Which scheme is better: Ayushman Bharat (PMJAY) or a state health scheme like Chiranjeevi Yojana?

The 'better' scheme depends on your state of residence. In states like Rajasthan, the state's Chiranjeevi Yojana is superior as it offers a much higher cover (₹25 lakh) and is universal. In states without a strong state scheme, the national Ayushman Bharat (PMJAY) is the primary safety net. In most cases, these schemes are integrated, so you receive the benefits of the best plan you are eligible for.

Can I have both an Ayushman Card and a state health scheme card?

Generally, no. The schemes are converged. You will typically be issued one co-branded card (like a PMJAY-MA card in Gujarat) or your eligibility will be linked to a single identifier (like the Jan Aadhaar Card in Rajasthan). The system automatically gives you the benefits of the scheme you are eligible for.

Why did some states like West Bengal launch their own scheme instead of using Ayushman Bharat?

States like West Bengal chose to implement their own universal health schemes, such as Swasthya Sathi, to have greater control over the program's design and to cover their entire population, not just the federally mandated SECC beneficiaries. This allows them to tailor the scheme to local needs.

Is the ₹5 lakh benefit of Ayushman Bharat the same in every state?

Yes, the core benefit of the central Ayushman Bharat (PMJAY) scheme is a uniform ₹5 lakh cover per family per year across all participating states and union territories.

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

Understanding India's Public Health Insurance Landscape

India's healthcare system is supported by a dual-engine of health insurance schemes: the national Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) and various powerful State Health Schemes. While PMJAY provides a foundational safety net across the country, many states have built upon it, creating their own unique, and often more inclusive, programs. This can be confusing for beneficiaries.

This article will provide a clear comparison between the national Ayushman Bharat scheme and some of the most prominent state health schemes. We will explore their differences in eligibility, coverage, and unique features to help you understand which scheme benefits you the most based on where you live.

What is Ayushman Bharat (PMJAY)? - The National Standard

Launched in 2018, PMJAY is the world's largest health insurance scheme, financed by the central government. Its key features are standard across all participating states:

Coverage: ₹5 lakh per family per year.
Eligibility: Based on the Socio-Economic Caste Census (SECC) 2011 data, targeting the bottom 40% of the population. If you are not on this list, you are generally not eligible for the central scheme. You can learn how to check your name here.
Portability: Its biggest advantage is national portability. A card made in Uttar Pradesh is valid in a hospital in Karnataka.
Funding: It is a centrally sponsored scheme, with costs shared between the central and state governments.

What are State Health Schemes? - Tailored for Local Needs

Many states had their own health insurance schemes even before PMJAY. Instead of replacing them, most states have **converged** their schemes with PMJAY. They use PMJAY as a base and expand upon it to cover more people and offer unique benefits. Let's look at some leading examples.

Rajasthan: Mukhyamantri Chiranjeevi Swasthya Bima Yojana

Rajasthan's scheme is arguably the most generous in India.

Coverage: A massive **₹25 lakh** for health insurance and **₹10 lakh** for accident insurance.
Eligibility: **Universal**. Every family in Rajasthan is eligible. Certain categories (NFSA, SECC) get it for free, while all others can join by paying a nominal ₹850 premium per year.
Verdict: For residents of Rajasthan, the state's Chiranjeevi Yojana is far superior to the base PMJAY due to its universal eligibility and significantly higher coverage amount.

West Bengal: Swasthya Sathi

West Bengal opted out of PMJAY to run its own successful universal scheme.

Coverage: ₹5 lakh per family per year.
Eligibility: **Universal**. Every resident of West Bengal is eligible, unless covered by another government scheme.
Unique Feature: The smart card is issued in the name of the senior-most female member of the family, promoting women empowerment.
Verdict: The Swasthya Sathi scheme provides the same financial cover as PMJAY but to a much larger population.

Maharashtra: Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)

Maharashtra also expanded its long-running state scheme to achieve universal coverage.

Coverage: ₹5 lakh per family per year.
Eligibility: **Universal**. As of 2024, all residents of Maharashtra are eligible for the scheme.
Verdict: The integrated PMJAY-MJPJAY scheme now ensures that every citizen of the state has access to the ₹5 lakh benefit, a significant upgrade over its previous eligibility criteria.

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

Karnataka has a unique tiered model for universal coverage.

Coverage: Tiered system. PMJAY-eligible families get a full ₹5 lakh cashless cover. All other residents ("General" category) get subsidized treatment at package rates, with the government covering a portion of the cost.
Eligibility: **Universal**, but with different levels of benefit.
Verdict: The AB-ArK scheme is excellent because it provides a safety net for everyone, even if the benefit is not fully cashless for all.

Conclusion: Which Scheme is Better for You?

The answer is simple: **the scheme of the state you reside in is the best one for you.** You do not need to choose. If you live in a state with a powerful, integrated scheme like Rajasthan's Chiranjeevi Yojana, you are automatically entitled to its superior benefits. The central PMJAY acts as the foundation, but the state schemes are the pillars that provide strength and wider coverage.

The most important step is to apply for your health card. The system will automatically identify which scheme (central or state) you fall under and issue you the appropriate card and benefits.

Frequently Asked Questions (FAQs)

Q. If my state scheme (like MJPJAY) covers only ₹1.5 lakh, do I still get ₹5 lakh?

In converged schemes, if you are eligible for the central PMJAY list, you will get the higher ₹5 lakh cover. If you are eligible only under the state component, you will get the benefit defined by the state (which is now mostly aligned to ₹5 lakh).

Q. Is the hospital network the same for PMJAY and state schemes?

In almost all states with converged schemes, the list of empanelled hospitals is the same for both PMJAY and state scheme beneficiaries, ensuring uniform access to care.