What Is Ayushman Card Balance?

The term “Ayushman Card balance” is commonly used to describe the remaining annual treatment cover available to an eligible family under PM-JAY.

The displayed information may include:

• Total annual cover applicable to the family
• Amount associated with authorised hospital packages
• Treatment utilisation recorded during the current benefit period
• Remaining cover available for applicable future packages
• Pending, approved or completed hospital transactions
• Family members who have used scheme benefits
• Hospital and package information where displayed

Is Ayushman Card Balance a Cash Wallet?

No. The ₹5 lakh PM-JAY benefit is not deposited into the beneficiary’s bank account, UPI wallet or Ayushman Card.

• You cannot withdraw the balance from an ATM
• You cannot transfer it to another bank account
• You cannot convert the unused amount into cash
• You cannot use it for general household expenses
• You cannot use it at a non-empanelled hospital without applicable rules
• You cannot use it for every outpatient service or medicine purchase

How Does the ₹5 Lakh Ayushman Cover Work?

PM-JAY generally provides eligible families with health cover of up to ₹5 lakh per family per year for applicable secondary and tertiary hospitalisation.

When a family member receives approved treatment, the applicable package amount is recorded against the family’s scheme utilisation.

What Is Family-Floater Coverage?

Family-floater coverage means that the applicable annual cover is generally shared among eligible members of the beneficiary family rather than providing a separate ₹5 lakh general limit to every individual.

For example:

• One eligible member may use part of the family cover
• Another eligible member may use the remaining cover later
• More than one member may receive treatment during the benefit period
• The total family utilisation is considered together
• There is generally no ordinary PM-JAY cap based only on family size

How to Check Ayushman Card Balance Through the Ayushman App

The official Ayushman App is the primary beneficiary-facing mobile application. Available features may differ according to the current app version, state and scheme.

1. Install or update the official Ayushman App.
2. Confirm that the application is provided by the National Health Authority.
3. Open the app and select beneficiary login.
4. Enter an active mobile number.
5. Complete OTP authentication.
6. Select the correct state.
7. Select the applicable scheme.
8. Search for the beneficiary or family record.
9. Select the correct family member.
10. Open the available benefit, utilisation or transaction section.
11. Review the total cover displayed.
12. Review any utilised or authorised amount.
13. Review the remaining available cover where displayed.
14. Check the hospital and package details of recorded transactions.
15. Save a screenshot only for personal reference where appropriate.

How to Check Coverage Through Official Online Services

Online options can change. The beneficiary portal is mainly used for beneficiary search, eKYC, card services and related self-service features. A transaction or utilisation view may not be displayed for every beneficiary.

1. Open the official PM-JAY beneficiary portal.
2. Log in using an active mobile number.
3. Select the correct state and scheme.
4. Search for the eligible family.
5. Open the correct beneficiary record.
6. Check the available card and benefit information.
7. Look for any transaction, utilisation or treatment-history section.
8. Review the displayed hospital-package information.
9. Use another official method when balance details are not shown.

How to Check Balance at an Empanelled Hospital

An Arogya Mitra or authorised PM-JAY help-desk operator at an empanelled hospital may check the beneficiary’s current coverage and transaction information through the official hospital system.

1. Visit a currently empanelled PM-JAY hospital.
2. Ask for the Ayushman or PM-JAY help desk.
3. Show the Ayushman Card.
4. Provide an accepted photo identity document.
5. Ask the Arogya Mitra to locate the correct family record.
6. Complete beneficiary authentication where required.
7. Ask for the current family-cover information.
8. Ask which authorised packages are recorded.
9. Ask whether any transaction is pending, blocked or cancelled.
10. Ask how much cover appears available for another package.
11. Request a clear explanation before planned treatment.

How to Check Through the PM-JAY Helpline

For official guidance, call the national PM-JAY toll-free support number.

