ABHA Card Benefits, Uses and Coverage Explained

Posted on: Jan 28, 2026 | 3 mins | Written by: HDFC ERGO Team

ABHA Card Benefits, Uses and Coverage Explained

India’s digital health push is now large enough to be measured in hundreds of millions. As of 1 November 2025, the government reported 79,91,18,072 (about 79.9 crore) ABHA accounts created under the Ayushman Bharat Digital Mission (ABDM). In the same update, 67,19,65,690 (about 67.2 crore) health records were linked with ABHA, while 4,18,964 health facilities and 6,79,692 healthcare professionals were registered on ABDM’s key registries. (1)

That scale matters because ABHA (Ayushman Bharat Health Account) is designed to act as a single digital identity for your health records. Let’s discuss ABHA Card benefits and a few more things related to this card.

What is an ABHA Card?

The ABHA Card (Ayushman Bharat Health Account) is a free digital health ID launched by the Government of India under the Ayushman Bharat Digital Mission. Issued by the National Health Authority, this 14-digit health ID card helps you store, access, and share your medical records safely across hospitals, labs, and doctors. It does not provide insurance cover or cash benefits.

Key Benefits of ABHA Card

Here are the key ABHA health card benefits:

• All your medical details, such as doctor visits, prescriptions, lab reports, diagnoses and treatment summaries, are stored in one place. This removes the need to carry physical files or repeat tests, saving time and money.

• By providing consent, you can share your health records with any hospital, clinic or diagnostic centre that supports ABDM. This means better continuity of care when you change doctors or move between states.

• With an ABHA Card, booking appointments becomes faster as hospitals can access your stored information.

• While the ABHA Card itself does not automatically provide free treatment, it can be linked to schemes like Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM- JAY) for cashless treatment and benefits if you are eligible under those programmes.

• It connects to national registries such as the Healthcare Professional Registry (HPR) and Health Facility Registry, helping you find verified doctors and nearby healthcare services.

₹5 Lakh Coverage Clarification

There is confusion between the ABHA Card and the ₹5 lakh health cover. However, ABHA Card benefits of ₹5 lakh are provided only under Pradhan Mantri Jan Arogya Yojana (PMJAY), and only to eligible beneficiaries. PMJAY offers medical coverage of up to ₹5 lakh per family per year for secondary and tertiary hospital treatment. This cover is available for both government and empanelled private hospitals across India.

PMJAY is meant for economically weaker families who are identified under SECC data and state-specific criteria. The scheme does not require any premium payment, and there is no age limit or restriction on family size. The scheme covers hospitalisation expenses, including surgery, medicines, diagnostics, and pre- and post-hospitalisation care.

Hospital S Usage Scope

When you use an ABHA number, its scope depends on whether the hospital or clinic is connected to the ABDM. You can use ABHA at ABDM-registered government and private hospitals, labs, and clinics to share your details and health records digitally, with your consent.

Let's take an example to understand this better:

Suppose you visit a private hospital in another city for a consultation. At the registration desk, you scan the ABDM QR code using your ABHA app. Next, you approve sharing your basic details and past reports. The doctor can instantly access your previous blood tests and prescriptions, avoid unnecessary tests, and provide treatment faster. However, if you need coverage for a hospitalisation bill, you still rely on PM-JAY or your health insurance separately.

ABHA Card vs Health Insurance

Here are the key distinctions between ABHA Card and health insurance online:

Parameters	ABHA Card	Health Insurance
Meaning	A 14-digit digital health ID used to link and share your health records across India's Ayushman Bharat Digital Mission (ABDM).	A financial cover contract that pays for eligible medical costs as per your policy terms (cashless or reimbursement).
Purpose	Helps store, fetch and share prescriptions, reports, discharge summaries, etc. after your consent.	Reduces out-of-pocket spend during hospitalisation and other covered medical needs, such as pre- and post hospitalisation expenses, daycare procedures, and OPD charges.
Coverage	ABHA is not an insurance policy and does not pay hospital bills.	Yes, you are covered up to the sum insured. However, there are certain exclusions, waiting periods, and deductibles that apply to the policy, and you should be aware of them.
Cost	You don't need to pay anything to create an ABHA Card.	You need to pay a premium to get an individual health insurance cover. The coverage depends on your age, health conditions, the number of family members you wish to cover, and a few more parameters.
Hospital List	ABHA works with ABDM- participating facilities listed in the ABDM ecosystem/registries.	Insurers have network hospitals that allow for cashless treatment. If you are receiving medical treatment outside the insurer's network, you need to apply for a reimbursement claim.
Usage	Use ABHA to organise records and share medical history quickly during treatment.	Use insurance to fund treatment and manage significant medical bills.

Conclusion

The ABHA Card lets you manage your medical records under one platform. It allows you to have quick access to medical care and OPD consultations, and to maintain better continuity when switching doctors or moving to a different city. However, you must clearly separate record management from financial protection. ABHA supports your healthcare journey, while PM-JAY or health insurance protects you from hefty medical costs.

If you are planning to buy medical coverage, it is recommended to use a medical insurance premium calculator to ensure coverage aligns with your needs.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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