{"id":1887,"date":"2026-11-06T12:13:17","date_gmt":"2026-11-06T12:13:17","guid":{"rendered":"https:\/\/www.coversure.in\/blog\/?p=1887"},"modified":"2026-11-06T12:13:17","modified_gmt":"2026-11-06T12:13:17","slug":"blog-health-insurance-ayushman-bharat-sikkim","status":"publish","type":"post","link":"https:\/\/www.coversure.in\/blog\/health-insurance\/blog-health-insurance-ayushman-bharat-sikkim\/","title":{"rendered":"What is the Ayushman Bharat Scheme in Sikkim?"},"content":{"rendered":"<table>\n<thead>\n<tr>\n<th><b>QUICK GIST<\/b><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><span style=\"font-weight: 400;\">Sikkim implements Ayushman Bharat PM-JAY through its State Health Agency. Eligible families get cashless cover of up to \u20b95 lakh per family per year for secondary and tertiary hospitalisation at empanelled hospitals, with packages that include medicines, diagnostics, room charges, doctor fees, OT and ICU. Eligibility starts with SECC 2011-identified families, and the state has run enrolment drives that include AAY ration card holders. Since 29 October 2024, every resident aged 70 and above is eligible for the Ayushman Vay Vandana card, regardless of income. As per a Lok Sabha answer, over 25,000 Vay Vandana cards had been created in Sikkim by December 2025. The card is portable across India, which helps when specialist care means travelling to Siliguri or beyond. Helplines: 14555, and 1800-110-770 for Vay Vandana.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2><b>Ayushman Bharat in Sikkim: \u20b95 Lakh of Cover for the Mountains, and Beyond Them<\/b><\/h2>\n<h3><b>Small state, long roads<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Sikkim is small on the map, but distances here are measured in hours, not kilometres. For serious care, families often head to Gangtok or down to Siliguri.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That&#8217;s where Ayushman Bharat helps. Eligible families get \u20b95 lakh of cashless cover a year, and the card works across India. Since late 2024, every Sikkimese senior aged 70+ can get their own card too.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Here&#8217;s who qualifies and how to make the most of it.<\/span><\/p>\n<table>\n<thead>\n<tr>\n<th><b>Parents in Namchi, you in Bengaluru?<\/b><span style=\"font-weight: 400;\"> Planning their cover from afar is easier with help. <\/span><a href=\"https:\/\/www.coversure.in\/?utm_source=blog&amp;utm_medium=website&amp;utm_campaign=blog&amp;utm_id=1#bookacall\"><span style=\"font-weight: 400;\">Book a call with us<\/span><\/a><span style=\"font-weight: 400;\">. No hairpin bends required.<\/span><\/th>\n<\/tr>\n<\/thead>\n<\/table>\n<h3><b>What the scheme covers<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>\u20b95 lakh per family per year,<\/b><span style=\"font-weight: 400;\"> floater.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Packages include<\/b><span style=\"font-weight: 400;\"> medicines, diagnostics, room charges, doctor fees, OT and ICU.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Portable across India.<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Seniors 70+<\/b><span style=\"font-weight: 400;\"> get separate Vay Vandana cover, regardless of income.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>No premium.<\/b><\/li>\n<\/ul>\n<table>\n<thead>\n<tr>\n<th><b>Have a private policy too?<\/b> <a href=\"https:\/\/www.coversure.in\/knowyourpolicy\"><span style=\"font-weight: 400;\">Know Your Policy<\/span><\/a><span style=\"font-weight: 400;\"> explains it in simple language, so you know exactly what it adds beyond Ayushman.<\/span><\/th>\n<\/tr>\n<\/thead>\n<\/table>\n<h3><b>How to get your card<\/b><\/h3>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Keep Aadhaar and your ration card<\/b><span style=\"font-weight: 400;\"> (if AAY) ready.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Visit a PM-JAY centre, Arogya Mitra desk or enrolment camp.<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Complete verification.<\/b><span style=\"font-weight: 400;\"> Seniors use Aadhaar e-KYC through the Ayushman app or beneficiary.nha.gov.in.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Get your card<\/b><span style=\"font-weight: 400;\"> and use it at an empanelled hospital.<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">Helplines: <\/span><b>14555<\/b><span style=\"font-weight: 400;\">; Vay Vandana <\/span><b>1800-110-770<\/b><span style=\"font-weight: 400;\">.<\/span><\/p>\n<table>\n<thead>\n<tr>\n<th><b>Check your status now.<\/b><span style=\"font-weight: 400;\"> Visit the <\/span><a href=\"https:\/\/beneficiary.nha.gov.in\/\"><span style=\"font-weight: 400;\">official PM-JAY beneficiary portal<\/span><\/a><span style=\"font-weight: 400;\">. Quicker than the drive from Gangtok to Siliguri.<\/span><\/th>\n<\/tr>\n<\/thead>\n<\/table>\n<p>&nbsp;<\/p>\n<table>\n<thead>\n<tr>\n<th><b>Family across Sikkim, West Bengal and Assam?