Does the Ayushman Card Cover Chemotherapy Treatment?

Dear Rashid ji,

Yes, chemotherapy is covered under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) .Cancer treatment, including chemotherapy, is available under approved PM-JAY packages at empanelled government and private hospitals.

Coverage depends on your type of cancer, treatment plan, and the approved PM-JAY package. The treating hospital will verify your eligibility and obtain the required pre-authorisation before starting treatment.

What Is Covered Under Ayushman Bharat?

Eligible patients receive coverage for

• Chemotherapy sessions under approved PM-JAY packages.

• Day-care chemotherapy (where overnight admission is not required).

• Hospitalisation for cancer treatment.

• Doctor consultation during hospital admission.

• Medicines and chemotherapy drugs administered during the approved treatment.

• Diagnostic tests and investigations required as part of the approved treatment package.

• Surgery, radiation therapy, and other cancer treatments covered under PM-JAY packages.

• ICU care, nursing charges, and hospital stay, if required.

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

Is Every Chemotherapy Session Covered?

Many chemotherapy treatments are given as day-care procedures, meaning the patient receives treatment and returns home the same day. These day-care chemotherapy sessions are generally covered under approved PM-JAY packages at empanelled hospitals.

However, the exact number of chemotherapy cycles and treatment plan depend on

• Type of cancer.

• Stage of cancer.

• Doctor's recommendation.

• PM-JAY approved treatment package.

• Hospital's pre-authorisation approval.

What Is Usually Not Covered?

Generally, the following may not be covered separately

• Routine OPD consultations.

• Health check-ups without hospital admission.

• Take-home oral chemotherapy medicines that are prescribed for home use (unless included in the approved package).

• Tests or medicines taken outside the approved treatment package.

The final coverage depends on the PM-JAY package approved for your treatment.

How to Avail Chemotherapy Under Ayushman Bharat

Follow these steps

• Visit a PM-JAY empanelled cancer hospital.

• Meet the Ayushman Mitra (Help Desk).

• Carry your Ayushman Card and Aadhaar Card.

• The oncologist will evaluate your condition.

• The hospital will submit the required pre-authorisation request.

• Once approved, your chemotherapy and other eligible treatments can be provided cashlessly.

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, coverage, and the chemotherapy approval process.

• Cancer Specialist Consultation: We help connect you with experienced medical oncologists and cancer specialists.

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

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

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

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

Please share

• Type of cancer (if diagnosed).

• City and state where you want treatment.

• Whether chemotherapy has already been recommended by your doctor.

Based on these details, we can help you find a suitable HexaHealth partner hospital or PM-JAY empanelled cancer hospital and guide you through the next steps.

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