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PM-JAY is the world's largest health assurance scheme providing health insurance of ₹5 lakh per year per family for secondary and tertiary hospitalisation. From September 2024, extended to ALL senior citizens aged 70+ years regardless of income. Over 42 crore Ayushman cards issued; 33,000+ hospitals empanelled; ₹1.52 lakh crore saved in out-of-pocket expenses.
Target Beneficiaries: 12 crore poor and vulnerable families (~55 crore individuals); ALL senior citizens 70+ years (from Sep 2024); 42 crore Ayushman cards issued
9406
Funding Ratio (Centre:State): 60:40 (States), 90:10 (NE/Hilly), 100:0 (UTs without legislature)
GS Paper: GS2
Syllabus Tags
Launched in September 2018 as part of Ayushman Bharat, based on the NHP 2017 recommendation to provide insurance to the bottom 40% of the population.
Component focused on primary health and preventive care
Metric
7.5+ Crore
Source: NHA Dashboard
Metric
35+ Crore
Source: NHA
PM-JAY is a massive step toward Universal Health Coverage (UHC). It has successfully moved the focus from primary care only to include secondary and tertiary care. The extension to all senior citizens (70+) addresses a major demographic challenge (geriatric care). However, the 'Missing Middle' (those not poor enough for PM-JAY but not rich enough for private insurance) remains a gap. Low package rates for private hospitals and 'supply-side' shortages in rural healthcare infrastructure remain significant hurdles.
How does Ayushman Bharat PM-JAY address the structural deficiencies in India's healthcare delivery system?
Key points: 1. Reduction in Out-of-Pocket Expenditure (OOPE). 2. Promotion of Health and Wellness Centers (HWCs) as the first point of contact. 3. Cooperative Federalism (States have their versions like Karunya, Aarogyasri). 4. Integration with Ayushman Bharat Digital Mission (ABDM).