Keep the following information ready:

• Beneficiary’s full name
• State and district
• Ayushman Card or PM-JAY ID
• Registered or active mobile number
• Family information
• Hospital name where treatment occurred
• Date of admission and discharge
• Package name or procedure, if known
• Any pre-authorisation or transaction number
• Exact balance or utilisation problem

Ask whether the representative can explain the current utilisation, direct you to the correct state support channel or help register a grievance where an incorrect transaction is suspected.

Information Needed for an Ayushman Balance Check

How Is Ayushman Treatment Usage Calculated?

PM-JAY generally records treatment through approved Health Benefit Packages rather than deducting the hospital’s ordinary retail bill from the family cover.

The recorded amount may depend on:

• Selected treatment-package code
• Approved package rate
• Medical or surgical package type
• State-specific package rules
• Implant or device provisions
• Package modification approved during treatment
• Multiple procedures permitted under applicable rules
• Final hospital claim and transaction status
• Cancellation or reversal of an earlier booking

How Does Pre-Authorisation Affect the Balance?

Some treatments require the hospital to submit a pre-authorisation request before planned treatment begins.

How Do Hospital Claims Affect the Displayed Amount?

Hospital treatment passes through several stages, including beneficiary registration, pre-authorisation, treatment, discharge and claim processing.

The displayed amount may change as a transaction moves through stages such as:

• Beneficiary registered for treatment
• Pre-authorisation submitted
• Package approved
• Treatment started
• Patient discharged
• Claim submitted
• Claim reviewed
• Claim approved or modified
• Transaction cancelled or reversed
• Claim settled

Why May the Displayed Balance Be Different?

Different screens or representatives may temporarily show different information when transactions have not reached the same processing stage.

Possible reasons include:

• A newly approved package has not yet appeared in every view
• A cancelled treatment is awaiting transaction reversal
• A pre-authorisation remains pending
• The wrong family or beneficiary record was selected
• The wrong state or scheme was selected
• A package was modified after initial approval
• Another family member used the shared cover
• A duplicate or incorrect transaction exists
• The app is showing cached or outdated information
• A state-specific top-up is displayed separately

Recommended action

1. Confirm the correct beneficiary family.
2. Refresh or update the official app.
3. Check the state and scheme selection.
4. Review every recorded hospital transaction.
5. Ask the hospital for the package and pre-authorisation number.
6. Ask whether any cancellation or reversal is pending.
7. Call 14555 when the difference remains unexplained.
8. Submit a grievance when an incorrect transaction is suspected.

What If Multiple Family Members Use the Ayushman Card?

Under general family-floater coverage, eligible family members share the applicable annual cover.

When Does the Ayushman Card Cover Reset?

PM-JAY provides the applicable cover per family per year. The precise benefit-period handling and reset date should be confirmed through the official system because state implementation and beneficiary categories may differ.

To confirm the current period:

1. Open the official Ayushman App.
2. Select the correct family record.
3. Review the displayed coverage period where available.
4. Ask an empanelled hospital’s Arogya Mitra.
5. Call 14555 and provide the beneficiary details.
6. Ask about state-specific or category-specific coverage rules.

Balance Rules for Senior Citizens Aged 70 Plus

Senior citizens aged 70 years and above may be eligible for the Ayushman Vay Vandana Card. Special coverage rules apply when the senior belongs to a family already covered under PM-JAY.

Depending on the family situation:

• The senior-citizen category may have a distinct coverage record
• An additional senior-citizen top-up may be displayed separately
• The additional cover is intended for eligible members aged 70 plus
• Members below 70 should not use the senior-only additional cover
• Multiple eligible seniors may share the applicable senior-family cover
• The official app or hospital system should confirm the available amount

What If Treatment Costs More Than the Available Cover?

Before planned treatment, ask the hospital to check the available cover, applicable package and authorised amount.

Ask these questions:

• What is the exact package name and code?
• What amount is authorised under the package?
• How much family cover is currently available?
• Is another scheme or state top-up applicable?
• Is the proposed treatment fully covered by the package?
• Which services are outside the package?
• Can another empanelled hospital provide the same package?
• Will any payment be required?
• Can the hospital provide a written estimate?

