- Why in news
- On 29 October 2026, Ayushman Vay Vandana completed two years. The Health Ministry released usage data: 23.46 lakh admissions worth ₹5,668.80 crore as on 20 October 2026.
- What it is
- Ayushman Vay Vandana is an extension of Ayushman Bharat PM-JAY to every citizen aged 70 years and above, whatever their income. It was launched by the Prime Minister on 29 October 2024. It is run by the National Health Authority and gives cashless hospital cover for secondary and tertiary care.
- Eligibility
- All citizens aged 70 and above are eligible, irrespective of socio-economic status.
- Cover
- Up to ₹5 lakh per family per year for secondary and tertiary care hospitalisation.
- Top-up for covered families
- Seniors in families already under PM-JAY get an extra top-up of up to ₹5 lakh a year, only for themselves.
- Implementing agency
- The National Health Authority implements it under the Ministry of Health and Family Welfare.
- Most common procedure
- Cataract surgery is the most availed procedure, about 20.1% of authorised treatments.
- Highest value procedure
- PTCA (coronary angioplasty) has the largest share of authorised value, about ₹649 crore.
- Expansion to senior citizens
- The scheme now covers all citizens aged 70 and above, irrespective of socio-economic status.
- Secure Data Environment
- Developed by NHA with IISc Bengaluru, it gives governed access to de-identified PM-JAY and ABDM data for research, with outputs reviewed before release.
- National Health Claims Exchange
- NHCX seeks to put hospitals and insurers on one common digital platform for claims.
- Scale of ABDM
- More than 97.8 crore ABHAs have been created and over 121 crore health records linked.
- Portability recognition
- Chhattisgarh, Maharashtra and Gujarat were recognised as top performers in claim settlement for inter-State portability.
- Beneficiary identification
- Families are identified from SECC 2011 deprivation and occupational criteria. Families earlier covered under RSBY are also included.
- Expansion to elderly
- On 11 September 2024 the scheme was extended to all citizens aged 70 and above, about 6 crore people.
- Coverage
- The scheme now operates in all 36 States/UTs.
- Senior citizens
- Citizens aged 70 and above are covered irrespective of socio-economic status: 6 crore people in 4.5 crore families.
- ASHA and Anganwadi inclusion
- About 37 lakh additional families of ASHAs, Anganwadi Workers and Helpers were added in March 2024.
- Portability
- Beneficiaries can get cashless treatment at any empanelled hospital in the country. By 30 June 2026, 29.05 lakh inter-state admissions worth over Rs 8,383.97 crore were authorised.
- Base families
- The original PM-JAY targets 12 crore families, the bottom 40% of the population.
- Expansion
- In October 2024 the scheme was extended to 6 crore senior citizens aged 70+ from 4.5 crore families, regardless of socio-economic status.
- Cards issued
- More than 96.73 lakh Vay Vandana cards had been created across all States and UTs by 31.12.2025.
- Launch
- PM-JAY was launched in 2018 and is implemented by the National Health Authority.
Don’t confuse with Vay Vandana vs PM-JAY: PM-JAY covers eligible poor and vulnerable families; Vay Vandana covers all aged 70+ regardless of income.
Don’t confuse with Vay Vandana vs Ayushman Bharat Digital Mission: Vay Vandana gives hospital cover; the Digital Mission builds a digital health ID and records system.
Don’t confuse with PM-JAY vs ABDM: PM-JAY is the health assurance (insurance) scheme for hospital care. ABDM is the digital health ecosystem built on ABHA IDs and health records.
Don’t confuse with Ayushman Card vs ABHA ID: The Ayushman Card shows PM-JAY eligibility. The ABHA is a health ID that links a person's health records.
Don’t confuse with PM-JAY vs PM-ABHIM: PM-JAY pays for hospital treatment of eligible families. PM-ABHIM builds health infrastructure such as health centres, labs and critical care blocks.
Don’t confuse with ABHA vs Ayushman card: ABHA is a digital health ID for anyone under ABDM. The Ayushman card shows eligibility for PM-JAY cover.
Don’t confuse with PM-JAY vs Ayushman Bharat Digital Mission: PM-JAY gives cashless hospital cover. ABDM builds digital health records and infrastructure.
