WAJAHAT SHABIR
SRINAGAR: In Jammu and Kashmir 6.70 lakh families are covered under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme.
The information was revealed by the Ministry of State in the Ministry of Health and Family Welfare after a question was raised by Member of Rajya Sabha Sat Paul Sharma.
The government informed that under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT scheme, settlement of claims is a regular and uninterrupted process and claims are settled by respective State Health Agency as per claim adjudication guidelines issued by National Health Authority. For timely settlement of claims, the permissible turnaround time is within 15 days of claim submission for intra-state hospitals (hospitals located within the State) and within 30 days of claim submission in case of portability claims (hospitals located outside the State).
As on 28.02.2026, a total of 1.29 lakh claims have been rejected in Jammu & Kashmir largely due to reasons like incomplete documentation, mismatch in booking health benefit package, etc.
Under AB-PMJAY, hospital empanelment is a continuous process and is undertaken by the implementing State/UT based on the requirements and availability of healthcare providers meeting the criteria within a given State/UT as per empanelment guidelines of National Health Authority. In order to improve the participation of hospitals under the scheme, a hospital-specific toll-free helpline number 14413 has been set-up to address the concerns of hospitals including concerns related to empanelment.
As on 28.02.2026, a total of 20.08 lakh hospital admissions amounting to Rs. 3706.45 crore have been authorized under the scheme in Jammu and Kashmir.
As per the details, 6.70 lakh families in J&K are covered under PM-JAY, 18.91 lakh families under SEHAT, 3.44 families covered under Ayushman Vay Vandana and 0.70 lakh families under ASHA/AWW/AWH.