<\/b><span style=\"font-weight: 400;\"> The <\/span><a href=\"https:\/\/unfold.coversure.in\/state-health-schemes\"><span style=\"font-weight: 400;\">CoverSure State Health Scheme Calculator<\/span><\/a><span style=\"font-weight: 400;\"> compares all three.<\/span><\/th>\n<\/tr>\n<\/thead>\n<\/table>\n<h3><b>Worth knowing<\/b><\/h3>\n<p><b>Your status must be verified.<\/b><span style=\"font-weight: 400;\"> Living in Sikkim or holding a ration card doesn&#8217;t guarantee eligibility. Check on the portal or at a camp.<\/span><\/p>\n<p><b>Plan before travelling for treatment.<\/b><span style=\"font-weight: 400;\"> Confirm the hospital you&#8217;re heading to is empanelled.<\/span><\/p>\n<p><b>Hospital stays only.<\/b><span style=\"font-weight: 400;\"> No routine OPD cover.<\/span><\/p>\n<p><b>Travel and stay costs aren&#8217;t covered.<\/b><\/p>\n<table>\n<thead>\n<tr>\n<th><b>Have a private plan you haven&#8217;t reviewed in years?<\/b><span style=\"font-weight: 400;\"> A <\/span><a href=\"https:\/\/policycheck.coversure.in\/?utm_source=blog&amp;utm_medium=website&amp;utm_campaign=blog&amp;utm_id=1\"><span style=\"font-weight: 400;\">Policy Health Check<\/span><\/a><span style=\"font-weight: 400;\"> reviews it across 30+ parameters for \u20b999, against 1,500+ plans. Find out if it still fits.<\/span><\/th>\n<\/tr>\n<\/thead>\n<\/table>\n<p>&nbsp;<\/p>\n<table>\n<thead>\n<tr>\n<th><b>Ayushman card in Gangtok, Vay Vandana for your grandparents, LIC in a trunk?<\/b> <a href=\"https:\/\/coversure.onelink.me\/40Yt\/blog\"><span style=\"font-weight: 400;\">Add your state scheme to your CoverSure insurance portfolio<\/span><\/a><span style=\"font-weight: 400;\">. Turn on <\/span><a href=\"https:\/\/coversure.onelink.me\/40Yt\/blog\"><span style=\"font-weight: 400;\">Family Share<\/span><\/a><span style=\"font-weight: 400;\"> so the whole family can access the details.<\/span><\/th>\n<\/tr>\n<\/thead>\n<\/table>\n<h3><b>Ayushman Bharat vs a private plan<\/b><\/h3>\n<p><b>What Ayushman Bharat does well<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>\u20b95 lakh free<\/b><span style=\"font-weight: 400;\"> for eligible families.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Seniors 70+<\/b><span style=\"font-weight: 400;\"> covered regardless of income.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Portable across India.<\/b><\/li>\n<\/ul>\n<p><b>Where a private plan usually adds more<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Open to anyone<\/b><span style=\"font-weight: 400;\"> who meets the insurer&#8217;s rules.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Higher sums insured and room choice.<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Restoration, cumulative bonus and 80D tax benefit<\/b><span style=\"font-weight: 400;\"> (old regime; please verify limits).<\/span><\/li>\n<\/ul>\n<h3><b>When treatment means a trip down the hill<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Meet the Bhutias of Mangan (a hypothetical family; numbers are illustrative).<\/span><\/p>\n<table>\n<thead>\n<tr>\n<th><span style=\"font-weight: 400;\">Event (hypothetical)<\/span><\/th>\n<th><span style=\"font-weight: 400;\">Covered?<\/span><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><span style=\"font-weight: 400;\">Mother&#8217;s surgery at an empanelled Siliguri hospital, \u20b91.8 lakh<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Yes<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Taxi from North Sikkim and a week&#8217;s stay for a relative<\/span><\/td>\n<td><span style=\"font-weight: 400;\">No<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Grandfather (74) admitted for pneumonia<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Yes, via Vay Vandana<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<table>\n<thead>\n<tr>\n<th><b>Underinsured, overinsured or balanced?<\/b><span style=\"font-weight: 400;\"> The <\/span><a href=\"https:\/\/www.coversure.in\/riskcalculator\"><span style=\"font-weight: 400;\">CoverRisk Calculator<\/span><\/a><span style=\"font-weight: 400;\"> checks your income, life stage, dependants and liabilities and tells you. Free.<\/span><\/th>\n<\/tr>\n<\/thead>\n<\/table>\n<h3><b>Who is eligible?<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>SECC 2011-identified families.<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>AAY ration card holders,<\/b><span style=\"font-weight: 400;\"> as covered in state enrolment drives.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>All residents aged 70+,<\/b><span style=\"font-weight: 400;\"> through Vay Vandana.