Women account for 49% of total hospital admissions under the government’s flagship health insurance scheme, the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), according to the National Health Authority’s (NHA) Annual Report, 2024-25. This signals improved access to institutional healthcare for women, the report said.
Haemodialysis was the most availed treatment (14%), followed by multiple packages (7%); treatment for acute febrile illness (4%); acute gastroenteritis, and cataract and related procedures (3%).
The AB-PMJAY, launched in 2018, is among the largest health assurance schemes in the world, aiming to provide health cover of ₹5 lakh per family per year. Recently, Odisha and Delhi were onboarded for the scheme’s implementation.
Other than West Bengal, 35 States and Union Territories are now under the AB-PMJAY umbrella. As of March 31, 2025, the AB-PMJAY covers 15.14 crore eligible families, with an additional 8.57 crore families under State-specific schemes, the report said.
“So far, over 9.19 crore hospital admissions have been facilitated under AB-PMJAY, with treatment worth ₹1,29,386 crore completed and 31,005 hospitals empanelled, ensuring nationwide accessibility — 55% public, and 45% private,’’ the report said.
It added that under the nationwide Ayushman card saturation drives, over 40.45 crore cards had been issued, covering 14.69 crore families. The ‘Aapke Dwar Ayushman’ (ADA 3.0) initiative achieved outreach through technology-led, community-based, self-registration campaigns, empowering citizens at the grassroots.
To further facilitate inclusivity, the 2023 interim Budget announced the inclusion of 37 lakh families of frontline workers, including Accredited Social Health Activists (ASHAs), Anganwadi workers, and Anganwadi helpers, into the AB-PMJAY.
In October 2024, the Union Cabinet approved the expansion of the AB-PMJAY to include all citizens aged 70 years and above, irrespective of income or socio-economic status.
Public hospitals remain crucial in rural and low-income districts, while private facilities dominate high-value procedures in several areas, including oncology, cardiology, and orthopaedics.
Private hospital participation continues to rise, with a 12% increase in empanelment in FY2024-25, the NHA said.
The government’s push to integrate healthcare delivery through the Ayushman Bharat Digital Mission (ABDM) is also transforming how hospitals manage patient data and claims, the report said. By March 2025, over 61.8 crore Ayushman Bharat Health Accounts (ABHA) had been created, while 3.4 lakh healthcare facilities and 1.7 lakh professionals had been registered on the platform.
“The integration of the AB-PMJAY and the ABDM is enabling paperless, cashless, and interoperable healthcare delivery,” the report said, highlighting that the digital ecosystem was speeding up claims settlement and reducing fraud.
The NHA has cautioned that the long-term sustainability of the scheme would depend on regular funding, faster claim settlements, and consistent participation from private hospitals across all regions. With several State health insurance programmes now being integrated into the AB-PMJAY, the total outlay for FY2024-25 is expected to exceed ₹20,000 crore.
Published – October 18, 2025 06:36 pm IST
Leave a Reply