Lok Sabha Question No. 117 (STARRED), answered on 2026-02-06
Subject: Issuance of Ayushman Cards under PM-JAY
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Smt. Shambhavi, Dr. Lata Wankhede

## GOVERNMENTOFINDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA STARRED QUESTION NO. 117 TO BE ANSWERED ON THE 6 TH FEBRUARY, 2026

## ISSUANCE OF AYUSHMAN CARDS UNDER PM-JAY

## *117. SMT. SHAMBHAVI: DR. LATA WANKHEDE:

Will the MINISTER OF HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the total number of families that have been issued Ayushman Cards under the PM-JAY scheme in the States of Bihar, Uttar Pradesh, Madhya Pradesh and Andhra Pradesh as of January 2026;
- (b) the number of hospitals, both public and private, empanelled under the scheme in the said States;
- (c) the details of the claim settlement ratio and the average time taken for the reimbursement of claims to the hospitals in the said States;
- (d) the measures taken by the Government to check the fraudulent practices and ensure genuine treatment of beneficiaries in these States; and
- (e) the details of the Government's plan to expand the coverage of the scheme to the left-out eligible families in these States?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE

## (SHRI JAGAT PRAKASH NADDA)

- (a) to (e) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 117* FOR 6 TH FEBRUARY, 2026

(a) to (e) The details of number of families that have been issued Ayushman Cards under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in the States of Bihar, Uttar Pradesh, Madhya Pradesh and Andhra Pradesh as of January 2026 are as under:

| State          |   Number of families (in crore) |
|----------------|---------------------------------|
| Bihar          |                            1.16 |
| Uttar Pradesh  |                            1.26 |
| Madhya Pradesh |                            0.89 |
| Andhra Pradesh |                            0.59 |

The details of number of hospitals empanelled, both public and private, in the States of Bihar, Uttar Pradesh, Madhya Pradesh and Andhra Pradesh under AB-PMJAY as on 31.01.2026 are as under:

| State          |   Public hospitals empanelled |   Private hospitals empanelled |
|----------------|-------------------------------|--------------------------------|
| Bihar          |                           430 |                            723 |
| Uttar Pradesh  |                          2926 |                           3413 |
| Madhya Pradesh |                          1113 |                            823 |
| Andhra Pradesh |                          1416 |                           1053 |

Under AB-PMJAY, settlement of claims is a regular and uninterrupted process and claims are settled by respective State Health Agencies (SHA) as per claim adjudication guidelines issued by National Health Authority (NHA). As per the guideline, the permissible turnaround time for settlement of claim to hospitals is within 15 days of claims submission for the intra-state hospitals (hospitals located within State) and within 30 days in case of portability claims (hospitals located outside State).

AB-PMJAY is governed on a zero-tolerance approach towards fraud. National Anti-Fraud Unit (NAFU) established at NHA, uses AI/ML-based automated triggers to flag unusual claim patterns such as duplicate entries, inflated procedures, or misuse of patient identity, etc. A comprehensive dashboard is designed to monitor the real time performance of AB-PMJAY. Regular capacity-building workshops and field-level training sessions are conducted to strengthen the overall anti-fraud framework.

AB-PMJAY provides health coverage of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to 12 crore families constituting bottom 40% of India's population. In March 2024, approximately 37 lakh families of Accredited Social Health Activists, Anganwadi Workers and Anganwadi Helpers were included under the scheme. In October 2024, the scheme was further expanded to cover 6 crore senior citizens of age 70 years and above belonging to 4.5 crore families irrespective of their socio-economic status. Many States/UTs implementing AB-PMJAY have further expanded the beneficiary base under their own state's scheme.

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