How to Use Ayushman Card in Hospital? - Important Steps

Medically Reviewed by Dr. Aman Priya Khanna
Written by Hexahealth Care Team, last updated on 17 August 2023
How to Use Ayushman Card in Hospital? - Important Steps

The Ayushman Bharat Yojna, popularly known as Pradhan Mantri Jan Sangh Aarogya Yojna, is a noble initiative that caters for providing necessary medical services to the less powerful economic sections of the country. The scheme allows a certain class of citizens to avail of these services, where they get an annual coverage of INR 5,00,000 to undergo any medical treatment which is necessary for them to undertake. The government has also introduced a unique identification card called the Ayushman Card that can be carried to store and share any patient's medical records instantly.

The next initiative in line is to introduce a completely cashless system for more than 50 Crore patients experiencing the benefits of this scheme. Adding to that, the initiative already encompasses a list of around 1,400 free procedures, with more and more procedures getting added with time. These procedures are performed across verticals with 24 areas of specialisation to pinpoint and eliminate the disease.

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How To Access Medical Packages And Approach Hospitalisation Process

After deriving the card, it is important to know everything about the available medical packages to list down the diseases that are covered under this scheme. The scheme offers medical and surgical treatments in 25 specific fields of specialities that incorporate branches like cardiology, neurosurgery, oncology, paediatrics, etc.It is imperative to note that the cost of medical and surgical expenses cannot be claimed one after the other.

In a situation where multiple surgeries are necessary, the highest cost is paid off first, followed by a 50% waiver for the second and a 25% waiver for the third event.The most compelling part about the Ayushman Bharat Scheme is the fact that there is no waiting period involved in the process. If one has an Ayushman card, he/she can visit any empanelled government or private hospital and get treatment under any of the covered packages.

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Hospitalisation Process

While there is no specific enrollment procedure, each patient must carry a valid government-issued photo identity proof like a ration card, aadhar card, or driving licence for their hospitalisation process.Along with the card mentioned above, the patient must also bring the Ayushman Bharat card with them during the hospitalisation process. Below mentioned are the steps involved in getting admitted into any empanelled hospital that is covered under the Ayushman Bharat Scheme:
  1. Walk into the OPD of any empanelled hospital to get an OPD ticket generated. 
  2. Consult with the physician or surgeon.
  3. If, after diagnosis, the patient is advised admission to the hospital, the specialist will mention the package code on the OPD ticket and perform mandatory investigations specific to the procedure. 
  4. The nurse in charge will identify if the patient is an Ayushman beneficiary and ask for the identification documents. 
  5. The nurse will then prepare an admission case sheet according to the provided format. 
  6. The patient's information will be checked on the Beneficiary Identification System (BIS). 
  7. The verification can be done for ambulatory patients at an Ayushman Bharat kiosk. However, for non-ambulatory patients, the warranty will be performed by Ayushman Mitra in hospital wards. 
  8. At the Ayushman Bharat kiosk, Ayushman Mitra will search patients’ information based on Samagra ID (a family ID of 8 digits).
  9. If the search is not completed with Samagra ID, they find the patient by their mobile number, HHID number, or SECC name. 
  10. If the search is successful and the patient’s information is found in the BIS, they can go ahead to get their KYC performed. 
  11. KYC (eKYC) will be done through Aadhar and biometric fingerprint devices. 
  12. In case the patient is non-ambulatory, or the biometric device is not configured with the laptop or tablet, a non-Aadhar verification is performed. 
  13. The approval (golden record cards created by ISA) is expected to be provided within 30 minutes to the operator. 
  14. Once approved, the nurse will place an Ayushman Bharat seal on the front page of the case sheet for quick identification. 
  15. After the validation (creating the golden card), Ayushman Mitra will register the patient on the Transaction Management System (TMS). Registration can be performed for up to five days from the admission date.
  16. If the validation gets rejected by ISA and SHA, Ayushman Mitra will repeat the same process, keeping in mind the reason for rejection. 
  17. Before performing the procedure, the nurse will send the case sheet to the kiosk for raising pre-authorisation.
  18. Ayushman Mitra will take the patient’s “on-bed photograph” and upload it on the TMS. 
  19. The Ayushman Mitra or the Medical Coordinator may raise the pre-authorisation within two days of the registration in the TMS. 
  20. Next, the Ayushman Mitra will select the surgical or non-surgical benefit packages according to the patient’s health condition with the help of the Medical Coordinator. They cannot choose both surgical and non-surgical packages together.
  21. The ISA will approve or reject the request within six hours.
  22. The nurse in charge will send the patient’s daily clinical notes to the kiosk for uploading on the TMS. 
  23. At discharge time, Ayushman Mitra will take an “on-bed photograph” or any other post-surgical photograph to be uploaded on the TMS. 
  24. After the treatment, the details will be saved on the TMS, and the patient will be discharged with a summary sheet. 
  25. The Ayushman Mitra will fill out an online discharge summary for the patient's discharge from the hospital. 
  26. They will raise a flag against the deceased member if the patient dies, declaring them dead or inactive. Additionally, they will upload a death certificate. 
  27. Upon discharge, the patient will be asked to fill out a feedback form, encouraging the hospital to improve its Ayushman Bharat services. 
  28. The ISA will accept or reject any claim received from the hospital. 
  29. If the ISA rejects the claim, it will send a rejection notice to the hospital. The message states the hospital’s right to appeal against the rejection of the claim. 
  30. The hospital gets the payment after the claim is accepted. 


