Prime Minister Narendra Modi Launched the AB PM-JAY SEHAT Scheme on December 26, 2020 Providing Universal, Cashless Health Insurance of ₹5 Lakh Per Family Per Year to All 21 Lakh Families of Jammu and Kashmir, With No Income Restriction, Full Pre-Existing Disease Coverage, and National Portability Across All PM-JAY Empanelled Hospitals in India…
Jammu & Kashmir Sehat Health Insurance Scheme
The Sehat Health Insurance Scheme officially named Ayushman Bharat PM-JAY SEHAT (Social, Endeavour for Health and Telemedicine) makes Jammu and Kashmir the first region in India to achieve near-universal public health coverage, extending cashless hospitalization benefits of up to ₹5 lakh per family per year to every resident household without any income or economic threshold.
Launched on December 26, 2020 by Prime Minister Narendra Modi, the scheme extended the existing Ayushman Bharat PM-JAY programme to cover approximately 15 lakh additional families who were previously outside the PM-JAY beneficiary database bringing the total coverage to all 21 lakh families across J&K. The scheme operates through Bajaj Allianz General Insurance Company as the implementing partner and runs under the supervision of the State Health Agency (SHA), J&K.
What SEHAT Covers: The Full Insurance Package
Every registered SEHAT family receives a comprehensive insurance package that covers a far wider range of medical situations than most standalone insurance products at this price point (the premium is zero — the government bears the full cost):
| Coverage Feature | Details |
| Sum Insured | ₹5,00,000 per family per year — floater basis |
| Medical Procedures | 1,500+ packages including oncology, cardiology, nephrology |
| Pre-existing Diseases | Covered from Day 1 — no waiting period |
| Pre-Hospitalisation | Up to 3 days of diagnostics and medicines |
| Post-Hospitalisation | Up to 15 days of follow-up care and medicines |
| Premium Cost to Beneficiary | Zero — fully government-funded |
| Hospital Network | Government + empanelled private hospitals across India |
| National Portability | Valid at all PM-JAY empanelled hospitals anywhere in India |
The floater basis means the ₹5 lakh coverage does not divide between family members the full amount is available to any one member or distributed across multiple members in the same year, whichever way hospitalisation occurs.
Who Is Eligible: The Universal Coverage Rule
The SEHAT scheme’s most distinctive feature is its universal applicability it carries no income ceiling, no caste restriction, and no employment status requirement:
- Must be a permanent resident of Jammu and Kashmir
- Must hold a J&K ration card or appear in the J&K household family database
- All families qualify — poor, middle-income, and above — with one exception
- Excluded: Government employees and their dependants already covered under CGHS (Central Government Health Scheme) or ECHS (Ex-Servicemen Contributory Health Scheme)
This universal design addresses a common gap in India’s health coverage architecture where middle-income families above the poverty line but below the income threshold for private insurance remain the most financially vulnerable during serious illness. SEHAT removes this gap entirely for J&K residents.
How to Get Your SEHAT Golden Card: Three Routes
Every eligible J&K family needs a SEHAT Golden Card to access cashless treatment at empanelled hospitals. The card is available through three pathways:
Route 1: Online Self-Check and Card Generation:
- Visit jkpmjaysehat.co.in the official State Health Agency portal
- Click “Check Eligibility” and enter your Ration Card Number or Aadhaar Number
- If your family appears eligible, proceed to card generation
- Visit the nearest Common Service Centre (CSC) or empanelled hospital for biometric verification and physical card printing
Route 2: CSC Centre Visit:
- Locate the nearest CSC in your block or district
- Carry your Aadhaar card and J&K Ration card
- The CSC operator performs biometric verification using a fingerprint scanner
- The SEHAT Golden Card is generated on the spot a nominal fee of ₹30 applies for card printing
Route 3: Direct Hospital Enrolment:
- Visit any SEHAT-empanelled hospital government or private
- Approach the Ayushman Mitra desk at the hospital
- The Ayushman Mitra verifies your details and generates the card immediately
- Cashless treatment begins right away no waiting period after card generation
Documents Required: Simple Two-Document Process
Unlike most government scheme registrations, the SEHAT card requires only two core documents:
- Aadhaar card: mandatory for biometric identity verification
- J&K Ration Card: confirms household registration in the J&K family database
Families whose Aadhaar data carries minor spelling mismatches with ration card records should get the discrepancy corrected at the nearest Aadhaar Enrolment Centre before approaching a CSC for the card a mismatch between the two documents is the most common reason for card generation failure.
How to Use the SEHAT Card at Hospitals
Using the Golden Card for cashless treatment follows a straightforward process:
- Visit any SEHAT-empanelled government or private hospital across India
- Approach the Ayushman Mitra helpdesk at the hospital’s reception
- Present your SEHAT Golden Card and Aadhaar card
- The Ayushman Mitra performs biometric authentication to confirm the beneficiary’s identity
- Once authenticated, the hospital initiates the cashless admission process — no advance payment required
- Treatment proceeds at zero out-of-pocket cost for all covered procedures up to ₹5 lakh
- Pre-discharge and post-discharge medicines and diagnostics within 3 days and 15 days respectively are also covered without additional payment
Hospital Network and National Portability
One of SEHAT’s most significant practical advantages is its all-India portability the Golden Card functions at every Ayushman Bharat PM-JAY empaneled hospital across the country, not just within J&K. This feature directly benefits J&K residents who travel to cities like Delhi, Mumbai, Chandigarh, or Bengaluru for specialized treatment in oncology, cardiac surgery, organ transplants, or advanced orthopedic procedures.
J&K’s internal hospital network under SEHAT includes both government facilities and 264 empanelled private hospitals across the Union Territory. For the full list of empanelled hospitals, visit jkpmjaysehat.co.in or use the hospital locator on the Ayushman Bharat app.
Helpline and Support
For any query, eligibility check, card-related issue, or hospitalisation dispute under the SEHAT scheme, beneficiaries can contact the national Ayushman Bharat helpline at 14555 available seven days a week.
