Official Ayushman Bharat Eligibility Rules (2026 Summary)
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) provides free, cashless hospitalization cover of up to ₹500,000 (₹5 Lakh) per family per year across secondary and tertiary care hospitals.
Unlike traditional health insurance policies that require monthly premiums, Ayushman Bharat eligibility is entitlement-based. The Government of India determines eligibility using the Socio-Economic Caste Census (SECC 2011) data, occupational categories in urban areas, and recent universal expansions such as the 70+ Senior Citizen Health Cover.
There is no enrollment fee or paper application required to qualify. If your household matches the rural deprivation criteria (D1–D7), urban informal worker categories, or includes a senior citizen aged 70+, your family is legally entitled to the ₹5 Lakh health benefit.
Rural Eligibility Criteria (SECC Deprivation Codes D1–D7)
For households located in rural villages, eligibility is categorized under 6 primary SECC deprivation indicators. If your family satisfies at least one of these official codes, you qualify for the Ayushman Card:
| SECC Code | Rural Household Deprivation Category | Qualification Status |
|---|---|---|
| D1 | Households living in a single room with kucha (temporary) walls and kucha roof. | Eligible |
| D2 | Households with no working-age adult members between ages 16 and 59. | Eligible |
| D3 | Female-headed households with no adult male member aged 16 to 59. | Eligible |
| D4 | Households with a disabled member and no able-bodied adult member. | Eligible |
| D5 | Scheduled Caste (SC) and Scheduled Tribe (ST) households. | Eligible |
| D7 | Landless households earning a major part of their income from manual casual labor. | Eligible |
Note: Destitute families, manual scavengers, primitive tribal groups, and legally released bonded laborers are automatically included without deprivation scoring.
Urban Eligibility: Occupational Worker Categories
In towns and cities, eligibility is defined by the main earner's occupation. If your family relies on informal, daily-wage, or unorganized work, you are eligible under the following 11 recognized urban categories:
Sanitation & Domestic
Ragpickers, sweepers, sanitation workers, maids, cooks, and home helpers.
Street Vendors & Artisans
Hawkers, cobblers, fruit/veg sellers, cobblers, tailors, and home artisans.
Construction & Craftsmen
Masons, plumbers, painters, welders, coolies, loaders, and security guards.
Transport & Services
Rickshaw pullers, auto drivers, cart pullers, washermen (dhobis), and mechanics.
Ayushman Card Income Limit & Financial Thresholds
A common misconception is that Ayushman Bharat has a fixed annual income cap (e.g. ₹1 Lakh or ₹2.5 Lakh).
The Reality: National PM-JAY guidelines do not mandate a single salary certificate cutoff. Instead:
- SECC Asset Deprivation: Rural eligibility is based on living conditions (housing, landlessness) rather than paper salary statements.
- Informal Sector Status: Urban workers qualify based on occupation type, regardless of month-to-month earning variations.
- State-Specific Co-Branded Expansion: Several states (such as Gujarat's MA Card merge or Assam's Ayushman Asom) have expanded eligibility to households earning up to ₹4 Lakh or ₹5 Lakh per year via Ration Card links.
Ayushman Bharat for Senior Citizens (Aged 70 and Above)
In 2024–2026, the Union Cabinet expanded PM-JAY to provide universal health coverage to all senior citizens aged 70 years and older.
Key Benefits for 70+ Seniors:
- No Income Bar: Seniors aged 70+ qualify regardless of family income, land ownership, or vehicle assets.
- Distinct Senior Card: Eligible seniors receive a distinct Ayushman Card with a dedicated ₹5 Lakh floater cover per year.
- Existing Govt Scheme Option: Seniors with CGHS, ECHS, or Railway medical benefits can choose to retain their existing scheme or opt into PM-JAY.
Automatic Exclusion & Disqualification Criteria
Even if a household meets rural or urban conditions, it will be strictly disqualified from PM-JAY if any family member meets any of the 13 exclusion criteria listed below:
| Exclusion Trigger | Specific Ownership / Status Rule | Eligibility Impact |
|---|---|---|
| Motorized Vehicle | Ownership of a 2-wheeler (motorcycle/scooter), 3-wheeler, car, or motorboat. | Excluded |
| Farming Machinery | Ownership of mechanized 3-wheel or 4-wheel agricultural equipment (tractors). | Excluded |
| Kisan Credit Card | Kisan Credit Card (KCC) with an approved credit limit exceeding ₹50,000. | Excluded |
| Government Employment | Any family member employed in a permanent Central or State government job. | Excluded |
| Tax Payers | Any household member who pays Income Tax or Professional Tax. | Excluded |
| Modern Appliances | Households owning an Air Conditioner (AC), refrigerator, or landline telephone. | Excluded |
| Irrigated Land Limit | Owning 5+ acres of irrigated land for 2+ crop seasons, or 7.5+ acres total land. | Excluded |
Required Documents for Ayushman Card Verification
When visiting an empaneled hospital, CSC operator, or logging into the official NHA Beneficiary Portal, ensure you have the following documents ready:
Aadhaar Card (Mandatory)
Required for identity verification and e-KYC biometric matching.
Ration Card or Family ID
Establishes family relationships and verifies beneficiary listing.
Active Mobile Number
Needed to receive OTP codes during online beneficiary login.
Frequently Asked Questions (FAQ)
There is no fixed annual salary cutoff (e.g. ₹2.5 Lakh) for PM-JAY. Instead, eligibility is determined by socio-economic vulnerability (SECC 2011 data), occupation type, or age 70+ status. However, income-tax payers and permanent government employees are strictly excluded.
Rural households qualify if they match any SECC deprivation code: living in a single kucha room (D1), no adult male worker (D3), disabled member with no fit adult (D4), SC/ST category (D5), or landless daily-wage laborers (D7).
Yes! Under the expanded PM-JAY guidelines, every Indian citizen aged 70 and above is eligible for a top-up health cover of ₹5 Lakh per year, irrespective of their family income or asset ownership.
Yes, owning a motorized 2-wheeler, 3-wheeler, 4-wheeler, or mechanized agricultural equipment is an automatic exclusion trigger under national PM-JAY guidelines.
You can search the official portal beneficiary.nha.gov.in using your Aadhaar number, Ration Card number, or mobile number. Alternatively, test your household parameters instantly on our interactive tool at /check/.