<\/span><\/li>\n<\/ul>\n<h3><b>At a glance<\/b><\/h3>\n<table>\n<thead>\n<tr>\n<th><span style=\"font-weight: 400;\">Detail<\/span><\/th>\n<th><span style=\"font-weight: 400;\">Ayushman Bharat PM-JAY (Sikkim)<\/span><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><span style=\"font-weight: 400;\">Run by<\/span><\/td>\n<td><span style=\"font-weight: 400;\">State Health Agency, Sikkim<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Cover<\/span><\/td>\n<td><span style=\"font-weight: 400;\">\u20b95 lakh per family per year<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Seniors<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Vay Vandana card for all 70+ (over 25,000 cards by December 2025)<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Hospitals<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Empanelled hospitals across India<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Premium<\/span><\/td>\n<td><span style=\"font-weight: 400;\">None<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Main limitations<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Verification needed, no OPD, travel costs not covered<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Helplines<\/span><\/td>\n<td><span style=\"font-weight: 400;\">14555; Vay Vandana 1800-110-770<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Official website<\/span><\/td>\n<td><a href=\"https:\/\/beneficiary.nha.gov.in\/\"><span style=\"font-weight: 400;\">beneficiary.nha.gov.in<\/span><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<table>\n<thead>\n<tr>\n<th><b>Want the swipe version?<\/b><span style=\"font-weight: 400;\"> Sikkim&#8217;s Ayushman cover in a short LinkedIn carousel. <\/span><a href=\"https:\/\/www.linkedin.com\/posts\/coversurein_ayushman-bharat-pm-jay-activity-7500824867542368256-tTzE?utm_source=li_share&amp;utm_content=feedcontent&amp;utm_medium=g_dt_web&amp;utm_campaign=copy\"><span style=\"font-weight: 400;\">Swipe through it on CoverSure&#8217;s LinkedIn<\/span><\/a><span style=\"font-weight: 400;\"> and share it with relatives in every district.<\/span><\/th>\n<\/tr>\n<\/thead>\n<\/table>\n<h3><b>Quick answers (FAQs)<\/b><\/h3>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Is Ayushman Bharat available in Sikkim?<\/b><span style=\"font-weight: 400;\"> Yes, through the State Health Agency.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>How much cover does it give?<\/b><span style=\"font-weight: 400;\"> \u20b95 lakh per family per year.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Can seniors get a card?<\/b><span style=\"font-weight: 400;\"> Yes, all residents aged 70+ can get Vay Vandana cover.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Can I use my card in Siliguri?<\/b><span style=\"font-weight: 400;\"> Yes, at empanelled hospitals anywhere in India.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Is OPD covered?<\/b><span style=\"font-weight: 400;\"> No.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Is there a premium?<\/b><span style=\"font-weight: 400;\"> No.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>How do seniors apply?<\/b><span style=\"font-weight: 400;\"> Aadhaar e-KYC on the Ayushman app or beneficiary.nha.gov.in.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>&#8220;Hey Google, what&#8217;s the Vay Vandana helpline?&#8221;<\/b><span style=\"font-weight: 400;\"> Call 1800-110-770.<\/span><\/li>\n<\/ol>\n<table>\n<thead>\n<tr>\n<th><b>Ayushman covers the hospital. CoverSure covers the rest.<\/b> <a href=\"https:\/\/coversure.onelink.me\/40Yt\/blog\"><span style=\"font-weight: 400;\">Download the CoverSure app<\/span><\/a><span style=\"font-weight: 400;\"> for policy storage, <\/span><a href=\"https:\/\/www.coversure.in\/insurance-renewal\"><span style=\"font-weight: 400;\">renewal<\/span><\/a><span style=\"font-weight: 400;\"> reminders and <\/span><a href=\"https:\/\/www.coversure.in\/SoS\"><span style=\"font-weight: 400;\">SOS<\/span><\/a><span style=\"font-weight: 400;\"> alerts.<\/span><\/th>\n<\/tr>\n<\/thead>\n<\/table>\n<p><span style=\"font-weight: 400;\">Next up: Andaman and Nicobar Islands. <\/span><a href=\"https:\/\/coversure.onelink.me\/40Yt\/blog\"><span style=\"font-weight: 400;\">Subscribe to the CoverSure newsletter<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>QUICK GIST Sikkim implements Ayushman Bharat PM-JAY through its State Health Agency. Eligible families get cashless cover of up to \u20b95 lakh per family per year for secondary and tertiary hospitalisation at empanelled hospitals, with packages that include medicines, diagnostics, room charges, doctor fees, OT and ICU. Eligibility starts with SECC 2011-identified families, and the [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":1888,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[7],"tags":[124],"class_list":["post-1887","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-insurance","tag-state-health-insurance"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.6 (Yoast SEO v22.6) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ayushman Bharat Sikkim: \u20b95 Lakh Cover, Seniors and AAY Cards<\/title>\n<meta name=\"description\" content=\"Sikkim&#039;s Ayushman Bharat gives eligible families \u20b95 lakh cashless cover a year, plus separate cover for seniors 70+. 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