How to Get Cashless Treatment at a PMJAY Hospital
One of the biggest benefits of the Ayushman Bharat PM-JAY scheme is completely cashless treatment at empanelled hospitals. This means you pay nothing — not for the surgery, not for the hospital stay, not for medicines during hospitalisation, and not for follow-up care for up to 15 days after discharge.
But many eligible families do not know the exact process of getting admitted for cashless treatment. This step-by-step guide walks you through the entire journey — from finding the right hospital to getting discharged.
Step 1 — Find the Right Hospital
Not every hospital accepts PMJAY, and not every empanelled hospital offers every specialty. You need to find a hospital that is both PMJAY empanelled AND offers the specific treatment you need.
Use PMJAYHospitals.com to search by your state, district, and the specialty or treatment you need. The directory shows you which hospitals are empanelled for which specialties, along with their contact numbers.
Important: Always call the hospital before visiting to confirm that they are currently accepting PMJAY patients for your required treatment. Empanelment status can change, and some hospitals may have temporary restrictions.
Step 2 — Visit the Ayushman Mitra Desk
Every PMJAY empanelled hospital has a dedicated Ayushman Mitra — a trained help desk officer whose job is to assist PMJAY patients. The Ayushman Mitra desk is usually located near the main entrance or the hospital registration counter.
Go directly to the Ayushman Mitra desk. Do not go to the regular OPD or billing counter first. The Mitra will handle your entire PMJAY process.
Step 3 — Identity Verification
At the Ayushman Mitra desk, present your Ayushman Bharat card (physical or digital) and your Aadhaar card. The Mitra will verify your identity through biometric authentication — usually a fingerprint scan or iris scan.
If biometric authentication fails (common among elderly patients or those with worn fingerprints from manual labour), the system allows OTP-based verification as an alternative. The OTP is sent to your Aadhaar-linked mobile number.
Step 4 — Pre-Authorisation
Once your identity is verified, the Ayushman Mitra initiates a pre-authorisation request through the PMJAY IT system. This request includes your diagnosis, the proposed treatment or surgery, and the estimated cost.
The pre-authorisation request is sent to the insurance company or state health agency for approval. For most standard treatments, approval comes within 30 minutes to a few hours. For complex or high-cost surgeries, it may take up to 24 hours.
During this time, the hospital will start your preliminary examination, blood tests, and other diagnostic workups so that treatment can begin immediately once pre-authorisation is approved.
Step 5 — Admission and Treatment
Once pre-authorisation is approved, you are formally admitted for cashless treatment. From this point forward, you pay nothing. The scheme covers:
- Hospital room charges (general ward)
- Doctor and surgeon fees
- Nursing and ICU charges
- All medicines during hospitalisation
- Diagnostic tests (blood tests, X-rays, CT scans, MRI, etc.)
- Surgical procedures and operation theatre charges
- Implants and prostheses (where applicable under the scheme)
- Food during hospital stay
Step 6 — Discharge and Follow-Up
After your treatment is complete and the doctor clears you for discharge, the hospital will process your discharge under the PMJAY system. You will receive a discharge summary detailing your diagnosis, treatment performed, medicines prescribed, and follow-up instructions.
The PM-JAY scheme covers post-hospitalisation expenses for up to 15 days after discharge, including follow-up consultations, prescribed medicines, and diagnostic tests related to your treatment. Keep your discharge summary safe — you will need it for follow-up visits.
What If the Hospital Asks for Money?
Under PM-JAY, the treatment is 100% cashless. The hospital cannot charge the patient any amount — not as a deposit, not as an advance, not for medicines, and not for any so-called “non-covered” expenses. If a hospital asks you to pay money for a PMJAY-covered treatment, this is a violation of scheme rules.
In such cases, immediately call the PMJAY helpline at 14555 and report the hospital. You can also file a complaint through the Ayushman Bharat app. The insurance company or state health agency will investigate and take action against the hospital.
Emergency Treatment
In case of a medical emergency, go to the nearest PMJAY empanelled hospital immediately. Emergency admissions do not require pre-authorisation — the hospital is required to start treatment first and complete the PMJAY paperwork within 24 hours. The Emergency Room Packages under PMJAY cover initial stabilisation and emergency care.
Disclaimer: PMJAYHospitals.com is an independent directory and is not affiliated with the National Health Authority or any government body. For official information, visit pmjay.gov.in or call 14555.