CGHS vs Ayushman Bharat (PM-JAY): Key Differences
Medically reviewed by Dr. Nikhil Singh
Last reviewed: 14 Jun 2026
CGHS and Ayushman Bharat (PM-JAY) are both government health schemes, but they serve different groups and work differently. This guide explains the key differences.
Who Each Covers
- CGHS: central government employees, pensioners and their dependants, in notified CGHS cities
- PM-JAY: poor and vulnerable families identified through SECC-2011 criteria — over 12 crore families
Funding
- CGHS is contributory — beneficiaries pay a monthly contribution graded by pay or pension level (which also sets ward entitlement)
- PM-JAY is fully government-funded — beneficiaries pay no premium or contribution
Coverage Model and Geography
- CGHS provides OPD and medicines through wellness centres plus referral to empanelled hospitals, and allows reimbursement; it covers outpatient and inpatient care
- PM-JAY provides Rs 5 lakh per family per year for secondary and tertiary hospitalisation, cashless at empanelled hospitals (mainly inpatient)
- CGHS operates in notified cities; PM-JAY is nationwide and portable
Frequently Asked Questions
Can I be covered by both CGHS and Ayushman Bharat?
They target different groups. Someone already covered under CGHS is generally not separately enrolled under PM-JAY on the same basis.
Which is better, CGHS or Ayushman Bharat?
They serve different people: CGHS is for central government employees and pensioners and covers OPD too, while PM-JAY is a Rs 5 lakh hospitalisation cover for eligible poor and vulnerable families. Eligibility decides which applies to you.
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Medical Disclaimer
The information provided in this article is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.
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They target different groups. Someone already covered under CGHS is generally not separately enrolled under PM-JAY on the same basis.
They serve different people: CGHS is for central government employees and pensioners and covers OPD too, while PM-JAY is a Rs 5 lakh hospitalisation cover for eligible poor and vulnerable families. Eligibility decides which applies to you.
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Written by Dr. Nikhil Singh
Last reviewed: 14 June 2026
Medical Disclaimer
The content provided on Zospital is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. If you think you may have a medical emergency, call your doctor or emergency services immediately.