Ayushman Bharat PM-JAY & Mukhyamantri Jan Arogya Abhiyan (MMJAA) in Uttar Pradesh: A Guide

In Uttar Pradesh, healthcare access for vulnerable families is supported by an integrated health insurance scheme combining the central government's Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) with the state's own Mukhyamantri Jan Arogya Abhiyan (MMJAA). This converged scheme provides significant financial protection against medical expenses.

The primary benefit is a health cover of ₹5 lakh per eligible family per year for secondary and tertiary care hospitalization. The scheme operates on a family floater basis, meaning the entire sum can be used by one or all members of the family, with no cap on family size or age.

The State Agency for Comprehensive Health and Integrated Services (SACHIS) is the nodal agency responsible for the implementation of this combined scheme in Uttar Pradesh, ensuring that the benefits reach the intended recipients through a wide network of hospitals.

Ayushman Bharat & MMJAA in Uttar Pradesh: At a Glance

• Health Cover — ₹5 lakh per family per year
• MMJAA Launch Date — March 1, 2019
• Implementing Agency — State Agency for Comprehensive Health and Integrated Services (SACHIS)
• State Helpline — 1800-1800-4444
• National Helpline — 14555

Rates shown are as per the State Agency for Comprehensive Health and Integrated Services (SACHIS), Uttar Pradesh (2026) and are subject to periodic revision. Always verify the latest approved rates on the official source.

What is Covered Under the Scheme?

The converged Ayushman Bharat PM-JAY and MMJAA scheme provides a substantial health cover of ₹5 lakh per family annually for inpatient care. This coverage is designed to handle significant medical expenses from hospitalization.

The scheme includes over 1,900 medical procedures across 27 different specialties. Key areas of treatment covered include cardiology, oncology (cancer treatment), neurosurgery, orthopedics, nephrology (kidney-related diseases), and pediatric care. A significant feature is that all pre-existing diseases are covered from the very first day of scheme enrolment, ensuring that beneficiaries receive care without a waiting period for prior health conditions.

The benefit package is comprehensive, covering expenses incurred before, during, and after hospitalization. It includes costs for up to 3 days of pre-hospitalization care and up to 15 days of post-hospitalization care, which covers diagnostics and medicines related to the hospital stay.

• **Exclusions:** It is important to note what is not covered. The scheme does not pay for Out-Patient Department (OPD) expenses, cosmetic surgeries, fertility treatments, drug rehabilitation programs, or routine dental procedures like fillings and root canals. Hospitalization solely for evaluation or diagnostic purposes without active treatment is also excluded.

Who is Eligible for the Scheme in Uttar Pradesh?

Eligibility for the scheme in Uttar Pradesh is determined based on pre-identified criteria from both central and state government databases. There is no open enrolment process for the general public.

Beneficiaries under the national Ayushman Bharat PM-JAY are identified using the deprivation and occupational criteria from the Socio-Economic Caste Census (SECC) of 2011 for both rural and urban areas. This includes households without shelter, landless households dependent on manual casual labour, manual scavengers, and certain categories of informal sector workers.

The Mukhyamantri Jan Arogya Abhiyan (MMJAA) extends this coverage to additional categories of Uttar Pradesh residents who were not included in the central PM-JAY list. This state-funded expansion includes:

**Antyodaya Anna Yojana (AAY) Families:** As of a government order from July 23, 2021, approximately 40.78 lakh families holding AAY ration cards were brought under the MMJAA.

**Construction Workers:** Registered Building and Other Construction Workers (BOCW) are also eligible for benefits under the scheme.

**Senior Citizens:** In a major expansion during September-October 2024, the scheme was extended to cover all citizens in Uttar Pradesh aged 70 years and above, irrespective of their income or socio-economic status.

How to Enrol and Get the Ayushman Card

Since beneficiaries are pre-identified, there is no formal registration or application process. The essential step for an eligible person is to complete the e-KYC (Know Your Customer) verification to get their Ayushman Card, also known as the Golden Card. This card is mandatory to avail cashless treatment.

The e-KYC process can be completed at various locations across the state to ensure easy access for everyone. These include:

**Common Service Centers (Jan Seva Kendra):** Local CSCs are equipped to handle e-KYC verification.

**Empanelled Hospitals:** Every empanelled hospital has an "Arogya Mitra" at a dedicated help desk to assist beneficiaries with card generation.

**Government Health Camps:** The state government frequently organizes special campaigns and camps in villages and towns for on-the-spot card creation.

