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Government Health Schemes Karnataka

Arogya Karnataka vs PM-JAY: What Actually Covers Your Parent

Karnataka's own scheme, Arogya Karnataka, now runs merged with the central Ayushman Bharat (PM-JAY) scheme — but which of its two tiers applies to your parent changes everything, since one is fully free and the other asks the family to pay a share.

Free & Independent Not medical, legal or financial advice Last updated: September 2026
This explains how Arogya Karnataka is structured, not a guarantee of cover for your specific case. Category cut-offs, coverage limits, and the empanelled hospital list are set and revised by the Suvarna Arogya Suraksha Trust (SAST), Karnataka's scheme administrator — always confirm current numbers at the hospital's Arogya Mitra desk or the official portal before relying on a figure here. Not affiliated with the Karnataka government.

Which tier is your parent likely in?

One tap — this is a starting point for the conversation with the hospital's Arogya Mitra desk, not an official determination.

What Arogya Karnataka Covers

1,650+ Procedures
Cardiology, oncology, neurosurgery, orthopaedics, paediatrics, burns, emergency care
Category A: Free
BPL/NFSA families — fully free up to the scheme limit, all family members under one cover
Category B: ~70/30
APL families — state pays ~70% of the cost, family pays the rest, lower annual ceiling
No Waiting Period
Pre-existing conditions covered from day one

The scheme runs on two tiers. Category A is for permanent Karnataka residents whose households qualify under the National Food Security Act (NFSA) — this includes BPL, Antyodaya Anna Yojana (AAY), and related ration-card categories, plus specific groups like registered farmers, unorganised-sector workers, and SC/ST families — and treatment here is intended to be fully free, with no separate limit dividing family members. Category B covers any other Karnataka-domiciled family without an NFSA card, at a lower ceiling and a cost-sharing arrangement (commonly cited as roughly 70% state, 30% family). Cosmetic procedures, treatment at non-empanelled hospitals, and conditions outside the scheme's listed package are excluded either way.

How to Enrol

  1. Bring Aadhaar and the family's ration card (the NFSA/BPL card if you have one — this is what decides Category A vs B) to any empanelled government or private hospital.
  2. Registration usually happens at the point of care — the hospital's Arogya Mitra help-desk verifies documents and biometrics on the spot and issues a unique ArK ID.
  3. Ask for pre-authorisation before treatment starts, not after — this is what makes the difference between genuinely cashless treatment and having to pay first and try to reclaim it later.
  4. Keep a photo of the ArK ID and the ration card on your phone — useful for family abroad coordinating a hospital admission remotely, and for any future visit.

Enrolment can also be started in advance through the official Arogya Karnataka portal or at a government hospital, Primary Health Centre, or taluk health office, rather than waiting for a hospital admission — worth doing ahead of time if your parent has a condition likely to need treatment soon.

How This Relates to Ayushman Bharat (PM-JAY)

Arogya Karnataka merged with the central PM-JAY scheme in October 2018, so in practice the two now run as one combined programme in Karnataka, officially Ayushman Bharat Arogya Karnataka (AB-ArK). Category A (BPL) beneficiaries are generally treated under PM-JAY's own national norms, which carries the advantage of national portability — usable at an empanelled hospital in another state. Category B (APL) cover and Karnataka's own state-funded top-up on top of PM-JAY are state-specific and are not expected to travel outside Karnataka.

Separately, every Indian citizen aged 70 or above — regardless of income or state — qualifies for the central Ayushman Vay Vandana Card (free ₹5 lakh/year cover, no means test): see our full Ayushman Bharat guide. A parent could potentially hold both an AB-ArK card and a Vay Vandana card; how the two would interact for a specific admission is exactly the kind of question to ask the hospital's Arogya Mitra desk directly, since it depends on the case.

Frequently Asked Questions

Is Arogya Karnataka the same as Ayushman Bharat (PM-JAY)?

They're merged, not identical. Since October 2018 the two run together in Karnataka as one combined scheme, officially called Ayushman Bharat Arogya Karnataka (AB-ArK). BPL families get treatment on PM-JAY's national norms with state top-up support; APL families get Karnataka's own state-only cover, which doesn't carry over if your parent needs treatment in another state.

Does my parent have to be Below Poverty Line to get any cover at all?

No. Arogya Karnataka has two tiers. Category A (BPL/NFSA ration card holders) gets treatment fully free up to the scheme limit. Category B (APL — any other Karnataka resident without an NFSA card) is still eligible, but pays roughly 30% of the treatment cost while the state covers about 70%, with a lower annual ceiling than Category A.

How does my parent actually enrol — is there a separate application?

For most families there's no separate advance application. Registration typically happens at the point of care — at the first empanelled hospital visit, using Aadhaar and the ration card, with biometric verification generating a unique ArK ID card on the spot. It's worth asking the hospital's Arogya Mitra desk (the scheme's help-desk staff present in empanelled hospitals) to register your parent before treatment starts, not after, so nothing has to be paid and reclaimed.

What if my parent is 70 or older?

They separately qualify for the central Ayushman Vay Vandana Card — free ₹5 lakh cover, no income test — regardless of Arogya Karnataka status. See our Ayushman Bharat guide for how to apply.

Official sources, so you can verify anything on this page yourself: the scheme is administered by the Suvarna Arogya Suraksha Trust at arogya.karnataka.gov.in; the Arogya Karnataka / health helpline is 104 or 1800-425-8330. The hospital's own Arogya Mitra desk is the fastest place to confirm anything specific to your parent's case.

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