In India, the cost of treatment has risen steeply in recent years. A stay in hospital – be it for a cancer treatment, heart operation, or an extended stay in the ICU – can quickly put paid to years of accumulated savings. Therefore, an ambitious proposal to enhance the health insurance cover provided by the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) from Rs 5 lakh to Rs 10 lakh is all set to grab the eye of the entire country.
But there’s one major caveat. Insurance cover is yet to be increased. The Parliamentary Standing Committee on Health and Family Welfare had given the recommendation but the central government has not announced any decision on it so far.
Here’s a look at the proposal, why the committee feels a higher insurance cover is required and what it could mean for the beneficiaries if the government gives its nod.
Why the Rs 10 lakh health insurance scheme is in the news
The 172nd Report of the Parliamentary Standing Committee on Health and Family Welfare recommends this.
The committee said the existing Rs 5 lakh annual health cover under Ayushman Bharat may no longer be sufficient as medical costs have increased over the years. Where once this limit was the norm, treatments now often cost a lot more.
The panel said that families facing serious illnesses often run out of the insurance they already have and have to arrange the rest themselves. In response, it has proposed doubling the annual health cover to Rs 10 lakh per family.
This is only a suggestion. The Centre has not approved it, nor has any official notification been issued.
Why will 5 lakh rupees not be enough anymore?
When Ayushman Bharat was launched, a Rs 5 lakh health cover was considered a big financial cushion. But in the meantime, healthcare costs have ballooned.
Today, treatments for diseases like cancer, heart disease, kidney failure, liver disorders, and organ transplants can easily cost several lakh rupees. Hospital bills can be further inflated by a prolonged stay in the ICU.
When the limit of the insurance is reached, the family has to pay the rest from their own savings or by borrowing money. The committee felt that raising the cover would ease this financial burden in times of medical emergencies.
What if the government accepts the proposal?
If the Centre accepts the recommendation, eligible Ayushman Bharat beneficiaries could get cashless health insurance cover of up to Rs 10 lakh per family per year, against the existing Rs 5 lakh.
Here are some of the benefits of a higher insurance cover:
More cash to help pay for costly medical treatment.
Reduce the cost of health care that families pay for themselves.
Fewer patients put off or stop treatment due to financial difficulties.
Greater financial protection for economically vulnerable households confronted with a serious health emergency.
It might also allow families to continue treatment without having to worry about having to come up with large sums when the current insurance limit is reached.
What is Ayushman Bharat PM-JAY?
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a central government flagship health insurance scheme for poor and vulnerable families.
As per the scheme, the eligible beneficiaries are provided cashless treatment up to Rs 5 lakh per family per annum in empanelled government and private hospitals in India.
The government pays for the treatment so that the eligible families can get hospital treatment without having to pay the bills out of their own pocket.
Who is eligible for the scheme?
The scheme mainly covers the economically weaker families identified through the Socio-Economic and Caste Census (SECC) and other eligibility rules as notified by the government.
Besides, the centre has also introduced the Ayushman Vaya Vandana Yojana, under which all senior citizens above the age of 70 years are eligible for health insurance benefits irrespective of their income.
Some states provide better health coverage
The top Ayushman Bharat scheme, which offers insurance cover of up to Rs 5 lakh, is now being merged with some states’ own health schemes, which offer more benefits.
For example, Odisha has combined Ayushman Bharat with the Gopabandhu Jan Arogya Yojana, enabling eligible women to avail themselves of a health insurance cover of up to Rs 10 lakh.
Many other states have also linked their own health schemes with PM-JAY, so the benefits available can vary from state to state.
Have you increased the health insurance coverage yet?
No.
Even after discussing the proposal, there is no change in the Ayushman Bharat insurance cover yet.
Eligible families will continue to get cashless treatment up to Rs 5 lakh per year as per the existing rules.
So far, the central government has not made any official announcement of raising the insurance limit. The proposal is still under consideration.
What do beneficiaries need to do now?
Beneficiaries can continue availing the scheme under the existing provisions, offering cashless health insurance of up to Rs 5 lakh per annum till then.
If the centre chooses to follow the committee’s recommendation, it will then issue an official notification with the revised insurance amount, rules of eligibility and the date from which the new limit will be effective.
Until then, any claim that the health cover has already been increased to Rs 10 lakh is wrong.
Ayushman card limit soon to be Rs 10 lakh?
The proposal comes amid growing concerns over the rising healthcare costs in India. If the drug is approved, it could bring significant financial relief to millions of families, especially those with expensive or long-term medical treatment.
But nothing has changed for now. The Ayushman Bharat scheme continues to provide health insurance coverage of up to Rs 5 lakh per eligible family per year. Beneficiaries are advised to look only at official government announcements for any future changes to the scheme.
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Priyanka Roshan is a business writer and assistant editor at the NewsX website who tracks everything from stock market swings and corporate earnings to personal finance trends and policy shifts. Known for turning fast-moving business developments into sharp, reader-friendly stories, she combines speed, accuracy, and a data-driven approach to break down complex financial news for everyday audiences.
With over 9.5 years of newsroom experience, Priyanka has worked with leading media organisations, including Moneycontrol, Times Now, and Ping Digital, covering diverse beats such as business, politics, technology, auto, travel, sports, and the world. From live breaking news desks to SEO-led digital storytelling, she specialises in creating engaging content that keeps readers informed without overwhelming them.
