**Executive Summary**
This document presents the Government of India's response to Unstarred Question No. 2302 regarding the implementation of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in Telangana. The response, dated February 13th, 2026, provides data on beneficiary coverage, claim processing, hospital empanelment, and grievance redressal mechanisms. The latest data included is up to January 31st, 2026.
**Key Points / Main Content**
* **Beneficiary Coverage:**
* 29.02 lakh families are eligible for AB-PMJAY in Telangana.
* 82.78 lakh Ayushman cards have been created in Telangana as of 31.01.2026.
* District-wise details of card creation are available online.
* **Claim Processing:**
* Claim settlement is an ongoing process handled by State Health Agencies according to National Health Authority guidelines.
* Permissible turnaround time for claim settlement:
* 15 days for intra-state hospitals.
* 30 days for hospitals outside the state (portability claims).
* 20.08 lakh claims amounting to Rs. 4,262.48 crore have been settled in Telangana as of 31.01.2026.
* **Hospital Empanelment:**
* 12 hospitals have been de-empanelled in Telangana since the scheme's launch in May 2021.
* **Scheme Utilization:**
* Scheme utilization in Telangana has increased year on year since May 2021, in line with the national trend.
* Hospital admission data, comparing national levels to Telangana levels, is provided for the financial years 2021-22 through 2025-26 (up to 31.01.2026).
* **Grievance Redressal:**
* A hospital-specific call center (14413) has been set up to address hospital concerns in real-time.
* Beneficiaries can register grievances through the Centralized Grievance Redressal Management System (CGRMS) or the toll-free helpline number 14555.
* A three-tier grievance redressal mechanism exists at the District, State, and National level, with designated officers and committees.
**Impact Analysis**
**Stakeholder: Beneficiaries of AB-PMJAY in Telangana**
* **Impact:** The document provides information on their access to healthcare under the scheme, including eligibility, card creation, and grievance redressal.
* **Action Required:** Beneficiaries may need to check their eligibility, obtain Ayushman cards, and utilize grievance mechanisms if needed.
**Stakeholder: Hospitals (Empanelled and those seeking Empanelment) in Telangana**
* **Impact:** The document outlines claim settlement processes, hospital de-empanelment status, and the availability of a hospital-specific call center for addressing concerns.
* **Action Required:** Hospitals may need to follow claim adjudication guidelines, utilize the hospital-specific call center for concerns, and participate in grievance redressal processes.
**Stakeholder: State Health Agencies in Telangana**
* **Impact:** The document details their role in claim settlement, adherence to timelines, and overall implementation of the scheme.
* **Action Required:** They must continue to settle claims according to the guidelines and within the stipulated timelines.
**Stakeholder: Ministry of Health and Family Welfare**
* **Impact:** The document provides data for oversight of the scheme, allowing for data driven policy and strategy adjustments.
* **Action Required:** Ensure the effective implementation and monitoring of AB-PMJAY in Telangana, addressing any challenges or gaps identified.
Key Entities Referenced
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY): A health insurance scheme providing financial coverage for medical expenses, specifically discussed in the context of its implementation in Telangana.
Telangana: The state where the AB-PMJAY scheme's implementation and beneficiaries are being assessed.
Ministry of Health and Family Welfare: The government ministry responsible for the AB-PMJAY scheme and answering questions about its implementation.
National Health Authority: The authority that issues claim adjudication guidelines for the AB-PMJAY scheme.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH ANDFAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 2302
TOBE ANSWERED ON 13TH FEBRUARY,2026
ISSUANCE OFAB-PMJAYIN TELANGANA
2302. SHRIARVINDDHARMAPURI:
Will the Minister of HEALTHAND FAMILYWELFAREbe pleased tostate:
(a) the number of beneficiaries covered and e-cards issued under Ayushman Bharat Pradhan
Mantri Jan Arogya Yojana (AB-PMJAY)inthe State of Telangana,district-wise;
(b) the numberand value of claims processed underthe scheme along with the average claim
settlement time;
(c) whether anyclaim rejections or hospital de-empanelments were reported, if so, the details
thereof;
(d) whether the Government has any comparative data on beneficiary utilisation trends in the
Stateof Telangana vis-a-vis the nationalaverage, andif so, the detailsthereof; and
(e)the steps taken by the Government to expandempanelledhospitals andimprove grievance
redressal mechanismsinthe said State?
ANSWER
THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND
FAMILYWELFARE
(SHRIPRATAPRAOJADHAV)
(a): In the State of Telangana, a total of 29.02 lakh families are eligible under Ayushman
Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).Ason31.01.2026,atotalof82.78
lakh Ayushman cardshave beencreated in the State of Telangana. The district-wise detailsof
number of Ayushman cards created in the State can be accessed at:
https://dashboard.nha.gov.in/public/card
(b) & (c): Under AB-PMJAY, settlement of claims is a regular and uninterrupted process and
claims are settled by respective State Health Agencies as per claim adjudication guidelines
issued by National Health Authority. As per the guideline, the permissible turnaround time
for settlement of claims is within 15 days of claim submission for intra-state hospitals
(hospitals located within the State) and within 30 days in case of portability claims (hospitals
locatedoutside the State).As on 31.01.2026, a total of 20.08 lakh claims amounting to Rs. 4,262.48 crore have been
settled in the State of Telangana. As reported by the State, a total of 12 hospitals have been
de-empanelledtill date,since the launchof the scheme inMay 2021inthe Stateof Telangana.
(d): The utilisation of the scheme in the State of Telangana (launched in May 2021) has
increased progressively year on year, in line with the national trend. The comparative
utilisation trend of the State of Telangana as compared to the national average under the
scheme isasunder:
Financial Year Number of hospital admissions
National level Telangana
2021-22 1.44 crore 3.23 lakh
2022-23 1.59 crore 5.53 lakh
2023-24 1.98 crore 6.18 lakh
2024-25 2.42 crore 6.77 lakh
2025-26* 2.27 crore 6.22 lakh
*Data upto31.01.2026
(e): In order to improve the participation of hospitals, a hospital-specific call center (14413)
has been set-up to address the concerns of hospitals on a real-time basis including concerns
related to empanelment. Under the scheme, the beneficiaries can register their grievances
through the CentralizedGrievance Redressal Management System(CGRMS) or the 24×7 toll
-free helpline number 14555.All such grievances are monitored through a three-tier
grievance redressal mechanism at the District, State and National level. At each level,
designated nodal officers and Grievance Redressal Committees are in place to examine and
resolve the grievances.
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