Don’t confuse with PM-JAY vs Health and Wellness Centres: Health and Wellness Centres (Ayushman Arogya Mandir) give primary care. PM-JAY covers secondary and tertiary hospitalisation.
Don’t confuse with PM-JAY vs Vay Vandana: PM-JAY targets poor families by socio-economic criteria; Vay Vandana covers all citizens aged 70+ regardless of income.
Schemes: 52 Prelims questions since 2013, 10 in Prelims 2026 alone. They test features, the period and who funds it. In Mains, 33 news-triggered questions, mostly GS3.
Why it matters
- Gives financial protection to about 6 crore elderly, reducing out-of-pocket hospital spending.
- Cashless cover reduces out-of-pocket spending for poor and elderly families.
- Portability helps migrant workers use the scheme across States.
- Gives cashless hospital care and cuts catastrophic out-of-pocket spending for poor families.
- Moves India towards universal health coverage, with the elderly, ASHAs and gig-type urban workers brought in.
- Links insurance with primary care, digital records and infrastructure under one Ayushman Bharat framework.
- Portability protects migrant workers who fall ill away from home.
- Cashless cover reduces out-of-pocket spending and moves India towards Universal Health Coverage.
- Gives older people, who face high health costs, financial protection irrespective of income.
Problems
- Cover is only for hospitalisation, so outpatient and medicine costs remain with families.
- Claim processing and programme integrity need stronger checks, which is why auto-adjudication is being introduced.
- Health data sharing needs consent and privacy safeguards, and ABHA adoption is yet to reach saturation.
- Eligibility rests on SECC 2011 data, which may exclude newly poor families.
- Uneven uptake and hospital empanelment across States, with risks of claim delays and fraud.
- Cover is for inpatient care, while much household spending is on outpatient care and medicines.
- States differ in how well they run the scheme, and some run their own schemes alongside it.
- Empanelled hospitals may refuse patients or delay claims, so access on the ground can be uneven.
- Hospital empanelment gaps and claim delays can limit access to cashless care.
Way forward
- Widen coverage to outpatient care and strengthen monitoring of private hospital claims.
- Strengthen NHCX, standard treatment protocols and common billing formats to improve quality and claims.
- Improve continuity of care and referral systems while protecting personal data.
- Update beneficiary databases and widen coverage to outpatient care.
- Strengthen claim audit, grievance redress and timely payment to hospitals.
- Expand public hospitals and primary care so the scheme does not rely only on private providers.
- Improve awareness of portability and speed up claim settlement.
- Further integrate state schemes with PM-JAY and monitor hospital conduct.
- Widen empanelment and speed up claim settlement using digital systems.
Put in your answer
Beneficiary base: Around 6 crore seniors in about 4.5 crore families are targeted.
PM-JAY scale: More than 60 crore beneficiaries covered, over 13 crore hospital admissions, and treatment worth over Rs 2 lakh crore.
Standard treatment workflows: ICMR has developed more than 150 standard treatment workflows, and HTAIn under DHR assesses cost-effectiveness of health technologies.
Scale of PM-JAY: 13.25 crore admissions worth Rs 2.03 lakh crore funded, with 38,000+ empanelled hospitals.
Digital health spine: Over 97.61 crore ABHA IDs operational, linking health records across providers.
Portability data: 29.05 lakh inter-state admissions worth over Rs 8,383.97 crore were authorised by 30 June 2026.
Senior citizen expansion: The scheme covers 6 crore senior citizens aged 70 and above in 4.5 crore families, irrespective of income.
- 2022Mains GS3 · Q5What newer health challenges arise from rising life expectancy, and what steps are needed?
- 2018Mains GS2 · Q7Explain why community-level healthcare is prerequisite for Health for All.
- 2024Mains GS2 · Q17State's role in grassroots public healthcare reach amid marketisation; suggest measures.
- 2018Mains GS4 · Q7Ethics case: officer selects beneficiaries for a senior citizens' healthcare scheme with criteria.
- 2015Mains GS2 · Q12Can private sector bridge gaps in universal health coverage; suggest alternatives?
- 2020Mains GS2 · Q6Discuss need for geriatric and maternal health care policies for social development.
