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Health Schemes & Coverage

Ayushman Bharat and — Chemotherapy: What Is Covered

Ayushman Bharat covers chemotherapy packages at empanelled hospitals, but the cover depends on which hospital you are at, which packages apply to your treatment, and whether you have the right documents on the day.

Medically reviewed by Dr. N. Kiranmayee, Medical Oncologist · Last reviewed September 2026

  • Most chemotherapy packages are covered — Day-care and inpatient chemotherapy cycles are included within defined package limits at empanelled hospitals.
  • The hospital must be empanelled — Cover applies only at hospitals registered under the scheme. Treatment at a non-empanelled centre is out of pocket.
  • State schemes work alongside it — In Telangana, Aarogyasri, and in Andhra Pradesh, NTR Vaidya Seva, often add cover at the same hospital.
  • Pre-authorisation is required — Your hospital's Arogya Mitra or scheme coordinator raises pre-authorisation before each cycle begins.
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Ayushman Bharat covers chemotherapy packages at empanelled hospitals. The scheme aims to meet day-care and inpatient chemotherapy costs within defined package limits. In Telangana, Aarogyasri often works alongside it. In Andhra Pradesh, NTR Vaidya Seva does the same. Whether your hospital is empanelled is what determines whether the cover applies to you.

What are the indicative costs, and what do the schemes cover?

ItemIndicative cost without scheme (2025)With Ayushman Bharat or state scheme at an empanelled centre
Day-care chemotherapy cycle₹10,000–₹40,000 per cycleCovered within package ceiling; ask your coordinator for the specific package code
Inpatient stay for complications₹20,000–₹80,000 or moreCovered under inpatient cancer packages within scheme limits
Supportive medicines (anti-nausea, etc.)₹3,000–₹20,000 per cycleIncluded in some packages; others need prior authorisation — confirm before each cycle
Diagnostic scans₹6,000–₹15,000 per scanCovered under relevant diagnostic packages; CION coordinates scans with partner imaging centres
Medicines not on the scheme formularyFull price — varies widelyNot covered; out-of-pocket even with a valid card — your coordinator will identify these in advance

How does the scheme actually work at the hospital?

You do not pay in advance at an empanelled hospital. The hospital raises a pre-authorisation request to the scheme before each cycle, and the scheme pays the hospital directly within the covered package.

Your first contact at the hospital should be the Arogya Mitra or the Ayushman Bharat scheme coordinator. They check your eligibility, raise the pre-authorisation, and tell you which costs fall inside and outside the package.

If a medicine or service is not on the approved list, you will be told before it is given. You can then decide whether to proceed out of pocket, or ask whether a covered equivalent exists.

Which centre is right for you?

We have centres across Telangana and Andhra Pradesh. Tell us where you are and we will point you to the closest one that offers what you need.

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What documents do you need to bring?

Bring your Ayushman Bharat card (physical or e-card from the PM-JAY portal) and your Aadhaar. If you are in Telangana, bring your Aarogyasri card alongside them. In Andhra Pradesh, bring your NTR Vaidya Seva card.

If you are visiting for the first time, also bring any previous cancer reports, your biopsy report if available, and a referral or discharge summary if you are being sent from another hospital.

Lost your card? Your Aadhaar number alone is often enough to verify eligibility on the spot, but call ahead to confirm, because not all coordinators can process it the same way.

How do the three main schemes compare for chemotherapy?

FeatureAyushman Bharat (PM-JAY)Aarogyasri — TelanganaNTR Vaidya Seva — Andhra Pradesh
Who is eligibleFamilies in the bottom two income quintiles listed in the SECC databaseFamilies below the poverty line in Telangana with an Aarogyasri cardFamilies below the poverty line in Andhra Pradesh with an NTR Vaidya Seva card
Annual ceiling (indicative, verify with coordinator)Up to ₹5 lakh per family — indicative, 2025Varies by package; cancer packages often have higher limits — check with coordinatorVaries by package — check with your hospital coordinator
Chemotherapy coverDay-care and inpatient cycles covered at empanelled hospitalsDay-care and inpatient cycles covered at government and enrolled private hospitalsDay-care and inpatient cycles covered at government and enrolled private hospitals
Can both schemes be used together?Yes — state scheme often tops up beyond the PM-JAY ceiling at hospitals enrolled in bothYes — works alongside PM-JAY where the hospital is enrolled in bothYes — works alongside PM-JAY where the hospital is enrolled in both
Key document neededPM-JAY card and AadhaarAarogyasri card and AadhaarNTR Vaidya Seva card and Aadhaar

Did you know?

Cancer care is one of the highest-value claim categories under Ayushman Bharat, according to the National Health Authority.

Empanelled hospitals are required to provide cashless treatment within the package. If you are being asked to pay upfront for a covered package, ask to speak to the scheme coordinator before paying.

Source: National Health Authority, Government of India — PM-JAY scheme documentation

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Common questions

Frequently asked questions

Is CION empanelled under Ayushman Bharat?

CION Cancer Clinics operates across more than 35 centres in Telangana and Andhra Pradesh, and empanelment status varies by centre and is updated periodically. The most direct way to confirm is to call the CION centre you plan to visit and ask whether it is currently empanelled under PM-JAY, Aarogyasri, or NTR Vaidya Seva. Bringing your card and Aadhaar on your first visit allows the scheme coordinator to check eligibility on the spot.

What if my treatment costs more than the scheme ceiling?

If your treatment cost exceeds what the scheme covers, the balance is your responsibility unless a second scheme can cover it. In Telangana, Aarogyasri can sometimes extend cover beyond the Ayushman Bharat ceiling at hospitals enrolled in both. In Andhra Pradesh, NTR Vaidya Seva can do the same. Ask your scheme coordinator before you start treatment what the ceiling is for your specific package and what happens if you reach it, so there are no surprises mid-course.

Can I use Aarogyasri and Ayushman Bharat at the same time in Telangana?

Yes, at hospitals enrolled in both schemes. The Ayushman Bharat cover applies first, and Aarogyasri can top up the remaining cost beyond the PM-JAY ceiling in many cases. The hospital coordinator handles how the two claims are raised — you do not need to manage this yourself. Bring both cards and your Aadhaar so the coordinator can process whichever combination applies.

My card says a different scheme name. Is it still valid?

Check the card carefully. In Andhra Pradesh, the correct current scheme is NTR Vaidya Seva. Schemes have been renamed over time, and presenting an old name at the counter can cause delays or a rejected claim even if you are genuinely eligible. Your Aadhaar number is the fastest way to look up your current status. If there is any doubt, visit the nearest government health centre or ask the scheme coordinator at your hospital before your appointment.

What happens if pre-authorisation is rejected?

Ask the scheme coordinator to explain the specific reason. Common reasons include an expired card, a package that does not match the treatment requested, or missing supporting documents. In most cases, the issue can be resolved by providing the missing information and reapplying. If the rejection stands, ask whether a formal grievance can be raised through the scheme's process. Do not start a cycle assuming the claim will be approved after the fact.

Are oral chemotherapy tablets covered under Ayushman Bharat?

Some oral chemotherapy packages are listed under PM-JAY, but coverage depends on the specific tablet, the cancer type, and the package your treatment falls under. The hospital's scheme coordinator can check whether your treatment has a covered package. If oral chemotherapy is not covered, ask your oncologist whether a covered alternative exists. If it does not, the cost is out of pocket even with a valid scheme card.

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