How to get cashless treatment under Ayushman Bharat for central government employees?

Hello,

Central government employees, pensioners and eligible family members receive medical treatment through the Central Government Health Scheme (CGHS). However, cashless treatment depends on the beneficiary category, hospital empanelment, treatment package and applicable CGHS rules.

Which government scheme applies to you?

CGHS for Central Government employees and pensioners: Eligible beneficiaries with a valid CGHS card can receive treatment at CGHS facilities and empanelled hospitals. Pensioners and other eligible categories can generally receive cashless treatment at empanelled hospitals. Serving employees may need to follow referral, approval and reimbursement procedures, depending on their category and treatment.

Ayushman CAPF: Serving personnel and eligible dependents of the Central Armed Police Forces (CAPF), Assam Rifles and National Disaster Response Force (NDRF) receive treatment under the Ayushman CAPF scheme. The cashless facility and referral requirements depend on the type of hospital and treatment.

Ayushman Vay Vandana for people aged 70 years and above: Indian citizens aged 70 or older are eligible for Ayushman Bharat PM-JAY coverage, irrespective of income. However, people already covered under schemes such as CGHS must choose between continuing their existing scheme and voluntarily switching to AB-PMJAY, as applicable under the government rules. Confirm the choice and its consequences before switching.

Important: A regular Central Government employee does not automatically qualify for a standard Ayushman Bharat PM-JAY card merely because they are a government employee. Eligibility must be checked separately.

How to check an Ayushman Bharat PM-JAY hospital

1. Open the official hospital search portal: Ayushman Empanelled Hospital List.
2. Select the patient's state.
3. Select the district.
4. View the PM-JAY-empanelled hospital list.
5. Select the hospital type, such as Government or Private.
6. Select the relevant speciality, if available.
7. Search for the exact hospital name.
8. Select empanellement type CGHS, CAPF
9. Enter the captcha shown on the screen.
10. Click Search.
11. Confirm the hospital's current empanelment and contact its Ayushman help desk to check whether the required treatment is covered under an approved package and whether cashless authorisation can be obtained.

Documents required for cashless treatment

• Valid CGHS card, Ayushman CAPF card or Ayushman Bharat card, depending on the scheme.
• Aadhaar card or another accepted photo identity document.
• Government employee identity card or pensioner identification, where applicable.
• Dependent or family eligibility documents, if required.
• Doctor's prescription, referral letter and prior treatment approval, if applicable.
• Medical reports, such as blood tests, ultrasound, CT scan, MRI or biopsy reports, depending on the condition.
• Previous medical records, discharge summaries and current medication details, if available.
• Any additional forms or documents requested by the hospital or the relevant scheme office.

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