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Date: 2025-07-25 Category: Not Applicable State: Union Government Country: India

Parliament Question: Increase in Health Cover Under AB-PMJAY

Issued by Ministry of Health and Family Welfare · Not Applicable

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Executive Summary & Key Takeaways

Executive Summary: This document is a response to Lok Sabha Unstarred Question No. 1002 regarding the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY). It details the eligibility criteria for availing benefits, provides district-wise Ayushman card creation data for Uttar Pradesh over the last five years, and clarifies the government's position on increasing health cover under the scheme. The response was given on July 25, 2025. Key Points / Main Content: Eligibility Criteria for ABPMJAY: Initially based on Socio Economic Caste Census (SECC) 2011 data, using 6 deprivation and 11 occupational criteria. In January 2022, the beneficiary base was revised to 12 crore families, with flexibility for States/UTs to use similar socio-economic profile databases for verification. Many States/UTs have expanded the beneficiary base at their own cost using non-SECC data sources, including the National Food Security Act. In March 2024, eligibility expanded to include 37 lakh ASHAs, AWWs, and AWHs and their families. In October 2024, the scheme was expanded to provide free treatment benefits of up to Rs. 5 lakh per year to approximately 6 crore senior citizens aged 70 years and above, belonging to 4.5 crore families, irrespective of their socioeconomic status, through VayVandanacards. Data on Ayushman Cards in Uttar Pradesh: Constituency-wise data is not captured; district-wise data is available. District-wise and year-wise details of Ayushman cards created in Uttar Pradesh for the last five years are provided in the Annexure. Health Cover and Scheme Updates: ABPMJAY provides free healthcare access up to Rs. 5 lakh per eligible beneficiary family per year for secondary and tertiary care hospitalization. This covers 27 medical specialties corresponding to 1961 procedures. Regular updates, including new procedures, hospital empanelment, and beneficiary base expansion, are done as per new requirements. Impact Analysis: Beneficiaries: Impact: Access to healthcare services up to Rs. 5 lakh per family per year, expanded eligibility criteria including senior citizens, ASHAs, AWWs and AWHs. Action Required: Check eligibility based on revised criteria; utilize Ayushman cards for accessing healthcare services. States/Union Territories: Impact: Flexibility to expand the beneficiary base using non-SECC data sources. Action Required: Utilize available socio-economic data to identify and verify beneficiaries; implement scheme expansions at their own cost. Healthcare Providers: Impact: Potential for increased patient volume and revenue through empanelment with ABPMJAY. Action Required: Seek empanelment with ABPMJAY to provide services to eligible beneficiaries. Government of India: Impact: Management and regular updates to the scheme, including expanding beneficiary base and healthcare services offered. Action Required: Continue to monitor and update the scheme based on evolving needs and requirements.

