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Indian Finance 🇮🇳

PMJAY Eligibility — Calculations & Slabs for FY 2026-27

Check whether your household SECC status, NHA state list, or category qualifies for AB PM-JAY cashless health cover of Rs 5 lakh per year.

Eligibility rules last verified: June 2026 | Source: beneficiary.nha.gov.in
⚡ Check Eligibility 📋 How to Apply ↓

1. Household Profile

Ayushman Bharat (PM-JAY) Eligibility Criteria Explained

Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the largest health assurance scheme in the world, aiming to provide a health cover of ₹5 Lakh per family per year for secondary and tertiary care hospitalization to over 12 crore poor and vulnerable families.

Senior Citizen Expansion (70+ Age Group)

In September 2024, the Union Cabinet expanded the PM-JAY scheme to cover all senior citizens aged 70 years and above, irrespective of their socio-economic status or income. The expansion operates as follows:

  • Senior citizens aged 70+ are issued a distinct **Ayushman Vay Vandana Card**.
  • They receive an exclusive, independent cover of **₹5 Lakh per year**.
  • If they belong to a family already covered under PM-JAY, they receive an additional top-up of **₹5 Lakh** dedicated only to them.

How to Apply — Step by Step

A clear guide to help you check your family records and complete your e-KYC online to receive ₹5 Lakh annual health insurance coverage.

Application steps last verified: July 2026 | Source: beneficiary.nha.gov.in

Step-by-Step Application Process

ℹ️ Portal Migration Notice

The older SETU portal (setu.pmjay.gov.in) has been merged. All public self-registrations and card downloads must now be completed on the unified National Health Authority Beneficiary Portal at beneficiary.nha.gov.in.

  1. 1

    Open the NHA Portal

    Go to beneficiary.nha.gov.in on your mobile device or computer.

  2. 2

    Login as a Beneficiary

    On the login section, select the Beneficiary radio button (do not select Operator). Type your 10-digit mobile number and click the "Verify" button. Type the OTP received via SMS, fill in the Captcha code, and click "Login".

  3. 3

    Search for Your Household

    In the search form, select your State, Scheme (PMJAY), District, and choose how you want to search. You can search by Aadhaar Number, Family ID (Ration Card), or Name. Click the Search button to view your household details.

  4. 4

    Initiate e-KYC

    🔒 Login Wall Restriction Notice

    Steps beyond this point require OTP authentication and family match records to proceed. Described below from official portal instructions:

    • Locate your name in the search results list.
    • Click on the Action / e-KYC button next to your name (indicated by an icon).
    • Select the authentication mode: Aadhaar OTP, Fingerprint, or Iris scan. Select Aadhaar OTP for self-service.
  5. 5

    Aadhaar OTP Verification

    Agree to the terms and click Get OTP. Enter the OTP sent to your Aadhaar-linked mobile phone. If the system matches your details with the PMJAY database, a green success banner and matching percentage will show.

  6. 6

    Download Ayushman Card

    Once verification is complete, your card status will change to Approved. Click the download icon to save a PDF copy of your golden Ayushman Card.

If Your Application Is Rejected or Card is Pending

If your card status remains 'Pending' for over 72 hours, it means local health authorities are manually verifying your ration card records. You can check the approval status by logging back into the beneficiary portal. If rejected, or if you face issues, you can file an official grievance on the NHA CGRMS portal at cgrms.pmjay.gov.in or call the national support helpline at 14555.

Frequently Asked Questions (FAQ)

What is the new Ayushman Vay Vandana Card for senior citizens?

Announced in late 2024, the Ayushman Vay Vandana card extends AB-PMJAY health benefits to all senior citizens aged 70 and above, regardless of income, wealth, or socio-economic status. It provides a dedicated cover of ₹5 Lakh per year for the senior citizen, which is not shared with the rest of the family.

If my family is already covered under PMJAY, does the 70+ senior get additional benefits?

Yes. If a family is already covered under PM-JAY and has a member aged 70+, that senior citizen gets a top-up of ₹5 Lakh per year exclusively for themselves. They do not have to share this limit with the other members under 70.

Can I apply for PMJAY if I already have private health insurance?

Yes. The universal 70+ expansion allows seniors to keep or switch private health insurance, and they remain eligible. For families under 70, holding private health insurance does not bar you from the scheme, provided you meet the SECC 2011 poverty indicators or hold a BPL/AAY card.

How do I check if my name is in the SECC 2011 PMJAY beneficiary list?

You can visit beneficiary.nha.gov.in, log in with your mobile number, search by your Ration Card (NFSA) number, Aadhaar number, or Location, and view the list of verified beneficiaries in your area. This ensures full compliance with the latest regulations, allowing you to estimate values correctly and avoid common filing errors.

Where can I verify the source data for this calculator?

You can verify the values against the official notifications listed in our data sources section at the bottom of the page.

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About This Calculator

Target Audience: Salaried taxpayers, investors & retirees planning Indian tax & wealth growth

What Does This Calculator Do?

This Ayushman Bharat (PM-JAY) Eligibility Calculator checks if you or your family members qualify for India's free national health insurance scheme. It evaluates your eligibility based on Socio-Economic Caste Census (SECC 2011) criteria, ration card status, and occupational categories. It also includes the newly expanded Ayushman Vay Vandana rules for senior citizens aged 70 and above.

How to Use It

  1. Age: Input the applicant's age. If the applicant is 70 or older, they qualify automatically under the Senior Citizen expansion.
  2. Ration Card: Select your card type (AAY, BPL, APL, or None).
  3. Occupation & Housing: Select your household's occupational class and the type of housing (Kuccha, Semi-pucca, or Pucca).
  4. Income: Input your monthly family income to check against state-specific thresholds.

The Logic Explained Simply

  • The Concept: PM-JAY offers a cashless health cover of ₹5 Lakh per family per year. For individuals under 70, eligibility is based on SECC 2011 deprivation indicators (like living in single-room Kuccha houses) or low-income occupations. For senior citizens aged 70+, coverage is universal (no income cap) and provides an independent cover of ₹5 Lakh.
  • The Formula:

Eligible = (Age >= 70) OR (Ration Card is BPL/AAY) OR (SECC Listed) OR (Occupational Deprivation Match)

Real-World Calculation Breakdown

Consider a household in Bihar where the primary earner is a construction worker earning ₹12,000/month, living in a Kuccha house, and one family member is 72 years old.

  • The family is ELIGIBLE based on occupation and housing deprivation, receiving ₹5,000,000 (₹5 Lakh) family cover.
  • The 72-year-old senior receives a separate, dedicated ₹5,000,000 (₹5 Lakh) Ayushman Vay Vandana card, bringing the total coverage to ₹10 Lakh for the household.

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