Ayushman Bharat's Monumental Achievement: Over 2 Crore Claims Settled Last Financial Year
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India's Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has achieved a significant milestone, settling over 2 crore claims worth more than ₹28,000 crore in the last financial year, transforming healthcare access for millions of vulnerable families across the nation.
Introduction to Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
Launched in September 2018, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) stands as the world's largest government-funded health assurance scheme, a flagship initiative by the Indian government under the Ministry of Health and Family Welfare. Its core objective is to provide financial protection and equitable access to quality healthcare services for the poor and vulnerable sections of society. The scheme offers a substantial health cover of up to ₹5 lakh per family per year for secondary and tertiary care hospitalisation, aiming to shield approximately 12 crore families, or about 50 crore individuals, from catastrophic healthcare expenses. This encompasses the bottom 40% of India's population, identified based on the Socio-Economic Caste Census (SECC) 2011 data.
The vision behind AB-PMJAY is to move towards universal health coverage by alleviating the financial burden of healthcare costs, enabling beneficiaries to access crucial medical treatments without enduring financial hardship. Since its inception, the scheme has made significant strides in making healthcare cashless and paperless, covering an extensive range of medical procedures, including diagnostic tests, doctor consultations, and treatment for various diseases. Moreover, it uniquely covers pre-existing diseases from day one and includes both pre- and post-hospitalisation expenses, ensuring comprehensive care.
A Monumental Milestone: Over 2 Crore Claims Settled
The last financial year (2025-2026) has marked an extraordinary achievement for the Ayushman Bharat scheme. Union Minister of State for Health and Family Welfare, Prataprao Jadhav, informed the Rajya Sabha that over 2 crore claims, amounting to more than ₹28,000 crore, were successfully settled during this period. This figure underscores the immense impact of AB-PMJAY in providing timely and critical financial assistance to millions of families across India.
This milestone reflects not just numbers, but countless stories of individuals and families who received life-saving treatments they otherwise might not have afforded. As of August 12, 2026, the scheme boasts an impressive track record, with over 45.5 crore Ayushman Cards issued and 12.69 crore hospitalizations covered, totaling an expenditure of ₹1.92 lakh crore. With approximately 40,000 claims processed daily for over 1,900 treatment packages, the scheme continues to operate on a massive scale, delivering on its promise of accessible healthcare. The network of empanelled facilities has also grown substantially, with over 38,466 public and private hospitals now part of the AB-PMJAY ecosystem, ensuring nationwide access to healthcare services.
Transforming Lives: Benefits of AB-PMJAY
The benefits of the Ayushman Bharat scheme are multi-faceted, profoundly impacting the lives of its beneficiaries:
- Financial Protection: The scheme provides crucial financial relief by covering healthcare expenses up to ₹5 lakh per family annually, preventing millions from falling into poverty due to medical costs.
- Cashless and Paperless Treatment: Beneficiaries can avail cashless hospitalisation at empanelled public and private hospitals nationwide, reducing administrative burdens and out-of-pocket expenses.
- Extensive Coverage: With coverage for around 1,949 medical procedures, including secondary and tertiary care treatments, surgeries, diagnostics, and medicines, most medical expenses are comprehensively addressed.
- Inclusion of Pre-existing Diseases: Unlike many insurance policies, AB-PMJAY covers pre-existing conditions from day one, a vital provision for chronic patients.
- Nationwide Portability: The unique feature of portability allows beneficiaries to seek treatment at any empanelled hospital across the country, irrespective of their place of residence.
- No Restrictions: The scheme places no restrictions on family size, age, or gender, ensuring broad eligibility.
Expanding Coverage: Ayushman Vay Vandana for Senior Citizens
In a landmark move to ensure healthcare for the elderly, the government expanded the AB-PMJAY scheme to include all senior citizens aged 70 and above, irrespective of their income or socio-economic background, effective from October 29, 2024. This extension operates through the Ayushman Vay Vandana scheme, providing the same ₹5 lakh annual health coverage.
This initiative acknowledges the particular vulnerabilities of senior citizens, who often face challenges in securing private health insurance due to pre-existing conditions or high premiums. As of July 2025, over 1.06 lakh claims have been settled under the Ayushman Vay Vandana scheme, demonstrating its immediate impact. Furthermore, more than 89 lakh cards have been issued to senior citizens under this category as of October 2025. This expansion reinforces the government's commitment to ensuring dignified and worry-free healthcare in later years, further strengthening India's journey towards universal health coverage.
Challenges and the Path Forward
Despite its remarkable successes, Ayushman Bharat faces several challenges in its ambitious mission. Issues such as varying state adoption, logistical hurdles, and the need for greater awareness among potential beneficiaries about enrollment and benefit utilization continue to be areas for improvement. Furthermore, hospital participation has sometimes been hampered by bureaucratic processes and payment delays. For instance, in February 2025, private hospitals in Haryana announced a temporary suspension of Ayushman Bharat services due to pending reimbursements. However, the Haryana government promptly assured the Indian Medical Association (IMA) that all pending claims would be cleared, with a budget of ₹2,500 crore allocated for claims settlement in the 2025-26 financial year, ensuring continuity of services. For more details on the resolution of such issues, you can read about the Haryana Private Hospitals Announce One-Day Ayushman Bharat Service Suspension Over ₹1200 Crore Payment Delays and Haryana's Healthcare Standoff: Private Hospitals Suspend Ayushman Bharat Services for 24 Hours.
Addressing the urban-rural disparity in healthcare infrastructure and the shortage of skilled healthcare professionals, particularly in remote areas, remains a critical focus. The government is actively working on strengthening the public health system through initiatives like the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), which has an outlay of ₹64,180 crore from FY 2021-22 to 2025-26, aimed at building a resilient and accessible public health system. This includes establishing thousands of rural and urban health and wellness centers and block public health units.
Future Outlook of India's Healthcare
The future of Ayushman Bharat looks promising, with continued efforts to enhance its reach and effectiveness. The scheme is expected to drive significant economic impact, fostering job creation in the healthcare sector and boosting the pharmaceutical industry. Integration of advanced technologies, such as telemedicine and AI-driven diagnostics, is on the horizon to make healthcare more accessible and efficient. The government also aims to increase public health expenditure to 2.5% of GDP by 2025, a goal that was outlined in 2018, reflecting a sustained commitment to healthcare investment, currently at 1.8% of GDP.
Ayushman Bharat is not merely a scheme; it is a movement towards a healthier, more financially secure India. The milestone of over 2 crore claims settled in the last financial year is a testament to its transformative power and its enduring role in safeguarding the health and well-being of the nation's most vulnerable citizens.