CION Ameerpet
Cost, Access & Schemes · Telangana & Andhra Pradesh
Is Immunotherapy Covered Under Aarogyasri? — What the Scheme Funds, and What It Does Not
For most families this is the question that decides everything else. Aarogyasri funds a great deal of cancer care through fixed-rate packages — but checkpoint-inhibitor immunotherapy is not one of the things it routinely funds. This page sets out what the package list does cover, what the ceilings are, and exactly how the approval process works. Every figure here is indicative, as of August 2026, and nothing here is a guarantee of cover.
Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed August 2026
- The honest answer, first — Aarogyasri funds cancer surgery, radiation and many chemotherapy regimens. Checkpoint-inhibitor immunotherapy is not a routine package.
- Care around the drug may still be funded — diagnostics, the chemotherapy part of a combination plan, surgery, radiation and complication admissions each have their own packages.
- Three limits, not one — an annual ceiling shared by the whole family, a fixed package rate per procedure, and cover only at an empanelled network hospital.
- Nobody can promise cover — the package list is revised. Get the position in writing from the Aarogyasri Mithra desk before cycle one.
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The short answer
Is Immunotherapy Covered Under Aarogyasri?
Usually not. Aarogyasri is built around fixed-rate procedure packages, and checkpoint-inhibitor immunotherapy is not routinely available as a funded package, as of August 2026. Parts of the care around it — diagnostics, surgery, radiation, many chemotherapy regimens and complication admissions — often are. No page can confirm your entitlement; the trust can.
| Part of your cancer care | Usually inside the package list? | What that means in practice |
|---|---|---|
| Cancer surgery | Yes — defined surgical-oncology packages | Cashless at an empanelled network hospital, up to the fixed package rate for that procedure. |
| Radiation therapy | Yes — defined radiation-oncology packages | Priced per approved course and technique, not per fraction as a hospital would otherwise bill it. |
| Chemotherapy | Yes — for many standard regimens | Funded cycle by cycle against the regimen's package, drawing down the family's annual ceiling. |
| Checkpoint-inhibitor immunotherapy (PD-1, PD-L1 and CTLA-4 drug classes) | Not routinely, as of August 2026 | There is no matching package for the drug, so families are usually directed to insurance, assistance and other routes. |
| Chemo-immunotherapy combination | Partly — the chemotherapy component may match a package | Ask for the bill to be split so you can see which line the scheme is actually touching. |
| Biomarker testing (PD-L1, MSI/MMR, NGS panels) | Varies — comprehensive genomic panels usually not | Confirm before the sample is sent. The laboratory bills separately from the treating hospital. |
| Response-assessment PET-CT | Sometimes, where it forms part of an approved package | At CION this is coordinated at partner imaging centres and billed by them, not by CION. |
| Managing a serious immune-related side effect | Admissions and supportive care may match their own packages | Genuinely useful cover that families routinely forget to ask about. |
| CAR-T and other cell therapies | No | CION does not provide CAR-T or cell therapy. If this is being discussed for you it is a referral conversation, not a CION service. |
Why the answer is "usually not" rather than a flat no. The package list is revised from time to time. Telangana and Andhra Pradesh run separate schemes with separate lists. Both states have converged parts of their scheme with Ayushman Bharat (PM-JAY), which has its own package list. So the honest answer depends on your card, your state and the exact regimen on your prescription — on the day you ask.
Nothing on this page is a coverage guarantee. The only answer you can plan around is the one you get in writing from the Aarogyasri Mithra desk at an empanelled network hospital, or from the state trust, before the first cycle.
Did you know?
Under a package-rate scheme the trust pays the hospital a fixed amount for a defined procedure — not the actual bill. A package rate written for a chemotherapy regimen was never designed to absorb the price of a checkpoint inhibitor. That pricing structure, rather than any judgement about whether immunotherapy works, is the real reason the drug sits outside the list.
Is it in the package list?
Is Immunotherapy in the Aarogyasri Package List?