What If the Hospital Demands Money Despite Available Balance?

An available balance does not automatically mean that every service is covered. The treatment must match an applicable package and receive required approval.

Before paying

1. Ask for the approved package name.
2. Ask for the package code.
3. Ask for the pre-authorisation status.
4. Ask how much cover is shown as available.
5. Ask which service is outside the package.
6. Request a written estimate.
7. Request an itemised bill.
8. Speak with the Arogya Mitra or nodal officer.
9. Obtain a receipt for every payment.
10. Use the official grievance process when necessary.

What If an Unknown Treatment Is Showing?

An unfamiliar hospital admission, package or transaction should be checked promptly. It may result from selecting the wrong family record, a data error, duplicate transaction or suspected misuse.

Collect this information

• Beneficiary’s name
• Ayushman Card or PM-JAY ID
• Hospital name and location
• Admission and discharge dates
• Package name and code
• Amount shown as utilised
• Transaction or pre-authorisation number
• Screenshot of the displayed record
• Confirmation that the beneficiary did not receive the treatment

Recommended action

1. Confirm that the correct family record is open.
2. Ask all family members whether treatment was received.
3. Contact the hospital shown in the transaction.
4. Call the official PM-JAY helpline.
5. Register a grievance through the official portal.
6. Save the Unique Grievance Number.
7. Track the complaint until the transaction is explained or corrected.

Common Ayushman Balance-Check Problems

1. Balance option is not visible in the app

Update the official app, confirm the correct state and scheme, and open the correct beneficiary record. Use the hospital help desk or helpline when the feature remains unavailable.

2. App shows zero available cover

Review all family transactions and ask whether an approved or pending package has reserved the available amount.

3. The family never used the card but the balance is reduced

Check every member and hospital transaction. Report an unknown entry through the official grievance system.

4. Cancelled treatment is still reducing the cover

Ask the hospital whether the package cancellation and transaction reversal have been completed in the official system.

5. The hospital and app show different amounts

Confirm the transaction stage, package modification and latest system update. Ask the Arogya Mitra to check the official TMS record.

6. One family member’s treatment is missing

Confirm whether the treatment was booked under the same scheme, family record and beneficiary ID.

7. The beneficiary cannot log in

Check the mobile number and OTP. Use an authorised help desk when login recovery or beneficiary identification is required.

8. The card has incorrect family details

Correct the beneficiary record through the official process before relying on the displayed family utilisation.

9. An agent offers to increase the balance

Do not pay. An unauthorised person cannot legitimately increase PM-JAY coverage or alter treatment utilisation.

10. The balance did not reset as expected

Confirm the official benefit period and state-specific coverage rules through the app, hospital help desk or helpline.

Ayushman Balance-Check Safety Precautions

• Do not use an unofficial balance-checking website
• Do not install an unknown Ayushman APK file
• Do not share an OTP with an unknown caller
• Do not publicly post the Ayushman Card or Aadhaar image
• Do not pay an agent to increase or restore the balance
• Do not believe promises of cash withdrawal from the card
• Do not share an ATM PIN, UPI PIN, CVV or banking password
• Do not ignore an unfamiliar treatment transaction
• Do not sign blank hospital or claim forms
• Do not provide false beneficiary or medical information
• Do not leave original documents with an unknown operator

Frequently Asked Questions

Final Words

Ayushman Card balance means the remaining annual hospital-treatment cover available under the beneficiary family’s applicable PM-JAY record. It is not withdrawable cash or money stored inside the physical card.

Use the official Ayushman App, an empanelled hospital’s Ayushman help desk or the national helpline to review the current coverage and transaction information. Check every authorised package when the amount appears lower than expected.

Report unknown transactions, unexplained deductions or delayed cancellations through the official grievance system. Never pay an agent who promises to increase the balance or transfer unused coverage into a bank account.