Ayushman Bharat PM-JAY in Delhi: A Comprehensive Guide

The Government of NCT of Delhi implemented the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) on April 5, 2025, providing significant health coverage to its residents. Delhi's version of the scheme includes a substantial top-up from the state government, enhancing the benefits available under the national program. The scheme also introduced a special component called the Ayushman Vay Vandana Yojana for senior citizens.

This initiative runs alongside the pre-existing Delhi Arogya Kosh (DAK), which continues to serve Delhi residents with its own set of guidelines and benefits. This guide provides a detailed overview of the Ayushman Bharat PM-JAY scheme in Delhi, its eligibility criteria, coverage, enrolment process, and how it functions within the state's healthcare system.

Ayushman Bharat PM-JAY Delhi: At a Glance

• Coverage Amount — ₹10 lakh per family per year
• Launch Date in Delhi — April 5, 2025
• Implementing Agency — National Health Authority (NHA)
• National Helpline — 14555 or 1800-111-565
• ABHA Helpline — 1800-11-4477

Rates shown are as per the Delhi Health & Family Welfare Department (2026) and are subject to periodic revision. Always verify the latest approved rates on the official source.

What the Delhi Ayushman Bharat Scheme Covers

The Ayushman Bharat scheme in Delhi provides a total health cover of ₹10 lakh per eligible family per year for secondary and tertiary care hospitalization. This amount is a combination of the central government's contribution of ₹5 lakh under the national PM-JAY and an additional ₹5 lakh top-up funded by the Delhi Government.

The scheme is designed to cover a wide range of medical expenses. It includes costs for over 1,900 medical procedures across 27 different specialities. Key expenses covered are:

An important feature of the scheme is that it covers pre-existing diseases from the very first day of enrolment, ensuring that beneficiaries do not have to wait to receive care for ongoing health issues.

• Hospitalization charges
• Pre-hospitalization expenses for up to 3 days
• Post-hospitalization expenses for up to 15 days, including medicines and diagnostics
• Costs for major treatments such as neurosurgery, coronary artery bypass grafting, knee replacements, and cancer therapies (chemotherapy and radiation).

Ayushman Vay Vandana Yojana for Senior Citizens

Launched alongside the main scheme, the Ayushman Vay Vandana Yojana is a special component targeted at senior citizens. It provides a health cover of ₹10 lakh annually for individuals aged 70 years and above. This coverage also consists of the ₹5 lakh central share and the ₹5 lakh Delhi government top-up. A key aspect of this component is that it is available to all eligible seniors irrespective of their income, making healthcare more accessible for the elderly.

Who is Eligible for Health Schemes in Delhi?

Eligibility for Delhi's government-sponsored health schemes varies depending on the program. The criteria for Ayushman Bharat PM-JAY and the Delhi Arogya Kosh are distinct.

**Ayushman Bharat PM-JAY (Delhi):**

Eligibility is determined by the Socio-Economic Caste Census (SECC) 2011 data. It is not open to everyone. Approximately 6.5 lakh families, which translates to about 30 lakh individuals in Delhi, are estimated to be eligible. The categories include:

**Ayushman Vay Vandana Yojana:**

Eligibility for this component is simpler. The two main requirements are:

**Delhi Arogya Kosh (DAK):**

For those not covered by Ayushman Bharat, the DAK provides a safety net. For financial aid at government hospitals, an applicant must be a resident of Delhi for at least three years and have an annual family income below ₹3 lakh. However, for free surgeries at empanelled private hospitals upon referral from a government facility, the income criterion is waived for any bona fide resident of Delhi.

• Families with no adult member between the ages of 16 and 59.
• Female-headed households with no adult male member between 16 and 59.
• Scheduled Caste (SC) and Scheduled Tribe (ST) households.
• Specific occupational groups, such as street vendors and construction workers.
• Being a resident of Delhi.
• Being 70 years of age or older and possessing a valid Aadhaar card.

How to Enrol and Get the Ayushman Card

The enrolment process for Ayushman Bharat PM-JAY and the Vay Vandana Yojana is designed to be straightforward and is based on an e-KYC (Know Your Customer) process.

**Enrolment Locations:**

You can register for the scheme through multiple channels:

**The Enrolment Process:**

The process begins with checking your eligibility. On the portal or app, you can enter your mobile number, receive an OTP, and then search the beneficiary database. Once your eligibility is confirmed, you must complete the e-KYC using your Aadhaar number and another OTP sent to your Aadhaar-linked mobile.

