Bihar pushes up its Ayushman Bharat health insurance coverage 

Bihar is now among the Indian States leading in the enrolment of cardholders under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), with 3.94 crore Ayushman cards created till date, according to data released by the State government.

It has also helped beneficiaries save over ₹1,000 crore in out-of-pocket medical expenses within a single year.

Bihar is the third most populous State in the country, with about 80% rural population, and a literacy rate of less than 70%. 

It faces health challenges, including high infant and maternal mortality rates, malnutrition, and limited access to quality healthcare.

As part of its drive to ensure maximum coverage, a recent four-day drive, from May 26-30, brought 17.38 lakh more cardholders into the Central government-run cashless health insurance scheme, offering treatment for secondary and tertiary care hospitalisation for the economically weaker sections of society.

Uttar Pradesh and Madhya Pradesh are the other two States that have recently indicated a high enrolment rate. 

The flagship health insurance scheme, launched in 2018, offers cashless healthcare treatment of up to ₹5 lakh per family per year.

Initially, the State Government had adopted the Socio Economic Caste Census (SECC 2011) data for implementing the AB-PMJAY scheme, Shailesh Chandra Diwakar, Administrative Officer, Bihar Swasthya Suraksha Samiti (Ayushman Bharat), said on the recent focus to expand the coverage of the Ayushman card.

In February 2024, the Bihar Government adopted the National Food Security Act (NFSA) database and provided coverage to all NFSA-registered family members.

“This saw many more ration cardholders coming into the AB-PMJAY fold. More than 2.8 crore Ayushman cards were created in 2024,” Mr. Diwakar said.

Besides this, the State has launched various measures, including an enhanced cash incentive of ₹15 (from ₹5) to ASHA workers involved in verified enrolments; camps at railway stations to capture those in need when people travel back into the State for festivals; and door-to-door campaigns. 

“These extensive mop-up rounds are for individuals who have been left behind,” Shashank Shekhar Sinha, CEO, Ayushman Bharat (PMJAY-Ayushman Bharat Digital Mission), said.

The State has also recently registered enrolment of 2.82 lakh persons under the Ayushman Vaya Vandana card (for senior citizens 70 years and above). 

According to the State government, the total claims paid rose from 3.03 lakh cases in FY 2023-24 to 7.52 lakh cases in FY 2024-25, and more than 2.83 crore Ayushman cards were created in 2024.

A first time Ayushman card user, speaking of his enrolment, and experience with availing the treatment, said that he had had his card made only after he reached the hospital to be treated for cataract.

“Though we had heard about the Ayushman card, since we didn’t need hospitalisation, we never got the card made,” Lalan Choudhary, a resident of Bihar’s Nalanda district, who is now undergoing free treatment at a private healthcare facility in Gaya under the AB-PMJAY, said.

“This is a problem we are facing in the State — though people know about the card, they will enrol under the scheme often only when they seek treatment,” Mr. Diwakar added. 

The State is now trying to rope in eligible individuals who have not opted for the scheme. 

Khushi Praveen, 19, who was operated for spinal deformity 10 days ago, speaking about her use of the Ayushman card, said that she had been suffering for a nearly a year without money to secure treatment and surgery. 

“Though I needed surgery, without money, there was no access to healthcare. My doctor in the private sector suggested that I get my Ayushman card and get operated. Using the card, I got surgery and am healing well now, and hope to be able to walk soon,” Ms. Praveen said.

Parmilla Devi, 50, had her cataract operation performed under the scheme. “My husband and I work as farmers and couldn’t have afforded the surgery otherwise. My husband is also now planning to apply for his card also,” Ms. Devi said.

Rajaram Prasad, Chief Surgeon, Gaya district, said that in Gaya district (one of the 38 districts in Bihar), which is seeing robust enrolment and use of the card, in 2024-25, a total of 18,734 people were treated in government hospitals at an expense of about ₹15 crore under the Ayushman scheme.

“Affordable, quality medical care is now no longer a distant dream for the rural population of Bihar,” Dr. Prasad said.

Besides the enrolment of more individuals under the scheme, Bihar is also looking at enhancing the number of hospital service providers.

Currently, over 1,100 hospitals are empanelled under the scheme in Bihar, 50% of which are private hospitals, a senior Bihar health official.

Published - June 07, 2025 11:50 pm IST