Quick answer: PM-JAY central coverage is ₹5 lakh per family per year everywhere in India, but your actual total coverage can be higher depending on your state. Several states layer their own scheme on top — Rajasthan and Tamil Nadu take combined cover up to ₹25 lakh, Gujarat and Punjab up to ₹10 lakh, and others extend eligibility to households PM-JAY alone does not cover. Use the calculator below to see exactly what applies where you live.
Key Takeaways
- The central PM-JAY scheme provides ₹5 lakh per family per year everywhere — that part is fixed nationwide.
- At least 8 states currently layer a state-funded top-up or convergence scheme on top, genuinely raising the total available cover.
- Rajasthan and Tamil Nadu currently offer the highest combined cover in the country, at up to ₹25 lakh per family.
- Some states (Karnataka, Chhattisgarh, Himachal Pradesh, Assam) do not raise the amount for PM-JAY-eligible families, but extend a separate, smaller cover to households PM-JAY itself would not include.
- Jammu and Kashmir and Ladakh are unique in offering universal ₹5 lakh cover to all residents, regardless of income.
How We Built This
Every figure in this tool comes from published state government scheme documentation and verified news reporting, cross-checked against at least two independent sources before being included — several conflicting figures found during research were discarded in favor of the better-supported number. Coverage amounts and scheme details change as state budgets and policies are revised, so treat this as a well-researched snapshot rather than a live government feed. For a decision that matters, confirm current details with your state health department, the PM-JAY helpline (14555), or the official beneficiary portal.
Full State-by-State Reference Table
| State/UT | Total Coverage | Scheme |
|---|---|---|
| Rajasthan | Up to ₹25 lakh | Chiranjeevi/MAAY |
| Tamil Nadu | Up to ₹25 lakh | CMCHIS |
| Gujarat | Up to ₹10 lakh | PMJAY-MA |
| Punjab | Up to ₹10 lakh | Mukh Mantri Sehat Bima Yojana |
| Delhi | Up to ₹10 lakh | PM-JAY + Delhi top-up |
| Odisha | ₹5 lakh (men) / ₹10 lakh (women) | AB PM-JAY + GJAY |
| Maharashtra | Up to ₹6.5 lakh (₹7.5 lakh renal) | PM-JAY + MJPJAY |
| Karnataka | ₹5 lakh (BPL) / ₹1.5 lakh (APL) | AB-ArK |
| Chhattisgarh | ₹5 lakh / ₹50,000 (APL) | DKBSSY |
| Jammu and Kashmir / Ladakh | ₹5 lakh (universal) | AB PM-JAY SEHAT |
| Himachal Pradesh | ₹5 lakh (PM-JAY or HIMCARE) | HIMCARE |
| Assam | ₹5 lakh (PM-JAY) or ₹2 lakh | AB PM-JAY + Atal Amrit |
| Telangana, Kerala, Andhra Pradesh, Jharkhand, West Bengal | ₹5 lakh (standard) | Integrated/aligned state schemes |
| All other states/UTs | ₹5 lakh (standard) | AB PM-JAY only |
Frequently Asked Questions
Which state offers the highest PM-JAY coverage?
Rajasthan and Tamil Nadu currently offer the highest combined coverage in India, at up to ₹25 lakh per family per year, through their respective state top-up schemes layered on top of the central ₹5 lakh PM-JAY cover.
Does a state top-up scheme replace PM-JAY or add to it?
It depends on the state. Some states genuinely add a higher rupee amount on top of PM-JAY (like Gujarat, Punjab, and Delhi). Others use a convergence model that keeps the same ₹5 lakh PM-JAY amount but extends eligibility to more households, or adds a smaller separate cover for people PM-JAY does not include.
Is this calculator official government data?
No, this tool is built from published state scheme documentation and verified news reporting, cross-checked across multiple sources. It is not an official government tool. For a decision that affects your treatment or finances, confirm current figures with your state health department or the PM-JAY helpline (14555).
My state is not showing a top-up. Does that mean I only get ₹5 lakh?
For most states, yes — the standard PM-JAY cover of ₹5 lakh per family per year applies unless your state runs a specific top-up or convergence scheme. Our research did not find a distinct top-up currently published for every state, but state policies can change, so it is worth checking with your state health department periodically.
Can coverage amounts change after this tool was published?
Yes. State governments periodically revise their health scheme budgets and coverage amounts — Tamil Nadu, for example, raised its cover from ₹5 lakh to ₹25 lakh in August 2026. We will update this tool as we identify verified changes, but always confirm high-stakes decisions against current official sources.
Related: State Top-Up Schemes guide, Rajasthan Chiranjeevi/MAAY guide, MJPJAY vs PM-JAY (Maharashtra) guide, and Delhi & West Bengal Rollout guide.
