Based on the comprehensive data presented to the Lok Sabha regarding implementation in Bihar, Uttar Pradesh, Madhya Pradesh, and Andhra Pradesh, here is a complete overview of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) as of early 2026.
📊 Quick Snapshot: The Numbers Speak
Families Covered (as of Jan 2026)
- Uttar Pradesh: 1.26 Crore families
- Bihar: 1.16 Crore families
- Madhya Pradesh: 0.89 Crore families
- Andhra Pradesh: 0.59 Crore families
- Total in 4 States: 3.9 Crore families (Over 15 crore individuals)
Hospital Network (as of 31st Jan 2026)
| State | Public Hospitals | Private Hospitals | Total |
|---|---|---|---|
| Uttar Pradesh | 2,926 | 3,413 | 6,339 |
| Madhya Pradesh | 1,113 | 823 | 1,936 |
| Andhra Pradesh | 1,416 | 1,053 | 2,469 |
| Bihar | 430 | 723 | 1,153 |
| GRAND TOTAL | 5,885 | 6,012 | 11,897 |
⚙️ How the Scheme Operates
Claim Settlement Process
- Timeline: Strict Turnaround Time (TAT) enforced
- 15 days for hospitals within the same state
- 30 days for portability claims (treatment in another state)
- Process: Digital submission → State Health Agency adjudication → Payment
- Governance: Standardized guidelines from National Health Authority (NHA)
Fraud Prevention Framework
- Zero-Tolerance Policy: Strict action against malpractice
- Technology Shield: AI/ML-based system flags suspicious patterns
- Duplicate claims detection
- Inflated procedures monitoring
- Identity misuse prevention
- National Anti-Fraud Unit (NAFU): Central monitoring body
- Real-Time Dashboards: Continuous performance monitoring
- Penalties: Financial recovery, suspension, de-empanelment for offenders
🎯 Recent Expansions & Coverage
Who is Eligible Now?
- Original Base: 12 crore families (bottom 40% population per SECC 2011)
- March 2024 Addition: ~37 lakh families of ASHA workers, Anganwadi Workers & Helpers
- October 2024 Addition: All senior citizens aged 70+ (~6 crore seniors from 4.5 crore families)
- State-Level Expansions: Many states have added more families using their own resources
Key Benefits
- Coverage Amount: ₹5 lakh per family per year
- Scope: Secondary and tertiary care hospitalization
- Payment Mode: Completely cashless
- Portability: Treatment available across India
🔍 For Beneficiaries: How to Access Services
Check Your Eligibility
- Online: Visit
mera.pmjay.gov.inor use PMJAY mobile app - Helpline: Call 14555 (24×7 toll-free)
- Physical Centers: Visit Common Service Centres (CSCs) or Ayushman Bharat kiosks at empanelled hospitals
When Seeking Treatment
- Carry your Ayushman Card and photo ID proof
- Choose from any empanelled hospital (public or private)
- No payment required – treatment is completely cashless
- Keep your registered mobile number active for updates
📈 The Bigger Picture: Impact & Vision
Achievements So Far
- Created one of world’s largest health protection schemes
- Built robust public-private partnership in healthcare delivery
- Established technology-driven governance framework
- Progressively expanded coverage beyond original targets
Future Direction
- Moving towards saturation coverage of all eligible families
- Enhancing quality of care in empanelled hospitals
- Strengthening preventive healthcare components
- Integrating with digital health ecosystem (Ayushman Bharat Digital Mission)
❓ Common Questions Answered
Q: What if I lost my Ayushman Card?
A: You can get a duplicate card from your nearest CSC or through the hospital kiosk. Your entitlement is linked to your family details in the system.
Q: Can I get treatment outside my home state?
A: Yes! PM-JAY is portable across India. Use the hospital search feature on the website/app to find empanelled hospitals anywhere.
Q: What treatments are covered?
A: Over 1,900 medical and surgical packages including serious ailments like cancer, heart diseases, organ transplants, and trauma care.
Q: How are hospitals paid?
A: Directly by the government/insurance company. You should NOT pay any money for covered treatments.
🤝 Your Role in Scheme Success
As a Beneficiary:
- Use the scheme only when genuinely needed
- Report any demands for payment at empanelled hospitals
- Keep your family details updated
- Inform eligible relatives/friends about the scheme
As a Citizen:
- Report suspected fraud via 14555 or NHA website
- Support awareness campaigns in your community
- Help elderly neighbors check eligibility and enroll
This overview is based on official data presented in the Lok Sabha on February 6, 2026. For the most current information, always refer to the official PMJAY website or helpline.
Remember: Ayushman Bharat is more than a health scheme—it’s a commitment to ensuring that no Indian family faces financial ruin due to healthcare expenses. Stay informed, stay protected, and help build a healthier India. 🇮🇳
Need Help?
- Website: https://pmjay.gov.in
- Helpline: 14555 (24×7, Toll-free)
- Mobile App: “Ayushman Bharat” on Play Store/App Store
Customer Care Phone Number 
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