Not as a checkpoint-inhibitor package, as of August 2026. The medical-oncology part of the list is built around chemotherapy regimens priced at fixed package rates. Those rates were set well below what one immunotherapy cycle costs, so the drug has no package to sit inside. Confirm the current list with the trust.
- The list is a list of procedures, not of drugs. Each entry names a defined procedure or regimen and attaches a fixed rate to it. A drug that has no procedure entry has no route into the scheme, however clearly it is indicated for you.
- The rate, not the invoice, is what gets paid. The trust pays the package rate to the hospital whatever the hospital's own tariff is. Anything outside the package is not automatically funded and usually becomes an out-of-pocket line.
- Telangana and Andhra Pradesh run separate lists. Telangana's scheme is administered by the Aarogyasri Health Care Trust. Andhra Pradesh runs Dr. YSR Aarogyasri with its own package list and its own ceiling. A package that exists in one state may not exist in the other.
- Convergence with Ayushman Bharat changes the picture. Where your entitlement runs through PM-JAY, a different package list may apply to the same treatment. Our companion page, Ayushman Bharat (PM-JAY) and Immunotherapy, works through what that route does and does not fund.
- Empanelment decides where, not only whether. Cashless cover applies only at a hospital empanelled for your scheme. Ask any centre you are considering — including this one — whether it is empanelled for your specific card, and get the answer before you register.
- A revision can change the answer. The list has been expanded more than once. Ask the scheme desk to check the current list against the exact regimen written on your prescription rather than against the word "immunotherapy".
- This page is not an entitlement check. Only the trust and the hospital's scheme desk can confirm what applies to your card, your state and your diagnosis. Treat everything here as background for that conversation.
What are the limits?
What Are the Aarogyasri Limits for Cancer Treatment?
Three limits apply at once, not one. There is an annual cover ceiling for the whole family. There is a fixed package rate for each individual procedure. And there is a network restriction — cover applies only at an empanelled hospital. All three are revised from time to time, so treat every figure below as indicative.
| Limit | How it works | Indicative position (as of August 2026) |
|---|---|---|
| Annual cover — Telangana (Aarogyasri) | One ceiling shared across everyone named on the card, resetting each policy year | Raised to roughly ₹10 lakh per family per year following a state government revision. Confirm the current figure with the Aarogyasri Health Care Trust. |
| Annual cover — Andhra Pradesh (Dr. YSR Aarogyasri) | A separate scheme with its own package list and its own ceiling | A higher headline ceiling has been announced for defined high-cost procedures. Confirm both the figure and the qualifying list with the state trust. |
| Package rate per procedure | A fixed amount the trust pays the hospital for one defined procedure | Applies regardless of the hospital's own tariff. Anything outside the package is not automatically funded. |
| Family, not per patient | The annual ceiling covers the whole family, not each member separately | A second illness in the same family draws from the same pot in the same year. |
| Empanelled network hospitals only | Cashless treatment is available only at hospitals empanelled for your scheme | Treatment taken elsewhere is generally not reimbursed afterwards. Check empanelment before you register. |
| Eligibility and documents | Rests on your card category, identity documents and state residency rules | Carry the scheme card, Aadhaar and any referral papers to the first visit. A name mismatch is the commonest avoidable delay. |
| What sits outside every ceiling | Items with no matching package, non-empanelled care, and most out-of-state treatment | Checkpoint-inhibitor immunotherapy usually falls in this row, which is why the drug cost has to be planned for separately. |
These ceilings are set by the state trusts and are stated here in plain text for planning only. They are not a quotation, not a confirmation of cover, and not a substitute for the written position from your scheme desk. For the indicative cost of the treatment itself, see Immunotherapy Cost in Hyderabad.
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The approval process
What Is the Aarogyasri Approval Process, Step by Step?
Approval runs through the hospital, not through you. An empanelled network hospital raises an electronic pre-authorisation against a named package, the trust's medical panel reviews it, and treatment proceeds cashless once it is sanctioned. Your job is documents and follow-up. The Aarogyasri Mithra desk inside the hospital owns the file.
