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PM-JAY & Ayushman Bharat

Understanding India’s largest government health-cover scheme, how it works in Gujarat as PMJAY-MA, who is eligible, and how to check and use your Ayushman card.

What is PM-JAY?

Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the Government of India’s health-assurance scheme, launched in September 2018 and run by the National Health Authority. It provides eligible families with cashless, paperless cover of up to ₹5 lakh per family per year for secondary and tertiary hospitalisation — surgery, ICU care, implants and more — at empanelled public and private hospitals across the country.

In Gujarat the scheme operates as PMJAY-MA Yojana: in 2019 the state integrated its own Mukhyamantri Amrutam (MA) and MA Vatsalya (MAV) schemes with AB-PM-JAY, so eligible Gujarat families hold a co-branded PMJAY-MA card and can access treatment at empanelled hospitals across the state, including in Ahmedabad.

This page explains the scheme in plain terms so you can check your eligibility and understand your entitlements before you need care.

₹5LCover per family, per year

2018Scheme launched nationally

70+Extra ₹5L cover for seniors

36k+Empanelled hospitals in India

What the scheme covers

PM-JAY covers a wide range of hospitalisation needs. Exact packages are defined by the National Health Authority and the State Health Agency.

Cashless hospitalisationCovered treatment up to the family cover limit, with no upfront payment at empanelled hospitals.

Secondary & tertiary careSurgery, intensive care, implants and specialist treatment across many disciplines.

Pre-existing conditionsCovered from day one — there is no waiting period under the scheme.

No cap on family size or ageAll eligible members of the family are covered under a single card.

Pan-India portabilityAn eligible card can be used at any empanelled hospital in any state, not only your home state.

Pre- and post-hospitalisationDefined diagnostics and follow-up around a covered admission are included as per scheme rules.

Who is eligible

Eligibility is set by the Government, not by any hospital. In broad terms it covers:

Low-income families (SECC 2011)Rural and urban households identified as economically vulnerable under the Socio-Economic Caste Census database.

Senior citizens aged 70+All citizens 70 and above are eligible regardless of income, with an additional ₹5 lakh cover under Ayushman Vay Vandana.

Gujarat MA / MAV familiesFamilies already enrolled under Gujarat’s MA or MA Vatsalya schemes are covered through the integrated PMJAY-MA card.

Certain worker categoriesGroups such as registered construction and unorganised-sector workers, as notified by the authorities.

Please verify your own eligibilityThe most reliable way to know if you are covered is to check the official records. Search your name on the National Health Authority beneficiary portal, or ask at a PM Jan Arogya Kendra / Ayushman Mitra desk with your Aadhaar.

Official portal: beneficiary.nha.gov.in | Toll-free helpline: 14555 (24×7) | Gujarat: ma.gujarat.gov.in

How to use your Ayushman card

Confirm eligibilityCheck your name on beneficiary.nha.gov.in or the Ayushman app, and generate your card with Aadhaar-based e-KYC if you don’t have one.

Go to an empanelled hospitalPresent your PMJAY-MA / Ayushman card and Aadhaar at the hospital’s Ayushman Mitra or TPA help desk.

Cashless verificationThe desk verifies your card and the treatment package. Covered care then proceeds without upfront payment, as per scheme rules.

SAL Hospital & PM-JAY — check with our help desk

Empanelment can change over time and by scheme. Before planning treatment under PM-JAY / PMJAY-MA at SAL Hospital, please confirm current empanelment and covered packages with our patient help desk — we will tell you exactly what applies to your card and your treatment.

Call 079-66115698 or email inquiry@salhospital.com.

Frequently asked questions

What is the difference between PM-JAY and PMJAY-MA?

PM-JAY is the national Ayushman Bharat scheme. PMJAY-MA is how it runs in Gujarat, after the state merged its own MA and MA Vatsalya schemes with PM-JAY in 2019. Eligible Gujarat families hold a co-branded PMJAY-MA card. The cover amount and cashless model are the same.

How much treatment cost does it cover?

Up to ₹5 lakh per family per year for secondary and tertiary hospitalisation. Citizens aged 70 and above get an additional ₹5 lakh cover exclusively for them under Ayushman Vay Vandana. The cover is shared across the family (except the seniors’ top-up) and resets each year.

How do I know if I am eligible?

Eligibility is decided by the Government, not by a hospital. Check your name at beneficiary.nha.gov.in or on the Ayushman app, call the toll-free helpline 14555, or ask at any Ayushman Mitra desk or Jan Arogya Kendra with your Aadhaar. In Gujarat you can also check at ma.gujarat.gov.in.

Is pre-existing illness covered?

Yes. Under PM-JAY there is no waiting period — eligible pre-existing conditions are covered from the first day the card is active, subject to the scheme’s defined packages.

Can I use my card at SAL Hospital?

Empanelment and covered packages can vary and change over time. Please confirm the current position for your card and your planned treatment with SAL Hospital’s patient help desk on 079-66115698 before admission, so there are no surprises.