pm ayushman bharat yojana eligibility who can and cannot avail e282b95 lakh free health insurance

PM Ayushman Bharat Yojana Eligibility: Who Can and Cannot Avail ₹5 Lakh Free Health Insurance

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Before applying for India’s largest government-backed health insurance scheme, check if you meet the eligibility criteria to avoid disappointment.

What Is PM Ayushman Bharat Yojana?

Launched in 2018 under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY), this flagship healthcare scheme by the Government of India offers free health insurance coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization.

It aims to benefit the economically weaker sections (EWS) of society who are unable to afford private health insurance. As of now, crores of families across India are benefiting from this scheme, receiving quality healthcare in both public and empaneled private hospitals — entirely cashless.

PM Ayushman Bharat Yojana

However, not everyone is eligible. The government has defined strict eligibility criteria to ensure the benefits reach only the truly deserving.

Who Is Not Eligible for PM Ayushman Bharat Yojana?

While the scheme is meant to be inclusive, it excludes individuals and families who are considered to be financially stable or better-off, based on specific socio-economic indicators.

The following groups are excluded from Ayushman Yojana:

  1. Vehicle Owners

    • If your household owns two-wheelers, three-wheelers, four-wheelers, or motor/fishing boats, you are ineligible.

  2. Land and Agricultural Machinery Owners

    • Those owning 5 acres or more of agricultural land

    • Households with mechanized farming equipment

  3. Government and Organised Sector Employees

    • Any government employee

    • Individuals working in non-agricultural government-run businesses

  4. Financial Criteria

    • Households with monthly income above ₹10,000

    • Kisan Credit Card holders with a credit limit of ₹50,000 or more

  5. Infrastructure and Utilities

    • Families living in pucca (permanent) houses

    • Those with a landline telephone connection

    • Individuals with refrigerators (as a proxy for economic status)

These exclusions are based on data from the Socio-Economic Caste Census (SECC) 2011, which the government uses to determine eligibility for PM-JAY.

Who Is Eligible for PM Ayushman Bharat Yojana?

The scheme is meant to benefit deprived rural families and vulnerable urban households, as per the SECC database.

Eligible categories include:

  • Families with no adult (16–59 years) member

  • Households with female-headed members with no adult male

  • Households with disabled members and no able-bodied adult

  • SC/ST families (based on SECC classification)

  • Landless households dependent on casual labour

  • Homeless individuals

  • Families involved in manual scavenging, begging, or rag picking

  • Primitive tribal groups and legally released bonded labourers

Urban beneficiaries are identified based on occupation categories like:

  • Domestic workers

  • Street vendors

  • Rickshaw pullers

  • Construction workers

  • Sanitation workers

  • Mechanics, electricians, tailors, etc.

If you fall under any of these categories, you can avail cashless treatment worth ₹5 lakh annually at empaneled hospitals across India under PM-JAY.

How to Check Eligibility for PM-JAY

To find out if you are eligible:

  1. Visit the official PM-JAY website: https://pmjay.gov.in

  2. Click on the “Am I Eligible” section.

  3. Enter your mobile number and OTP.

  4. Search using your name, ration card, or family ID.

You can also check eligibility through Common Service Centres (CSCs) or by contacting the Ayushman Mitra at your nearest government hospital.

What Does PM-JAY Cover?

Eligible beneficiaries receive coverage for:

  • Hospitalization expenses

  • Day-care surgeries

  • Pre- and post-hospitalization (3 and 15 days respectively)

  • Diagnostics and medicines

  • All pre-existing diseases

  • Free treatment in empaneled public and private hospitals

There is no cap on family size, no age limit, and no waiting period.

Final Thoughts: Check Before You Apply

While the Ayushman Bharat Yojana offers a life-changing opportunity for many, it’s crucial to verify your eligibility before applying. Individuals with stable incomes, assets, or government jobs are not eligible, as the scheme is targeted at India’s most vulnerable.

Ensure that you meet the inclusion criteria and have your documents and identification ready for seamless enrollment and benefits. For those who qualify, Ayushman Bharat offers an unparalleled safety net during medical emergencies without financial burden.

Author Profile

Ganpat Singh Chouhan
Ganpat Singh Chouhan
My name is Ganpat Singh Choughan. I am an experienced content writer with 7 years of expertise in the field. Currently, I contribute to Daily Kiran, creating engaging and informative content across a variety of categories including technology, health, travel, education, and automobiles. My goal is to deliver accurate, insightful, and captivating information through my words to help readers stay informed and empowered.