- 1
Get the card and the documents in order first
Your scheme card, Aadhaar and proof of residency decide eligibility before any clinical question is asked. Check that the name and spelling match across documents. A mismatch is the single most common reason a file stalls, and it is entirely avoidable.
- 2
Go to a hospital empanelled for your scheme
Cashless cover applies only at empanelled network hospitals. Ask the centre directly whether it is empanelled for your specific card and state before you register, and take the answer from the scheme desk rather than from the reception counter.
- 3
Register at the Aarogyasri Mithra desk on day one
This is the scheme help desk inside the hospital and it is a different counter from general billing. Register the case there at the first visit. Ask for the name and number of the person handling your file, and use them for every follow-up.
- 4
Diagnosis, then package selection
The treating oncologist records the diagnosis and stage, and the team identifies which package, if any, matches the treatment planned. If the plan is checkpoint-inhibitor immunotherapy, expect to be told there is no matching package for the drug, and ask what parts of the plan do have one.
- 5
The hospital raises the electronic pre-authorisation
Clinical notes, biopsy and imaging reports and the proposed package are uploaded to the trust. Treatment under the scheme should not start before this is sanctioned. Ask the desk to confirm the date the file was submitted and to give you the reference.
- 6
The trust's medical panel approves, queries or rejects
A query is not a rejection. It usually means a report or a document is missing. Ask exactly what was asked for and supply it the same day. If the file is rejected, ask for the reason in writing — you cannot appeal a reason you have not been given.
- 7
Treatment, discharge and the paperwork you keep
Approved treatment is cashless up to the package rate. Keep every document — sanction letters, discharge summaries, pharmacy bills and reports. If part of the plan sits outside the package, get the split in writing before you agree to start, so no line item is a surprise later.
If pre-authorisation is refused, do three things the same week. Ask for the reason in writing. Ask your oncologist whether a different, clinically appropriate plan has a matching package. And start the alternative funding routes below in parallel, rather than waiting for one door to close before trying the next.
Do not let a paperwork delay quietly postpone treatment. Some cancer treatment is time-sensitive. Tell your treating oncologist that the scheme file is pending, so the clinical timeline and the funding timeline are being managed by the same team rather than in separate silos.
If the answer is no
What Can You Do If Aarogyasri Will Not Fund Immunotherapy?
Six routes are worth checking, roughly in this order: Ayushman Bharat cover, insurance or employer schemes, a CDSCO-approved biosimilar, manufacturer assistance programmes, relief funds, and a frank conversation about whether the plan itself can change. Check them in parallel, not one at a time.
- Ayushman Bharat (PM-JAY). If your entitlement runs through PM-JAY rather than, or alongside, the state scheme, a different package list applies. Ayushman Bharat (PM-JAY) and Immunotherapy sets out what that route currently funds and where it stops.
- Private insurance, employer cover, CGHS, ECHS and ESI. Each has its own pre-authorisation route, and several apply sub-limits or waiting periods to high-cost therapies. File early. A cycle delayed by paperwork is the outcome nobody wants and the one most easily avoided.
- Ask whether a CDSCO-approved biosimilar is clinically appropriate. Where an approved biosimilar or domestically manufactured product exists for the molecule advised, the same drug class can cost materially less. It remains a clinical decision for your oncologist, never a purchasing decision made on price alone.
- Manufacturer patient-assistance programmes. These exist for some products, vary by molecule and change without notice. Patient Assistance Programmes: How They Work and How to Apply explains the application route and what qualifying usually depends on.
- Relief funds and welfare desks. The Chief Minister's Relief Fund in your state, the Prime Minister's National Relief Fund and hospital welfare desks each have their own application and their own timeline. Applications take weeks, so start them alongside everything else rather than at the end.
