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Indian Finance 🇮🇳

Sehat Jk Health Scheme — Calculations & Slabs for FY 2026-27

Check whether you qualify for J&K's SEHAT scheme providing cashless health cover of Rs 5 lakh per family per year.

Last verified: June 2026 | Source: jknhm.com

1. Demographic Details

Frequently Asked Questions (FAQ)

What makes the J&K SEHAT scheme different from the national PMJAY?

While the national AB-PMJAY scheme covers only identified poor families (around 40% of India's population), the SEHAT scheme is a universal healthcare initiative by the J&K administration that covers 100% of J&K residents, regardless of income.

What is the annual medical coverage under the SEHAT scheme?

The scheme provides a health cover of up to ₹5,00,000 (five lakh rupees) per family, per year on a floater basis for secondary and tertiary hospitalisation care.

Is there any premium to be paid for the SEHAT card?

No. The SEHAT health card is provided entirely free of cost, and the entire premium amount is paid by the Government of Jammu & Kashmir.

Are pre-existing diseases covered under the J&K health insurance?

Yes. All pre-existing diseases and medical conditions are covered from day one of card activation. There is no waiting period.

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 calculator checks your eligibility for the Jammu & Kashmir Ayushman Bharat PM-JAY SEHAT scheme. It verifies residency, ration card status, and current health insurance coverage to estimate cashless medical treatment limits for J&K families.

📋 How to Use It

  1. 1
    Resident Status: Select whether you are a permanent resident of Jammu & Kashmir or Ladakh.
  2. 2
    Ration Card Category: Choose your ration card type (PHH, AAY, NPHH, or No Card).
  3. 3
    Active Health Insurance: Confirm if you are already covered under ESIC, CGHS, or other government employee health schemes.
  4. 4
    Family Size: Enter the number of members in your household.

🧬 The Logic Explained Simply

  • The Concept: Unlike the national PM-JAY which targets only BPL families, the J&K SEHAT scheme provides universal health insurance coverage to all residents of the UT.
  • Cashless Treatment Limit: Renders a cashless health cover of up to ₹5,00,000 per family per year on a family floater basis.
  • Premium Cost: The program offers zero-premium coverage, meaning the entire cost of treatment up to the limit is funded by the government.
  • Exclusion Check: Families with members actively enrolled in other government insurance programs like CGHS or ESIC are excluded to prevent duplicate benefits.

💡 Real-World Calculation Breakdown

A family of 5 living in Srinagar, Jammu & Kashmir, applies for the SEHAT health card:

  • Residency Check: Permanent residents of J&K (Eligible).
  • Ration Card Check: Holds an NPHH (Non-Priority Household) card (Eligible, as coverage is universal).
  • Other Insurance Check: No members are government employees or covered under ESIC/CGHS (Eligible).
  • Verdict: Eligible for AB-PMJAY SEHAT Card.
  • Coverage Allocation: Renders a cashless medical insurance cover of ₹5,00,000 per year, applicable for pre-existing diseases, critical care surgeries, and hospitalizations across network hospitals.

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