**Online Portal:** Beneficiaries can also use the national portal at beneficiary.nha.gov.in to check eligibility and complete their e-KYC online.

The primary document required for e-KYC is the Aadhaar card for identity verification. Other supporting documents like a ration card or the official PM/CM letter confirming eligibility can also be useful.

The Role of Mukhyamantri Jan Arogya Abhiyan (MMJAA)

In Uttar Pradesh, Ayushman Bharat PM-JAY and the Mukhyamantri Jan Arogya Abhiyan (MMJAA) work together as a single, unified health insurance program. MMJAA, launched on March 1, 2019, is a 100% state-funded initiative designed to complement the national scheme.

The primary purpose of MMJAA is to extend health insurance coverage to vulnerable families within Uttar Pradesh who meet the state's eligibility criteria but were left out of the central beneficiary list derived from the SECC 2011 data. This ensures a wider safety net and more inclusive coverage across the state.

Beneficiaries covered under MMJAA receive the exact same benefits as those under PM-JAY. This includes the ₹5 lakh annual health cover, access to the same network of over 6,000 empanelled public and private hospitals, and the use of the same Ayushman Card for cashless treatment. The entire integrated system is managed by SACHIS, which streamlines claims, hospital empanelment, and beneficiary support for both components of the scheme.

Using the Scheme at Hospitals in Uttar Pradesh

The Ayushman Bharat scheme in Uttar Pradesh operates on a completely cashless basis. This means that a beneficiary does not have to pay any money for covered treatments at an empanelled hospital. Upon discharge, the hospital submits the claim for the treatment cost directly to the government for settlement.

Treatment can be availed at a vast network of empanelled hospitals, which includes all government hospitals and a large number of private hospitals. As of late 2025, Uttar Pradesh had the highest number of empanelled facilities in India, with over 6,000 hospitals participating in the scheme.

A key advantage of the scheme is its portability. A beneficiary from Uttar Pradesh can receive cashless medical treatment at any Ayushman Bharat empanelled hospital anywhere in India. To facilitate the process at the hospital, Arogya Mitras are stationed at help desks to verify eligibility, check the Ayushman Card, and assist patients with the admission process.

Recent Developments in the Scheme

The Uttar Pradesh government has actively worked to expand the scheme's reach and improve its accessibility. In 2025 and 2026, special campaigns were launched to accelerate the issuance of Ayushman cards to all eligible individuals. Furthermore, in June 2026, the process for resolving issues related to card approvals and modifications was decentralized to the district level, empowering Chief Medical Officers (CMOs) to provide quicker solutions.

It is also worth noting that the state launched the Pandit Deendayal Upadhyay Rajya Karmchari Cashless Chikitsa Yojana in July 2022. While this is a separate scheme for state government employees and pensioners, it utilizes the same network of empanelled hospitals as the Ayushman Bharat scheme.

Frequently Asked Questions

Is there a registration process for Ayushman Bharat in UP?

No, there is no formal registration process as beneficiaries are pre-identified by the government based on specific criteria. The main step is to complete your e-KYC at a designated center or online to get your Ayushman Card.

What is the difference between PM-JAY and MMJAA in Uttar Pradesh?

They are part of a single, converged scheme. PM-JAY is the national scheme, while MMJAA is a state-funded extension to cover eligible UP families who were not on the central list, such as Antyodaya ration card holders. Both offer the same benefits and use the same card and hospital network.

Can I get treatment for a pre-existing disease?

Yes, all pre-existing diseases and conditions are covered from day one of your enrolment in the scheme. You cannot be denied treatment for a condition you already have.

Do I have to pay anything at the hospital for treatment?

No, the scheme provides completely cashless treatment for over 1,900 approved procedures at empanelled public and private hospitals. The beneficiary does not have to pay any money out-of-pocket for covered treatments.

What documents are needed to get an Ayushman Card?

The primary document required for e-KYC verification is your Aadhaar card. It is also helpful to carry your ration card or the PM/CM eligibility letter if you have one.

Are OPD consultations and regular medicines covered?

No, the scheme is designed to cover expenses related to hospitalization (inpatient care). It does not cover routine Out-Patient Department (OPD) consultations or the cost of medicines purchased outside of a hospital stay.

Are all senior citizens in Uttar Pradesh eligible for the scheme?

Yes. Following an expansion in late 2024, the scheme now covers all citizens of Uttar Pradesh aged 70 years and above, regardless of their family's income or social status.

Related

• Government hospital OPD guides in Uttar Pradesh
• 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.