- 2022Prelims Q19Which statements about Ayushman Bharat Digital Mission are correct?
UPSC’s own questions that come close to this issue, from our Prelims and Mains banks.
Prelims practice · Statements
Ours, not from a UPSC paper
Consider the following statements:
- 1.Ayushman Vay Vandana is open to all citizens aged 70 years and above, irrespective of their socio-economic status.
- 2.Ayushman Vay Vandana is implemented by the National Health Authority under the Ministry of Health and Family Welfare.
- 3.Senior citizens from families already covered under PM-JAY get a top-up cover of up to ₹5 lakh per year that is shared with all members of the family.
Which of the statements given above is/are correct?
True or false?
1 of 19
Statements the way Prelims prints them. Say first, then see the fact.
1.Ayushman Vay Vandana is open to citizens aged 70 years and above irrespective of their socio-economic status.
True. Eligibility is based on age (70+), not income.
2.It is implemented by the National Health Authority under the Ministry of Health and Family Welfare.
True. NHA implements it.
3.It covers outpatient consultations and medicines as its main benefit.
False. It covers secondary and tertiary care hospitalisation.
4.Senior citizens from families already covered under PM-JAY receive an additional top-up of up to ₹5 lakh per year meant only for themselves.
True. The top-up is separate from cover for family members below 70.
5.The top-up cover for seniors in covered families is shared with all family members.
False. It is exclusively for the senior citizen, separate from other members' cover.
6.Chronic haemodialysis is the most frequently availed procedure under the initiative.
False. Cataract surgery is the most frequent; haemodialysis ranks next.
7.Ayushman Bharat PM-JAY, of which this is an extension, was launched in 2018.
True. PM-JAY was launched in 2018.
8.AB PM-JAY is a centrally sponsored scheme.
True. It is centrally sponsored, with funds shared between Centre and States.
9.Under AB PM-JAY, the Centre and States share funds in the ratio 60:40 for Himachal Pradesh and Uttarakhand.
False. Himachal Pradesh, Uttarakhand, the North-East States and J&K share 90:10.
10.Rural beneficiaries under AB PM-JAY are identified using deprivation criteria from the Socio-Economic and Caste Census 2011.
True. Rural eligibility rests on SECC 2011 deprivation criteria.
11.AB PM-JAY covers primary healthcare only, which is delivered at Ayushman Arogya Mandirs.
False. PM-JAY covers secondary and tertiary hospital care; primary care is the role of Arogya Mandirs.
12.The Ayushman Bharat Digital Mission was launched in September 2021 and is built on ABHA digital health IDs.
True. ABDM began in September 2021 and rests on ABHA IDs.
13.Transgender persons covered under the SMILE initiative and workers covered under NAMASTE are among the additional categories eligible under AB PM-JAY.
True. SMILE transgender beneficiaries and NAMASTE waste pickers and sanitation workers are covered.
14.Ayushman Vay Vandana card covers senior citizens aged 70 years and above irrespective of their socio-economic status.
True. Eligibility is by age 70+, not income.
15.AB-PMJAY provides health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation.
True. Rs 5 lakh per family per year, for secondary and tertiary care.
16.The Ayushman Vay Vandana card was introduced in October 2024 as an expansion of PM-JAY.
True. The expansion happened in October 2024.
17.Female beneficiaries account for more hospital admissions than male beneficiaries under Ayushman Vay Vandana.
False. Males had 6.40 lakh admissions; females 3.93 lakh.
18.PM-JAY is implemented at the national level by the National Health Authority.
True. The National Health Authority runs PM-JAY.
19.PM-JAY was launched in 2014 as a centrally sponsored scheme.
False. It was launched in 2018.
Written by us from the release, not by UPSC; checked by a second model.
Mains practice
15 marks · 250 words
On the eighth anniversary of Ayushman Bharat PM-JAY, about 33% of India's population holds Ayushman cards and 13.25 crore hospital admissions worth Rs 2.03 lakh crore have been funded. Discuss the main provisions of the scheme, its significance for universal health coverage, and the challenges in its implementation.
Worth revising until Prelims 2028: most news questions come within two years of the event.