SocietyGS2+ GS3

Health Ministry Marks Eight Years of AB-PMJAY, Five of ABDM

PIB·2026-09-26· Read original

"Health Ministry Marks Eight Years of AB-PMJAY, Five of ABDM"

Prelims Facts

  • •AB-PMJAY offers cashless treatment across 1,961 procedures in 27 medical specialties, with cover up to ₹5 lakh per family per year
  • •Centre-State funding for AB-PMJAY is shared in a 60:40 ratio for most states and 90:10 for North-Eastern states, Himachal Pradesh, Uttarakhand and Jammu & Kashmir
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Key Terms

ABHA

Ayushman Bharat Health Account, a unique digital health ID for citizens under ABDM

NHCX

National Health Claims Exchange, a common digital platform linking hospitals and insurers for claims processing

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Study Note

BackgroundCore Concept

Background

Universal health coverage (UHC) means every citizen can get needed care without facing financial ruin. India's National Health Policy, 2017 set a target of raising public health spending to 2.5% of GDP, a goal budgetary allocations alone have struggled to meet. To bridge this gap, the government launched Ayushman Bharat in 2018 with two linked components. One strengthens primary care through Health and Wellness Centres. The other shields families from catastrophic hospital bills through a publicly funded insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

Over time, a digital layer was added. The Ayushman Bharat Digital Mission (ABDM), launched in 2021, aims to make health records portable through a unique digital health ID. It is important to be precise about what ABDM actually guarantees. Hospital participation in ABDM is voluntary, not compulsory. Universal enrolment of every citizen is a stated ambition, not an achieved fact. The one feature ABDM reliably delivers today is seamless portability of health records for those who have enrolled. This distinction separates ABDM's real design from the common assumption that a digital health mission automatically means compulsory, universal participation.

The Topic Explained

AB-PMJAY is a centrally sponsored scheme offering cashless treatment across 1,961 procedures in 27 medical specialties, with a cover of up to ₹5 lakh per family per year on a floater basis, through empanelled public and private hospitals. The Centre and States share costs in a 60:40 ratio for most states, rising to 90:10 in the Centre's favour for North-Eastern states, Himachal Pradesh, Uttarakhand and Jammu & Kashmir. Since 2024, the scheme covers all senior citizens aged 70 years and above irrespective of income, adding a large elderly population regardless of socio-economic category. …

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Related PYQs

2022GS1 Prelims

With reference to Ayushman Bharat Digital Mission, consider the following statements:

1.Private and public hospitals must adopt it.

2.As it aims to achieve universal health coverage, every citizen of India should be part of it ultimately.

3.It has seamless portability across the country.

Which of the statements given above is/are correct?

A1 and 2 only
B3 only
C1 and 3 only
D1, 2 and 3
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2018GS2 Mains

Appropriate local community-level healthcare intervention is a prerequisite to achieve 'Health for All' in India. Explain.

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Practice MCQs

Societymedium

With reference to the Ayushman Bharat Digital Mission (ABDM), consider the following statements: 1. Adoption of ABDM by hospitals, whether public or private, is mandatory. 2. Universal enrolment of every citizen is an eventual goal, not yet realised. 3. ABDM guarantees seamless portability of health records across the country for enrolled users. How many of the above statements are correct?

AOnly one
BOnly two
CAll three
DNone
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Societyeasy

Consider the following statements regarding Ayushman Bharat PM-JAY: 1. It provides a cover of up to ₹5 lakh per family per year on a floater basis. 2. Scheme funds are shared between the Centre and States in the ratio of 60:40 for most States. 3. Since 2024, all citizens aged 70 years and above are covered under the scheme irrespective of income. Which of the statements given above are correct?

A1 and 2 only
B2 and 3 only
C1 and 3 only
D1, 2 and 3
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Societymedium

Match List I (ABDM/health component) with List II (function) and select the correct answer using the codes given below:

List I:

A.ABHA

B.Healthcare Professionals Registry

C.Health Facility Registry

D.National Health Claims Exchange

List II:

1.Common platform linking hospitals and insurers for claims

2.Unique digital health ID for citizens

3.Registry of verified doctors and health workers

4.Registry of hospitals and clinics

AA-2, B-3, C-4, D-1
BA-1, B-2, C-3, D-4
CA-2, B-4, C-3, D-1
DA-3, B-2, C-4, D-1
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Societyeasy

Which of the following organisations is responsible for implementing both Ayushman Bharat PM-JAY and the Ayushman Bharat Digital Mission (ABDM)?

ANational Health Authority
BIndian Council of Medical Research
CInsurance Regulatory and Development Authority of India
DNITI Aayog
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