Key Entities Referenced

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana: A health scheme (ABPMJAY) providing financial risk protection by providing health cover to identified beneficiaries at the secondary and tertiary levels. Uttar Pradesh: A state in India, mentioned in the context of beneficiaries under the ABPMJAY scheme. Baghpat Lok Sabha Constituency: A Lok Sabha constituency in Uttar Pradesh, used as a reference for beneficiary details under ABPMJAY. Socio Economic Caste Census 2011: A census (SECC 2011) used as a primary basis for identifying eligible beneficiary families under ABPMJAY. Accredited Social Health Activists: ASHAs - Included in the eligibility criteria under the scheme in March 2024. Anganwadi Workers: AWWs - Included in the eligibility criteria under the scheme in March 2024. VayVandanacards: Cards used to extend AB PMJAY to senior citizens aged 70 years and above, irrespective of their socioeconomic status. National FoodSecurityAct: A data source (non-SECC) used by States/UTs for verification of beneficiaries against SECC beneficiaries who could not be identified and verified.
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GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH ANDFAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 1002 TOBE ANSWERED ON25TH JULY,2025 INCREASE INHEALTH COVER UNDER AB-PMJAY †1002.DR. RAJKUMAR SANGWAN: Will the Minister of HEALTHAND FAMILYWELFAREbe pleased tostate: (a) the criteria fixed for availing the benefits under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana; (b) the details of the beneficiaries under this scheme in Uttar Pradesh including Baghpat Lok SabhaConstituency during each of the last five years, LokSabhaConstituency-wise; (c) whether the Government proposes to increase the amount of health cover under this scheme; and (d) if so, the time bywhich it islikely tobe done? ANSWER THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND FAMILYWELFARE (SHRIPRATAPRAOJADHAV) (a): Under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the eligibility criteria for the beneficiary families were initially identified from the Socio- Economic Caste Census (SECC) of 2011 on the basis of 6 deprivation and 11 occupational criteria across rural and urban areas respectively. Further, in January 2022, on the basis of decadal growth rate of 11.7%, Government of India revised the beneficiary base to 12 crore families and provided the flexibility to States/UTs to use other databases (of similar socio- economicprofile)for verification of beneficiariesagainst such SECCbeneficiaries who could not be identified and verified. Many of the States and Union Territories (UTs) implementing AB-PMJAY have further expanded the beneficiary base at their own cost under the scheme using non-SECCdata sources (including National FoodSecurityAct, Statespecific datasets). 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) and their families. Further, in October 2024, the government expanded AB- PMJAY to provide free treatment benefits of up to ₹5 lakh per year to approximately 6 crore senior citizens aged 70 years and above, belonging to 4.5 crore families, irrespective of their socio-economic status, through VayVandanacards.(b): Constituency-wise data is not captured in the scheme, instead, district-wise data is available. District-wise and year-wise details of number of Ayushman cards created in Uttar Pradeshinthe last five yearsare at Annexure. (c)and (d): AB-PMJAYcurrently providesfree healthcare accessup toRs. 5 lakhpereligible beneficiary family per year for secondary and tertiary care hospitalization in 27 different medical specialties corresponding to 1961 procedures. Regular updation such as inclusion of new procedures, empanelment of new hospitals, expansion of beneficiary base and other improvementsare done