHAs, Anganwadi Workers, Anganwadi Helpers, and their families.
* **Ayushman Vay Vandna Card:**
* Provides universal health coverage to senior citizens (70+ years) with free health benefits up to Rs. 5 lakh per year.
* **Implementation and Enrollment:**
* State Health Authorities are responsible for onboarding and implementation.
* Ayushman App and web portal (beneficiary.nha.gov.in) facilitate enrollment.
* National helpline number 14555 provides assistance.
* Beneficiaries can create cards at empanelled hospitals.
* **On-site Assistance:**
* Pradhan Mantri Arogya Mitras (PMAMs) guide beneficiaries at empanelled hospitals.
* PMJAY kiosks at hospitals provide awareness, card creation assistance, and overall support.
* **Ayushman Card Creation:**
* Over 41 crore Ayushman cards created nationwide, including 83.75 lakh in Kerala.
Impact Analysis:
* **Economically Vulnerable Families:**
* *Impact:* Access to improved healthcare services and financial protection against hospitalization expenses.
* *Action Required:* Enroll in the scheme through available channels (app, portal, hospitals, kiosks).
* **Senior Citizens (70+):**
* *Impact:* Entitled to free health benefits up to Rs. 5 lakh per year regardless of socio-economic status.
* *Action Required:* Obtain Ayushman Vay Vandna card and utilize healthcare services at empanelled hospitals.
* **ASHAs, Anganwadi Workers, and Helpers:**
* *Impact:* Inclusion in the scheme, providing access to healthcare benefits.
* *Action Required:* Enroll in the scheme to avail benefits.
* **State Health Authorities:**
* *Impact:* Responsible for implementing and managing the scheme within their respective States/UTs.
* *Action Required:* Onboard beneficiaries, manage empanelled hospitals, and ensure smooth operation of the scheme.
* **Empanelled Hospitals:**
* *Impact:* Provide healthcare services to beneficiaries under the scheme.
* *Action Required:* Deploy PMAMs, install PMJAY kiosks, and facilitate card creation and benefit delivery.
Key Entities Referenced
Pradhan Mantri Jan Arogya Yojana PMJAY: A flagship health insurance scheme providing health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization.
Ayushman Card: A card associated with the PMJAY scheme, providing access to healthcare benefits.
Kerala: A state in India where 83.75 lakh Ayushman cards have been created.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana ABPMJAY: A comprehensive health scheme providing health cover to economically vulnerable families.
VayVandanacard: A card that enables health coverage for senior citizens of age 70 years and above under ABPMJAY.
Health Benefit Package HBP 2022: A set of revised and rationalized health benefit packages under ABPMJAY comprising of 1,961 procedures across 27 medical specialties.
Accredited Social Health Activists ASHAs: Community health workers who are now included in the eligibility criteria under ABPMJAY.
Anganwadi Workers AWWs: Childcare and mother support workers who are now included in the eligibility criteria under ABPMJAY.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
STARREDQUESTION NO. 192
TO BE ANSWERED ON1STAUGUST,2025.
BENEFITS UNDER AYUSHMAN CARD
*192.SHRIE.T.MOHAMMED BASHEER:
Will the Minister of HEALTHANDFAMILYWELFAREbe pleasedtostate:
(a) whether the Government plans to introduce any new health schemes specifically for
senior citizens or enhance the insurance coverage under existing schemes like the Pradhan
Mantri Jan Arogya Yojana (PMJAY)andif so, the details thereof;
(b) whether the Government has reviewed the premium rates and benefits under the
AyushmanCard,includingthecriteriaforenrolmentunderPMJAY,ifso,the detailsthereof;
(c)whether steps have been takenby the Government to ensure that all eligiblecitizens inthe
countryparticularlyinKerala,jointhescheme without anyobstacles, ifso, the detailsthereof;
and
(d) whether the Government proposes to open or upgrade online portals to facilitate the
enrolmentof newbeneficiaries underPMJAYandif so, the detailsthereof?
ANSWER
THE MINISTER OFHEALTH AND FAMILYWELFARE
(SHRIJAGATPRAKASH NADDA)
(a)to(d): AStatementislaid on the Tableof the House.STATEMENTREFERRED TOIN REPLYTO LOK SABHASTARREDQUESTION
NO.*192 FOR1STAUGUST, 2025
******
Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a flagship
scheme of the Government which provides health cover of Rs. 5 lakh per family per year for
secondary and tertiary care hospitalization to 12 crore families constituting economically
vulnerable bottom 40% of India’s population. In October 2024, the scheme has been
expanded to cover 6 crore senior citizens of age 70 years and above belonging to 4.5 crore
families, irrespective of theirsocio-economic status, through VayVandanacard.
Under AB-PMJAY, the health benefit packages have been revised and rationalized
since the launch of the scheme. Health Benefit Package (HBP) 2022 comprises of 1,961
proceduresacross 27medicalspecialties.
TheeligibilitycriteriaunderAB-PMJAYhaveevolvedovertime.SinceJanuary2022,
the beneficiary base of AB-PMJAY has been expanded from 10.74 crore families to 12 crore
families, and provided the flexibility to States/UTs to use other aadhaar-seeded databases of
similar socio-economic profile. In March 2024, the eligibility criteria under the scheme were
expanded to include 37 lakh Accredited Social Health Activists (ASHAs), Anganwadi
Workers(AWWs),Anganwadi Helpers (AWHs) andtheir families.
Under AB-PMJAY, Ayushman Vay Vandna cards provide a form of Universal Health
Coverage wherein all senior citizens aged 70 Years and above, irrespective of their socio-
economic status, are provided free health benefits of up to ₹5 lakh per year. State Health
Authoritiesof the implementing States/UTsare the nodal agenciesresponsible for onboarding
andimplementation of the scheme intheirrespective States/UTs.
A dedicated Ayushman App and web portal (beneficiary.nha.gov.in) have been
created to enable beneficiaries to enroll in the scheme. A national helpline number (14555)
also provides assistance andaddresses all the queries related tothe scheme. Beneficiaries can
also createtheircards at anyempanelledhospital.
Pradhan Mantri Arogya Mitras (PMAMs) are deployed at empanelled hospitals to
guide the scheme beneficiaries. PMJAY kiosks have also been installed at hospitals as the
first point of contactfor facilitating awareness and overallsupport of beneficiaries, assistance
with cardcreationandensuring efficientdeliveryof benefits.
As on date, more than 41 crore Ayushman cards have been created under the scheme
across the country, including83.75 lakhAyushman cardscreatedinthe State of Kerala.
*****