The Ayushman Bharat Scheme has helped hundreds and thousands of Indians access required healthcare assistance. However, it is important to determine the correct usage of the Ayushman card for the best possible help. With the help of HexaHealth, you can end all these queries and connect with a medical expert straight away! You can learn everything about the Ayushman card and its usage by contacting HexaHealth at 8860688606 or logging in to website for complete in-person assistance for free. 

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Frequently Asked Questions

How do I claim under Ayushman Bharat?

There is a set criterion for claiming under the Ayushman Bharat Scheme since it is a governmental initiative meant for a certain class of people. The initiative covers the bottom 40% of the income class by offering coverage of INR 5,00,000 per family on a family floater basis.
Here is how you can apply for the Ayushman Card:
  1. Log on to the PMJAY portal and click on the tab which says ‘Am I Eligible’.
  2. Get the OTP via mobile number and verify it.
  3. Select your state and search by either your name, HHD number, ration card number or mobile number.
  4. Fetch the results to check if the scheme covers you and your family.

Is medicine free under Ayushman Bharat?

Yes, the Ayushman Bharat scheme covers all hospitalisation expenses, including consultations, medicines, examinations, and treatments. It is created to support the people who succumb to illness owing to a lack of healthcare facilities.

What is the income limit for Ayushman Bharat?

According to the official website, everyone falling below the poverty line is covered under this scheme; however, if any member in the family earns more than INR 10,000/month or if the family has a Kisan card with a credit limit of INR 50,000, the scheme will not be applicable.

What is the Ayushman Card Limit?

The Ayushman Card provides a limit of INR 5,00,000 to each eligible family under the scheme. This money is used to cover all the medical expenses of the family to facilitate good healthcare services.

Which diseases are not covered under Ayushman Bharat?

Here is what is not covered:
  1. Out-Patient Department (OPD) expenses
  2. Drug rehabilitation
  3. Cosmetic surgeries
  4. Fertility treatments
  5. Individual diagnostics
  6. Organ transplant

What is the benefit of an ABHA Health card?

The ABHA Health card facilitates the quick and secure transfer of a patient’s health records by leveraging the use of proprietary software. It helps people to access healthcare services in any part of the country without the trouble of carrying their medical records everywhere.

What is the use of a health ID card?

The health ID card is a great use of technology by storing a patient’s medical records digitally using their Aadhar number as the key identifier. This helps patients to access healthcare services without any hassle.

What disease does the Ayushman Card cover?

The Ayushman Card gives the cardholder access to more than 13,000 procedures including one unspecified surgical package, across 24 specialities encompassing remedies to Non-Communicable diseases (NCDs), Mental health, ENT, Ophthalmology, Oral health, Geriatric and palliative health care and Trauma care, alongside other communicable diseases.

Is cataract surgery covered by Ayushman Bharat?

While the government did include free cataract surgeries, in the beginning, they revoked this decision and excluded free cataract surgeries from the roster. There were further developments in the domain of curing rare diseases; however, cataract surgeries could not be cut.

How does the ABHA health card work?

The ABHA Health card is a distinctive card that stores the medical records of patients and comes with a 14-digit unique identification code to maintain the sanctity of each individual. There is a QR code on the card, which can be scanned to access the records instantly.

Is pregnancy covered under Ayushman Bharat?

Yes, pregnancy is covered under the provisions introduced by Ayushman Bharat. An eligible pregnant woman can claim an amount up to INR 5,00,000 for all the procedures and surgeries.

How do I check if my Ayushman Card is valid?

The government has made it extremely easy for citizens to check the status of their Ayushman Card. Either you can access the governmental website at, or you can dial the toll-free numbers at 14555 or 1800-111-565.
If you wish, you can also visit your nearest Empanelled Health Care Provider (EHCP).

How many diseases are covered in the Ayushman Card?

The Ayushman Card provides the holder to choose amongst 1393 defined procedures for the treatment of 1350+ diseases and one unspecified surgical procedure encapsulating 24 different specialities.

What are the benefits of a health card?

If a patient falling under the poverty line has a health card, they can access almost every medical service, including consultations, medicines, treatments, examinations, and recovery supplies. 
It is a great move towards refurbishing the state of healthcare in the rural region of the country.

How do I benefit from the Ayushman Card?

Having an Ayushman Card verifies an individual to experience a range of healthcare services across the country in certified government healthcare centres. This helps the patient to opt for the best procedure since the financial constraint is removed from their heads.

Updated on : 17 August 2023


Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More


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HexaHealth Care Team

HexaHealth Care Team brings you medical content covering many important conditions, procedures falling under different medical specialities. The content published is thoroughly reviewed by our panel of qualified doctors for its accuracy and relevance.

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