+91-98111-67809Ayushman Bharat PM-JAY & Government Insurance Schemes in India: Complete Guide 2026
A huge number of Indians have no insurance at all. The government has been trying to fix that with a handful of schemes that provide free or near-free health, life, and accident coverage. The biggest of these is Ayushman Bharat PM-JAY, which covers hospital expenses up to Rs 5 lakh per family per year. But there are others worth knowing about too, including life cover for Rs 436 a year and accident insurance for Rs 20.
Here's a straightforward look at each one: who qualifies, what you get, and how to sign up.
Ayushman Bharat PM-JAY
The basics
PM-JAY launched on September 23, 2018. It gives Rs 5 lakh per family per year for hospitalisation (both secondary and tertiary care). It targets the bottom 40% of the population, roughly 12 crore families or about 55 crore people.
The whole thing is cashless and paperless. You walk into an empanelled hospital, show your Ayushman card, get treated, and leave. No bills to pay at the counter.
Who qualifies?
Eligibility comes from the Socio-Economic Caste Census (SECC) 2011 data, and has been expanded since then.
For rural families, you need to meet at least one deprivation criterion:
- Only one room with kutcha walls or roof
- No adult member aged 16-59
- Female-headed household with no male member aged 16-59
- Household with a disabled member and no able-bodied member
- SC/ST households
- Landless households earning mainly from manual labour
For urban families, you need to belong to specific occupational categories:
- Rag pickers, street vendors, domestic workers
- Construction workers, plumbers, painters, welders
- Security guards, coolies, rickshaw pullers
- Sweepers, sanitation workers, gardeners
- Home-based artisans, handloom and handicraft workers
- Transport workers (drivers, conductors, helpers)
- Shop workers, assistants, peons, delivery workers
In September 2024, coverage was extended to all senior citizens aged 70 and above, regardless of income. That brought in roughly 6 crore more people.
What PM-JAY covers
- Hospitalisation expenses (room, nursing, ICU)
- Pre-hospitalisation costs (up to 3 days before admission)
- Post-hospitalisation costs (up to 15 days after discharge)
- Over 1,900 medical and surgical procedures
- Day-care treatments
- Medicines, diagnostics, and consumables during hospital stays
- Transport allowance
What it doesn't cover
- OPD consultations and medicines (unless tied to a hospitalisation)
- Cosmetic surgery
- Fertility treatments
- Organ transplant (partially covered in some states)
How to check eligibility and get your card
- Go to pmjay.gov.in and enter your mobile number or ration card number
- Visit a Common Service Centre (CSC) or empanelled hospital to get your Ayushman card
- Bring your Aadhaar card, ration card, and a government-issued ID
- You can also create the card through the Ayushman app on Android or iOS
The card is free. If anyone asks you to pay for it, that's a scam.
PM-JAY by the numbers (2026)
- Beneficiary families: over 12 crore
- Hospital admissions processed: over 11.6 crore
- Empanelled hospitals: over 30,000
- Treatment packages: 1,900+
PMJJBY: life insurance for Rs 436 a year
Pradhan Mantri Jeevan Jyoti Bima Yojana is a government-backed term life insurance scheme. It gives Rs 2 lakh in life cover for a premium of Rs 436 per year. That's it. Simple, cheap, and designed for people who don't have any other life insurance.
| Detail | What you get | |---|---| | Coverage | Rs 2 lakh (death from any cause) | | Annual premium | Rs 436 | | Age group | 18-55 years (cover continues until 55) | | How it works | Auto-debit from your savings bank account | | Claim | Paid to the nominee | | Renewal | Annual, auto-debited on or before June 1 |
Who can join?
Any Indian citizen aged 18-55 with a savings bank account. You give consent for auto-debit, and Rs 436 gets deducted every year. No medical exam needed.
How to enrol
Visit your bank branch, use net banking, or use mobile banking. Fill the form, consent to auto-debit, done. You can do this at any participating bank.
PMSBY: accident insurance for Rs 20 a year
Pradhan Mantri Suraksha Bima Yojana is accident insurance. Rs 20 per year. Twenty rupees. It covers death and disability from accidents.
| What happens | How much you get | |---|---| | Accidental death | Rs 2 lakh | | Total permanent disability (loss of both eyes, both hands/feet) | Rs 2 lakh | | Partial permanent disability (loss of one eye, one hand/foot) | Rs 1 lakh |
Age group: 18-70 years. Premium auto-debited from your bank account once a year. Coverage runs from June 1 to May 31. No medical exam.
If you meet with an accident causing death or disability, file a claim through your bank with the FIR, hospital records, and disability certificate (if applicable).
