Ayushman Card Limit To Double To ₹10 Lakh? 5 Key Things You Should Know

A proposal to increase the health insurance cover under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) from ₹5 lakh to ₹10 lakh per family per year has sparked widespread interest. However, it's important to note that this is currently a recommendation, not a government-approved change. The proposal comes from a Parliamentary Standing Committee, which believes the existing cover may no longer be sufficient given the rising cost of healthcare. Here's what you need to know.

The ₹10 lakh health cover has not been approved by the Central government. The recommendation was made by the Parliamentary Standing Committee on Health and Family Welfare in its 172nd report. Until the government formally accepts and implements it, the existing benefits under AB-PMJAY remain unchanged.

At present, eligible beneficiaries under Ayushman Bharat receive cashless health insurance of up to ₹5 lakh per family per year for secondary and tertiary hospitalisation at empanelled hospitals across India. The scheme covers thousands of medical procedures, including surgeries, diagnostics and hospitalisation expenses.

The committee said the current ₹5 lakh cap may not be enough to cover the cost of expensive treatments such as organ transplants, advanced cancer therapies, complex cardiac procedures and other life-saving interventions. It believes doubling the limit would reduce out-of-pocket medical expenses for families facing serious illnesses.

In certain situations, total coverage can already reach ₹10 lakh, but this is not due to the new proposal. For example: In Delhi, the state government provides an additional ₹5 lakh over the Centre's ₹5 lakh cover, taking the total annual benefit to ₹10 lakh per family. Families with members aged 70 years and above may also receive an additional ₹5 lakh top-up for eligible senior citizens under the expanded AB-PMJAY rules, subject to the scheme's conditions.

The recommendation to increase Ayushman Bharat's insurance cover to ₹10 lakh reflects concerns over rising healthcare costs, but it has not yet become policy. Until an official announcement is made, eligible beneficiaries will continue to receive the existing ₹5 lakh annual health cover under the scheme.