Will Insurance or a Government Scheme — Pay for Bevacizumab?

Check through the Ayushman Bharat eligibility portal or ask at your nearest government hospital — they can look up your status using your Aadhaar number or ration card. Eligibility is based on the Socio-Economic Caste Census and is not linked to whether you have applied: many families are enrolled without knowing it. If your name appears, your care coordinator can help you activate the benefit at an empanelled centre.

PM-JAY covers cancer treatment under defined packages, and the annual family limit applies across all treatment in that year. Whether bevacizumab fits within the package for your cancer type and stage is something your care coordinator can confirm by checking the scheme's package list. If the cost of a full course exceeds your remaining cover, the Aarogyasri top-up scheme in Telangana and Andhra Pradesh may bridge part or all of the gap. We do not have a single answer that applies to every patient — ask us to check your specific situation.

Group policies vary more than individual policies, and some have tighter sub-limits on high-cost drugs. Ask your HR team for the full policy schedule — not just the brochure — and share it with your care coordinator. The key things to check are whether biological therapy is explicitly included, what the per-hospitalisation and high-cost drug sub-limits are, and whether day-care chemotherapy is covered — because that is how bevacizumab is administered at CION.

Several pharmaceutical companies that manufacture bevacizumab biosimilars in India run patient assistance programmes for patients who cannot meet the full cost. Your oncologist can make a referral. CION's care coordination team can advise on available support at the time of your consultation. Cost alone is never a reason to delay telling your team — speak up early, not after a cycle has already been missed.

CGHS reimburses treatment at empanelled private hospitals at notified rates. Bevacizumab is reimbursable when prescribed as part of an approved treatment protocol and when the treating hospital holds a valid CGHS empanelment. The reimbursement rate is set by CGHS and may differ from the hospital's billing rate — your care coordinator can tell you what the gap, if any, is likely to be. ECHS, the equivalent scheme for ex-servicemen, operates in a similar way.

PM-JAY and Aarogyasri: enrolment is prospective, but if you were already eligible when treatment started, ask at the scheme helpdesk whether a retrospective claim is possible. CGHS: claims for past cycles can sometimes be submitted with original bills and a referral note, depending on whether the hospital was empanelled at the time. Private insurance: most policies require pre-authorisation before treatment, and retrospective claims for high-cost drugs are commonly declined. Start the process for future cycles now rather than waiting.