Over 562 million people have enrolled since launch. For Rs 20, it's hard to argue against it.
PMFBY: crop insurance for farmers
Pradhan Mantri Fasal Bima Yojana protects farmers against crop loss from natural disasters, pests, and diseases. It covers the entire crop cycle from pre-sowing to post-harvest.
What farmers pay
| Season | Crop type | Farmer's premium share | |---|---|---| | Kharif | Food grains, oilseeds | 2% of sum insured | | Rabi | Food grains, oilseeds | 1.5% of sum insured | | Both | Commercial/horticultural crops | 5% of sum insured |
The rest of the premium (which can be much higher) is split between central and state governments.
What's covered
- Crop loss from floods, drought, hailstorm, cyclone, fire
- Prevented sowing (when weather conditions stop you from planting)
- Post-harvest losses (up to 14 days after harvest, for specific causes)
- Localised damage (hailstorm, landslide, inundation on isolated farms)
- Pest and disease attacks
How to apply
If you have a crop loan, enrolment used to be automatic (now voluntary since Kharif 2020). You can also apply through Common Service Centres, the PMFBY portal at pmfby.gov.in, or the Crop Insurance App. Bring land records, Aadhaar, bank details, and a sowing certificate.
AABY: insurance for unorganised workers
Aam Aadmi Bima Yojana covers heads of families in rural landless households. Administered by LIC.
| Event | Amount | |---|---| | Natural death | Rs 30,000 | | Accidental death | Rs 75,000 | | Permanent total disability (accident) | Rs 75,000 | | Partial permanent disability (accident) | Rs 37,500 |
Premium: Rs 200 per year (half paid by state government, half from Social Security Fund). There's also a scholarship of Rs 100/month per child studying in Class 9-12, for up to 2 children.
ESI scheme: for organised sector workers
The Employee State Insurance scheme is mandatory for establishments with 10+ employees where workers earn up to Rs 21,000 per month.
What ESI provides:
- Full medical care for the worker and their family
- 70% of wages during certified sickness (up to 91 days/year)
- Full wages for 26 weeks of maternity leave
- 90% of wages for temporary disability; pension for permanent disability
- Pension for dependents if the worker dies
- Rs 15,000 for funeral expenses
Employees contribute 0.75% of wages. Employers contribute 3.25%.
Government schemes vs private insurance
Government schemes are good baseline coverage. They're absurdly cheap and cover the essentials. But they have real limitations.
| Factor | Government schemes | Private insurance | |---|---|---| | Cost | Rs 20 to Rs 436/year | Rs 5,000 to Rs 50,000+/year | | Coverage | Rs 2 lakh to Rs 5 lakh | Rs 5 lakh to Rs 2 crore+ | | Hospital network | Government + limited private | Larger private hospital network | | Claim process | Can be slow | Generally faster and more digital | | Customisation | Fixed, take it or leave it | Lots of add-ons and options | | Waiting periods | Usually none | 2-4 years for some conditions |
The practical approach for most families: sign up for PMJJBY and PMSBY (Rs 456/year total for life + accident cover) AND get a proper private health insurance plan for broader medical coverage. They're not mutually exclusive.
Common questions
Can I have both Ayushman Bharat and private health insurance?
Yes. No restriction. You can use PM-JAY at empanelled hospitals and private insurance elsewhere.
My name isn't on the SECC list. Can I still get PM-JAY?
If you're 70 or older, yes, automatically (since the September 2024 expansion). For everyone else, you need to be on the SECC list or meet the deprivation criteria.
Is PMJJBY available for NRIs?
No. You need to be an Indian resident with a savings bank account in India.
Can I enrol in both PMJJBY and PMSBY?
Yes, and you should. They cover different things: PMJJBY is life insurance (any cause of death), PMSBY is accident insurance. Together they cost Rs 456/year for Rs 4 lakh in combined coverage.
What if I miss the PMSBY renewal?
If the premium isn't debited by June 1, coverage lapses. You can re-enrol next year by paying the premium and submitting a self-declaration of good health.
The bottom line
Government insurance schemes in India now cover hundreds of millions of people. PM-JAY alone has processed over 11 crore hospital admissions. PMJJBY and PMSBY together have over 800 million enrolments.
These schemes won't replace a good private health insurance plan, but they provide a safety net that didn't exist a decade ago, especially for families that couldn't afford any coverage at all. If you or your family members haven't enrolled, do it. The cost is negligible and the process is simple.
At PolicyWings, we help people understand both government and private insurance options, because real financial protection usually involves a combination of both, tailored to what you can afford and what you actually need.