- Ask whether the plan itself can change. Cycle interval, treatment duration and the number of cycles are clinical decisions, but they are worth discussing openly with cost on the table. Can You Take Fewer Cycles to Reduce Cost? explains what is and is not reasonable to ask for here.
- Clinical trials — information, not a promise. Some patients receive treatment within a clinical trial, where the investigational treatment is usually supplied by the sponsor. Trials recruit against strict eligibility criteria and no page can promise you a place. Ask your oncologist whether a trial is open and appropriate for your diagnosis.
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Common questions
Aarogyasri and Immunotherapy: Your Questions Answered
Is immunotherapy covered under Aarogyasri?
Usually not. Aarogyasri pays hospitals a fixed package rate for a defined procedure, and checkpoint-inhibitor immunotherapy is not routinely available as a funded package, as of August 2026. Parts of the care around it are often covered under their own packages, including cancer surgery, radiation therapy, many standard chemotherapy regimens and admissions to manage a serious side effect. The package list is revised from time to time and Telangana and Andhra Pradesh run separate lists, so the current position for your card and your diagnosis has to come from the Aarogyasri Mithra desk at an empanelled network hospital or from the state trust. No website, including this one, can confirm cover for you.
Is immunotherapy in the Aarogyasri package list?
Not as a checkpoint-inhibitor package, as of August 2026. The medical-oncology part of the list is built around chemotherapy regimens, each priced at a fixed package rate. Those rates were set well below what a single immunotherapy cycle costs, so the drug has no package to sit inside. This is a pricing-structure problem, not a clinical judgement about whether immunotherapy works. Where a chemo-immunotherapy combination is planned, the chemotherapy component may match a package while the immunotherapy drug does not, so ask for the bill to be split. Ask the scheme desk to check the current list against the exact regimen written on your prescription.
What are the Aarogyasri limits for cancer treatment?
Three limits apply at once. There is an annual cover ceiling shared by the whole family, which resets each policy year. There is a fixed package rate for each individual procedure, which is what the trust pays the hospital regardless of the hospital's own tariff. And there is a network restriction, so cashless cover applies only at hospitals empanelled for your scheme. Telangana raised its Aarogyasri family cover following a state government revision, and Andhra Pradesh runs Dr. YSR Aarogyasri with its own list and its own ceiling. All of these figures are revised, so confirm the current numbers with the state trust before you plan around them.
What is the Aarogyasri approval process?
Approval runs through the hospital, not through you. You register at the Aarogyasri Mithra desk inside an empanelled network hospital with your card and identity documents. The treating oncologist records the diagnosis and the team identifies which package, if any, matches the planned treatment. The hospital then raises an electronic pre-authorisation to the trust with the clinical notes and reports attached. A medical panel at the trust approves it, raises a query, or rejects it. A query usually means a document is missing rather than that cover has been refused. Once sanctioned, approved treatment is cashless up to the package rate.
Can I use Aarogyasri and health insurance together for immunotherapy?
Often yes, but not on the same bill line, and the sequence matters. A scheme package and a private policy are separate funders with separate paperwork, and a hospital cannot claim the same item twice. In practice families use the scheme for what has a package and a policy, employer cover, CGHS, ECHS or ESI for what does not. Private insurers usually require pre-authorisation before treatment starts and may apply sub-limits or waiting periods to high-cost therapies. Tell the hospital scheme desk and your insurer about each other at the start, and get both positions in writing before the first cycle.
What can I do if Aarogyasri will not fund immunotherapy?
Check several routes in parallel rather than one at a time. Ayushman Bharat cover may apply if you hold a PM-JAY entitlement. Employer or private insurance, CGHS, ECHS and ESI each have their own pre-authorisation route. Where a CDSCO-approved biosimilar exists for the molecule advised, the cost of the same drug class can be materially lower, though whether it suits you is a clinical decision for your oncologist. Manufacturer patient-assistance programmes exist for some products and change without notice. State and central relief funds and hospital welfare desks are worth an application. Ask your oncologist what changes if funding is not found.