What are Ayushman Bharat Guidelines for Cancer Patients?

Dear Somnath Banerjee ji

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) provides financial support for eligible cancer patients by offering cashless treatment of up to ₹5 lakh per family per year at PM-JAY empanelled government and private hospitals.

Cancer treatment under PM-JAY is available through approved treatment packages. The hospital will verify your eligibility and obtain the necessary pre-authorisation before starting treatment.

Cancer treatment often involves multiple stages such as surgery, chemotherapy, radiation therapy, and regular follow-up care. Before beginning treatment, discuss the complete treatment plan with your oncologist and confirm with the hospital's Ayushman Help Desk that each stage of your treatment is covered under the approved PM-JAY package. This can help avoid delays and ensure a smoother cashless treatment experience.

What Cancer Treatments Are Covered?

Depending on your diagnosis and the approved PM-JAY package, the scheme cover

• Cancer surgery.

• Chemotherapy.

• Radiation therapy.

• Day-care chemotherapy.

• Hospitalisation.

• ICU care, if required.

• Medicines and consumables during hospitalisation.

• Diagnostic tests included in the approved treatment package.

• Pre-hospitalisation and post-hospitalisation expenses as per PM-JAY guidelines.

Guidelines for Cancer Patients Under PM-JAY

Cancer patients should keep the following points in mind

• Treatment must be taken at a PM-JAY empanelled hospital.

• The treating doctor will evaluate your condition and prepare a treatment plan.

• The hospital must obtain pre-authorisation before starting eligible treatment.

• Cashless treatment is available only for approved PM-JAY treatment packages.

• Carry your Ayushman Card and Aadhaar Card during hospital visits.

• Follow the treatment schedule and attend regular follow-up appointments as advised by your oncologist.

Documents Usually Required

Keep these documents ready

• Ayushman Card.

• Aadhaar Card.

• Doctor's prescription.

• Biopsy or pathology report.

• Blood test reports.

• CT Scan, MRI, PET Scan, or other investigation reports (if available).

• Previous medical records and discharge summaries.

How to Avail Cancer Treatment Under PM-JAY

Follow these steps:

• Visit a PM-JAY empanelled cancer hospital.

• Meet the Ayushman Mitra (Help Desk).

• Submit the required documents.

• The oncologist will examine your condition.

• The hospital will apply for pre-authorisation.

• Once approved, eligible treatment can begin under the PM-JAY scheme.

How to Check Whether the Hospital Accepts Ayushman Bharat (PM-JAY)?

Before starting treatment, verify whether the hospital is empanelled under PM-JAY.

Online Verification

• Visit the PM-JAY Hospital Finder.

• Select:

  • State

  • District

  • Hospital Name (or Oncology specialty).

• Click Search.

• Confirm that the hospital is PM-JAY empanelled.

How HexaHealth Can Assist You

• Ayushman Bharat Guidance: We help you understand PM-JAY eligibility, cancer treatment coverage, and the approval process.

• Cancer Specialist Consultation: We help connect you with experienced medical, surgical, and radiation oncologists.

• Hospital Selection: We help you find PM-JAY empanelled and HexaHealth partner cancer hospitals near your location.

• Treatment Guidance: We explain chemotherapy, radiation therapy, cancer surgery, and other available treatment options.

• Documentation Support: We guide you on the documents required for PM-JAY verification and pre-authorisation.

• Appointment Assistance: We help coordinate specialist consultations, treatment planning, and hospital appointments.

Wishing you and your family good health always.
Warm regards,
Team HexaHealth