DOES PRADHAN MANTRI JAN AROGYA YOJANA (PMJAY) PROTECT abstract

Background: More than 50% of health expenditure in India is borne by families through out-of pocket payments (OOPE) (Nanda & Sharma, 2023). In many cases, such high OOPE becomes catastrophic, pushing households into financial distress. Both OOPE and catastrophic health expenditure (CHE) have the potential to impoverish families (Sinha et al., 2016). To address this, the Government of India has introduced several health insurance schemes aimed at protecting vulnerable populations from the financial burden associated with healthcare. One such initiative is Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), which aims to provide economically vulnerable groups with access to secondary and tertiary healthcare services without financial hardship. AIM: To assess the impact of the scheme on Out-of-Pocket Expenditure (OOPE) and Catastrophic Health Expenditure (CHE), evaluate its effectiveness in providing financial risk protection and preventing further impoverishment, and identify existing knowledge gaps to guide future research.Methods: In this narrative review, we conducted a descriptive analysis of the secondary data available through open access. A systematic search was conducted in PubMed, Science Direct and Google Scholar for articles published between October 2021 and September 2025. A total of 59 articles from PubMed, 17 from Science Direct and 543 from Google Scholar were accessed. At the end, 25 articles were reviewed after applying the inclusion and exclusion criteria.Results: The findings were organized into themes including knowledge, awareness, coverage, utilization, PMJAY’s impact on OOPE, CHE & financial risk protection and challenges in implementing the scheme. Conclusion: The findings suggested the need for monitoring and evaluation mechanisms to strengthen the PMJAY scheme.