Ayushman Bharat vs. State Health Schemes: Which is Better for You (2025)?

Compare PMJAY with top state schemes like Chiranjeevi, Swasthya Sathi, MJPJAY, AB-ArK, CMCHIS, and Dr YSR Aarogyasri for eligibility, coverage, and benefits in 2025.

India’s Health Insurance Landscape in 2025

India’s healthcare system combines national and state-level health insurance schemes. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) provides a nationwide safety net, while states enhance it with tailored schemes. As of 2025, PMJAY has facilitated over 92 million hospital admissions and expanded to cover all seniors above 70, benefiting approximately 60 million elderly.

This guide compares PMJAY with leading state schemes, detailing eligibility, coverage, and unique features to help you choose the best option based on your state. Learn how to apply with our Ayushman Card application guide or check eligibility at our eligibility checker.

Ayushman Bharat (PMJAY): The National Benchmark

Launched in 2018, PMJAY is the world’s largest government-funded health insurance program, covering 15.14 crore families under SECC 2011 and 8.57 crore through state expansions as of March 2025. Key features include:

PMJAY protects against catastrophic health expenses, which affect nearly 6 crore Indians annually. For more benefits, read our PMJAY benefits guide.

State Health Schemes: Customized Solutions

States often converge their schemes with PMJAY, offering broader eligibility or higher coverage. Below is a comparison of key state schemes for 2025.

State Scheme Coverage Eligibility Key Features
Rajasthan Chiranjeevi Yojana ₹25 lakh health + ₹10 lakh accident Universal; free for NFSA/SECC, ₹850 for others Includes organ transplants
West Bengal Swasthya Sathi ₹5 lakh Universal (except other schemes) Female-centric card
Maharashtra MJPJAY ₹5 lakh Universal Integrated with PMJAY
Karnataka AB-ArK ₹5 lakh (full/subsidized) Universal, tiered Oncology focus
Tamil Nadu CMCHIS ₹5 lakh Income < ₹1.2 lakh 1,090 procedures
Andhra Pradesh Dr YSR Aarogyasri ₹5 lakh BPL families Cashless treatment

Rajasthan: Mukhyamantri Chiranjeevi Swasthya Bima Yojana

India’s most generous scheme, covering 1,929 procedures, including organ transplants.

  • Coverage: ₹25 lakh health + ₹10 lakh accident insurance.
  • Eligibility: Universal; free for NFSA/SECC, ₹850 premium otherwise.
  • Verdict: Outperforms PMJAY. See Chiranjeevi Yojana.

West Bengal: Swasthya Sathi

Independent scheme prioritizing women’s empowerment.

  • Coverage: ₹5 lakh per family.
  • Eligibility: Universal, excluding other scheme beneficiaries.
  • Unique Feature: Card in senior female’s name.
  • Verdict: Matches PMJAY but broader reach. Learn more at Swasthya Sathi.

Maharashtra: Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)

Fully integrated with PMJAY for universal access.

  • Coverage: ₹5 lakh per family.
  • Eligibility: All residents since 2024.
  • Verdict: Seamless coverage. Check MJPJAY.

Karnataka: Ayushman Bharat – Arogya Karnataka (AB-ArK)

Tiered model with increased oncology focus in 2025.

  • Coverage: ₹5 lakh for PMJAY-eligible; subsidized for others.
  • Eligibility: Universal, tiered benefits.
  • Verdict: Broad safety net. See AB-ArK.

Tamil Nadu: Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS)

Converged with PMJAY, strong in oncology and pediatrics.

  • Coverage: ₹5 lakh per family.
  • Eligibility: Families with income below ₹1.2 lakh.
  • Verdict: Ideal for low-income families.

Andhra Pradesh: Dr YSR Aarogyasri

Targets BPL families with cashless care.

  • Coverage: ₹5 lakh per family.
  • Eligibility: BPL families (1.29 crore covered).
  • Verdict: Vital for vulnerable groups.

Pros and Cons: PMJAY vs. State Schemes

PMJAY Pros: Nationwide portability, uniform ₹5 lakh coverage, inclusive for seniors.
PMJAY Cons: Limited to SECC and seniors above 70.
State Schemes Pros: Often universal (e.g., Rajasthan, Maharashtra), higher coverage in some states.
State Schemes Cons: Portability may be restricted outside the state.
For tips on choosing health insurance, read our health insurance guide.

Which Scheme Suits You in 2025?

Your state’s scheme is usually the best, as integrations maximize benefits. For example, Rajasthan’s Chiranjeevi offers ₹25 lakh vs. PMJAY’s ₹5 lakh. Apply for your health card to access the right scheme automatically. Find empanelled providers in our hospital list.

Start your application today with our application guide.

Frequently Asked Questions (FAQs)

Q. If my state scheme offers less coverage, do I get PMJAY’s ₹5 lakh?

In converged schemes, PMJAY-eligible families get ₹5 lakh; others get state-defined benefits.

Q. Are hospital networks shared between PMJAY and state schemes?

Yes, converged schemes use the same empanelled hospitals for seamless access.

Q. How has PMJAY expanded for seniors in 2025?

All citizens above 70 now qualify for cashless care.

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