As of 28 February 2026, the Ayushman Bharat‑Pradhan Mantri Jan Arogya Yojana (AB‑PMJAY) has expanded its network to 36,229 empanelled hospitals (19,483 public, 16,746 private) and authorised 11.69 crore admissions, of which 6.74 crore are in private facilities. The scheme’s grievance redressal and claim‑settlement mechanisms continue to operate through a three‑tier system and stipulated 15‑day (intra‑state) or 30‑day (portability) timelines, underscoring its growing role in India’s universal health coverage agenda.
Overview The AB‑PMJAY has witnessed a massive expansion in its hospital network and utilisation as of 28 February 2026 . The scheme now covers 36,229 empanelled hospitals across India, authorising a total of 11.69 crore hospital admissions. Key Developments Empanelled hospitals increased more than five‑fold from 6,917 in FY 2018‑19 to 36,229 in 2026. Public‑sector participation rose to 19,483 hospitals; private‑sector participation stands at 16,746 hospitals (voluntary empanelment). Total authorised admissions reached 11.69 crore , with 6.74 crore occurring in private hospitals. Grievances are addressed via the CGRMS and a three‑tier redressal mechanism. Claims are settled within 15 days for intra‑state hospitals and 30 days for portability claims, as per guidelines of the NHA . Important Facts Under the scheme, empanelment is a continuous process driven by State/UT health agencies based on provider eligibility. Private hospitals join voluntarily, and once empanelled they cannot refuse treatment to eligible beneficiaries. Claims are adjudicated against clinical documents, investigation reports and standard treatment guidelines, ensuring uniformity and cost‑control. UPSC Relevance Understanding AB‑PMJAY is crucial for GS 2 (Polity) and GS 3 (Economy & Health) as it illustrates: The scale of India’s universal health coverage effort and its fiscal implications. Public‑private partnership dynamics in delivering health services. Governance mechanisms such as grievance redressal and claim settlement timelines, reflecting administrative efficiency. The role of the empanelled hospitals network in expanding access to secondary and tertiary care. Way Forward To sustain the momentum, the government may focus on: Strengthening monitoring of private‑hospital participation to ensure quality and prevent misuse. Enhancing the claim settlement turnaround time through digital verification and faster adjudication. Expanding the grievance redressal capacity of the CGRMS to address emerging issues promptly. Periodic review of empanelment criteria to incorporate emerging specialties and regional health needs. These steps will reinforce AB‑PMJAY’s objective of providing equitable, quality health care to India’s most vulnerable sections.
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Overview
AB‑PMJAY’s hospital network surges to 36,229, boosting universal health coverage
Key Facts
Empanelled hospitals rose from 6,917 in FY 2018‑19 to 36,229 by 28 Feb 2026.
Total authorised admissions under AB‑PMJAY reached 11.69 crore, of which 6.74 crore were in private hospitals.
Claims are settled within 15 days for intra‑state hospitals and 30 days for portability claims as per NHA guidelines.
Beneficiary grievances are addressed through CGRMS (online portal & 14555 helpline) with a three‑tier redressal mechanism.
Empanelment is a continuous process driven by State/UT health agencies; empanelled hospitals cannot refuse treatment to eligible beneficiaries.
AB‑PMJAY covers over 10 crore poor and vulnerable families, representing a major fiscal commitment to health financing.
Background & Context
The expansion of AB‑PMJAY’s empanelled hospital network underscores India’s push for universal health coverage and illustrates a large‑scale public‑private partnership in health service delivery. It also reflects governance mechanisms—such as claim‑settlement timelines and grievance redressal—that are critical for programme efficiency and fiscal sustainability.
UPSC Syllabus Connections
Essay•Youth, Health and WelfareGS2•Welfare schemes for vulnerable sectionsEssay•Economy, Development and InequalityGS2•Government policies and interventions for development
Mains Answer Angle
GS2/GS3: Evaluate the impact of AB‑PMJAY’s rapid hospital network expansion on health equity, fiscal burden, and public‑private partnership dynamics, and suggest measures to enhance quality and accountability.