PMJAY Pre-Authorisation — How Long Does It Take?
Pre-authorisation is the approval step before your treatment begins at a PMJAY empanelled hospital. The Ayushman Mitra submits a request detailing your diagnosis and proposed treatment, and the insurance company or state health agency approves it. Understanding the timeline helps you plan your hospital visit.
Typical Timelines
Standard procedures (hernia, cataract, delivery): 30 minutes to 6 hours. Most routine general surgery and eye surgery pre-authorisations are approved within a few hours. The hospital can begin preliminary tests while waiting.
Complex procedures (cardiac surgery, joint replacement, cancer): 6-24 hours. Cardiac surgery, joint replacement, and cancer treatment packages are higher value, so the insurance company may take longer to verify and approve.
Emergency cases: No pre-authorisation needed. For emergencies — accident trauma, heart attack, stroke, acute abdomen — the hospital must start treatment immediately. Pre-authorisation is completed within 24 hours of admission. Emergency polytrauma care and emergency room packages are designed for this.
What Causes Delays
Document issues (Aadhaar mismatch, expired card), system downtime on PM-JAY portal, incomplete clinical information submitted by the hospital, high-value packages requiring additional verification, and weekends or holidays can slow down the approval process.
What to Do If Approval Is Delayed
Ask the Ayushman Mitra for the pre-authorisation request status. If it has been more than 24 hours for a non-emergency case, call 14555 with your request reference number. The helpline can escalate the approval. Meanwhile, the hospital should continue necessary diagnostic workup so treatment can begin immediately once approval arrives.
Find hospitals: Search PMJAY hospitals by state and specialty
Disclaimer: PMJAYHospitals.com is an independent directory. For official information, visit pmjay.gov.in or call 14555.