**Documents Required:**

The main document needed for the e-KYC is the Aadhaar Card. A Ration Card or other family identification may be useful for verifying your family unit against the SECC database. For the Ayushman Vay Vandana Yojana, only an Aadhaar card and proof of Delhi residency are required.

Upon successful registration, a personal Ayushman Card is generated. Beneficiaries under the Vay Vandana Yojana receive a distinct purple-coloured card. This card can be downloaded and used to avail benefits.

• **Online:** The national beneficiary portal (`beneficiary.nha.gov.in`) or the official 'Ayushman App'.
• **Offline:** At any Common Service Centre (CSC) or by visiting the 'Ayushman Mitra' help desk located at any empanelled hospital.

Using the Ayushman Card at Delhi Hospitals

The Ayushman Bharat PM-JAY scheme provides cashless treatment at empanelled healthcare facilities. This means beneficiaries do not have to pay out-of-pocket for covered procedures. The process at the hospital is managed by a dedicated representative.

When a beneficiary visits an empanelled hospital for treatment, they must present their Ayushman Card or provide their registration details at the 'Ayushman Mitra' help desk. The Ayushman Mitra verifies the patient's identity and eligibility using the system. Following this, the hospital seeks a pre-authorization for the required medical treatment package. Once approved, the hospital provides the necessary treatment, and all payments are settled directly between the hospital and the National Health Authority (NHA).

As of May 2026, the network in Delhi included 233 empanelled hospitals, comprising 181 private and 52 government facilities. A significant advantage of the scheme is its portability, which allows a beneficiary from Delhi to receive cashless treatment at any empanelled hospital across India.

Co-existence with Delhi Arogya Kosh (DAK)

While Delhi has adopted Ayushman Bharat PM-JAY, the long-standing Delhi Arogya Kosh (DAK) continues to operate. The DAK provides financial assistance up to ₹5 lakh for treatments and diagnostics at government hospitals for Delhi residents with an annual income under ₹3 lakh. Recent revisions to DAK guidelines in May 2026 were made to prevent benefit duplication and streamline processes. The new rules require verification that a patient is not covered by other schemes like PM-JAY, CGHS, or DGEHS. Furthermore, referrals to private facilities for imaging or surgeries are now permitted only if the service is unavailable or has excessive wait times at a government hospital, promoting the use of public infrastructure first.

Frequently Asked Questions

What is the total health coverage amount under Ayushman Bharat PM-JAY in Delhi?

The total health coverage is ₹10 lakh per eligible family per year. This includes ₹5 lakh from the central government and a ₹5 lakh top-up from the Delhi government.

How are senior citizens covered under Delhi's health scheme?

Senior citizens aged 70 and above are covered under the Ayushman Vay Vandana Yojana component. They are eligible for ₹10 lakh health coverage annually, regardless of their income status. They receive a special purple-coloured Ayushman Card.

How can I check if my family is eligible for Ayushman Bharat in Delhi?

You can check your eligibility online by visiting the national beneficiary portal at beneficiary.nha.gov.in or by using the 'Ayushman App'. You will need to use your mobile number and may need your Aadhaar or Ration Card details.

Can I use my Delhi Ayushman Card for treatment in another state?

Yes, the Ayushman Bharat PM-JAY scheme offers portability. This allows you to avail cashless treatment at any empanelled hospital across India, not just in Delhi.

What is the difference between Ayushman Bharat PM-JAY and Delhi Arogya Kosh (DAK)?

They are two different schemes. Ayushman Bharat PM-JAY eligibility is based on the SECC 2011 census data, providing ₹10 lakh cover. Delhi Arogya Kosh (DAK) eligibility is based on Delhi residency and an annual income under ₹3 lakh, providing up to ₹5 lakh assistance primarily at government hospitals. They run in parallel to cover different segments of the population.

Are pre-existing illnesses covered from the start?

Yes, under the Ayushman Bharat PM-JAY scheme in Delhi, all pre-existing diseases and conditions are covered from day one of enrolment.

Related

• Government hospital OPD guides in Delhi
• How to find an Ayushman Bharat (PM-JAY) hospital near you
• Ayushman Bharat PM-JAY eligibility check
• Government health schemes in India: a guide

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.