inthe scheme aspernewrequirementsfrom time totime.Annexure District-wise andyear-wisedetails of numberof Ayushmancardscreated inUttar Pradeshin the last five years District 2020-2021 2021-2022 2022-2023 2023-2024 2024-2025 Agra 66,871 46,806 1,00,653 4,97,455 53,984 Aligarh 99,006 62,853 1,37,006 5,63,948 36,054 Ambedkar Nagar 45,486 78,035 1,00,306 4,29,252 24,735 Amethi 64,067 51,137 1,21,699 2,09,462 16,723 Amroha 15,212 29,207 63,849 2,77,001 22,083 Auraiya 41,847 47,889 63,882 1,34,701 15,012 Ayodhya 50,967 59,281 1,38,396 3,08,889 24,812 Azamgarh 44,214 79,782 2,29,275 6,52,605 53,942 Baghpat 21,880 17,476 34,354 2,14,879 22,208 Bahraich 88,713 1,29,025 1,38,519 4,04,545 31,634 Ballia 70,689 72,612 2,62,697 3,42,267 39,724 Balrampur 60,201 40,805 63,421 2,97,360 21,883 Banda 79,707 16,745 88,169 2,35,184 7,643 Bara Banki 59,696 66,956 1,52,237 4,10,931 63,392 Bareilly 1,06,657 1,09,710 2,53,866 4,12,394 91,202 Basti 52,125 57,620 1,26,943 3,95,544 28,870 Bhadohi 40,817 30,193 60,273 1,66,494 15,830 Bijnor 47,517 1,21,057 1,87,298 4,22,750 69,108 Budaun 73,639 30,342 1,80,608 2,76,995 45,762 Bulandshahr 74,894 76,207 1,44,164 3,95,888 47,039 Chandauli 69,988 49,840 1,16,748 1,78,582 21,374 Chitrakoot 29,483 14,253 46,746 1,42,950 19,884 Deoria 43,875 1,13,001 1,94,628 2,17,089 50,233 Etah 32,985 25,472 58,484 2,59,576 20,891 Etawah 43,831 36,518 95,167 1,33,475 22,454 Farrukhabad 74,609 34,295 1,08,462 1,78,883 25,689 Fatehpur 82,967 50,616 1,00,175 3,03,391 37,767 Firozabad 38,382 38,425 1,13,043 2,85,272 42,804 Gautam Buddha Nagar 9,964 9,503 21,557 1,16,917 23,958 Ghaziabad 24,014 31,669 60,295 3,59,627 38,771 Ghazipur 44,797 50,377 1,72,923 3,63,380 52,794 Gonda 82,573 73,109 64,285 4,10,757 28,064 Gorakhpur 88,502 1,65,737 1,17,295 4,41,685 90,688 Hamirpur 48,814 26,064 57,914 1,53,796 10,455 Hapur 19,265 16,755 36,017 1,99,246 19,026 Hardoi 87,117 48,388 2,53,231 5,25,139 23,151 Hathras 38,602 26,524 55,402 1,65,444 14,772 Jalaun 29,933 48,748 76,636 1,69,829 21,635 Jaunpur 94,021 91,284 2,26,413 5,45,632 97,157 Jhansi 44,598 60,569 1,00,082 1,33,172 31,127 Kannauj 45,863 20,810 87,054 1,70,204 16,805Kanpur Dehat 74,030 94,883 80,268 1,75,014 17,948 Kanpur Nagar 89,212 62,333 1,14,975 3,09,812 92,811 Kasganj 37,494 31,795 27,236 1,71,231 10,018 Kaushambi 48,029 26,326 59,626 2,21,762 19,493 Kheri 1,70,412 46,783 1,84,045 3,85,167 47,911 Kushinagar 1,12,903 75,013 2,10,371 3,57,538 36,590 Lalitpur 20,486 29,118 40,124 1,08,693 11,618 Lucknow 71,637 75,730 1,36,561 3,10,483 79,644 Mahoba 32,384 10,823 45,660 85,559 11,016 Mahrajganj 44,237 60,866 1,28,225 3,96,581 56,661 Mainpuri 31,109 70,763 72,478 2,20,936 24,355 Mathura 35,218 31,573 1,19,307 2,56,133 45,547 Mau 25,111 66,198 1,98,893 2,40,978 34,153 Meerut 68,241 44,113 1,20,413 3,84,931 63,373 Mirzapur 83,912 43,136 1,66,724 2,33,510 32,299 Moradabad 90,252 71,142 1,66,853 4,66,527 55,952 Muzaffarnagar 43,966 47,784 1,04,686 3,34,584 52,019 Pilibhit 1,06,571 54,923 1,75,926 2,88,035 25,409 Pratapgarh 86,763 75,284 1,01,770 5,35,574 30,765 Prayagraj 71,381 60,184 1,53,962 4,97,547 58,130 Rae Bareli 76,247 46,331 1,58,581 3,82,012 58,533 Rampur 36,699 47,888 78,720 2,79,086 39,050 Saharanpur 48,668 1,36,455 1,61,090 6,40,488 57,835 Sambhal 18,643 33,271 72,325 2,77,573 18,755 SantKabir Nagar 25,500 34,627 1,10,929 1,54,196 28,394 Shahjahanpur 86,357 78,717 1,87,707 2,64,501 62,244 Shamli 20,816 32,042 56,362 2,09,571 26,283 Shrawasti 31,297 18,380 31,368 1,75,183 4,327 Siddharthnagar 45,225 51,339 53,848 2,56,996 24,699 Sitapur 1,07,227 1,19,701 1,65,337 6,20,527 34,818 Sonbhadra 23,478 30,969 1,31,601 1,21,755 18,746 Sultanpur 62,418 56,429 1,64,556 2,96,147 26,604 Unnao 1,41,912 34,470 1,28,058 4,04,927 28,371 Varanasi 43,794 78,870 1,85,829 6,00,739 73,735 *****

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