From April 10, residents of Delhi can start using their Ayushman Bharat health cards for free treatment at hospitals. The Union Health Ministry, in partnership with the Delhi Government, officially rolled out this scheme for the people of Delhi. Under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY), beneficiaries can receive treatment worth up to Rs. 10 lakh annually.
For senior citizens aged above 70, the special Ayushman Vy Vandana Card will allow treatment up to Rs. 5 lakh. But just having the card in your hand is not enough. Like other insurance schemes, there is a fixed process that patients and hospitals must follow to access the benefits.
Let’s understand how to use the Ayushman card in real hospital situations.
First Step: Select the Right Hospital and Treatment Package
When someone falls sick and wants to use the Ayushman card for treatment, the first step is choosing the right hospital. Not all hospitals can treat every disease under this scheme. You must select a hospital that is listed under the Ayushman Bharat panel and has the department for the treatment you need.
Each disease is covered under a specific treatment package under the scheme. The hospital can only provide treatment for diseases that fall under their listed packages. A hospital operator, often known as Ayushman Mitra, will help block a suitable treatment package for you after seeing the medical reports prepared by the doctor.
What Documents Are Needed for Treatment?
Once the treatment package is selected, the following documents must be uploaded online for pre-approval:
- Ayushman card
- Aadhaar card
- Medical reports
- Identity proof (if separate from Aadhaar)
- ABHA card (if available)
It is advised to keep a soft copy of all important documents on your mobile for easy sharing. The ABHA card can also be used to digitally store and access medical reports.
How Will You Know Your Package Is Approved?
Once the hospital operator uploads the details and blocks the treatment package, an SMS will be sent to the beneficiary’s registered mobile number. This message confirms that the package has been successfully blocked.
Additionally, the hospital will provide a printed registration slip to the patient or their family. If for some reason the treatment doesn’t happen, the package can be “unblocked” after discharge.
Step-by-Step Process to Get Treated Through Ayushman Card
The process for starting treatment in the hospital under this scheme is systematic and digital:
| Step | Action |
| Step 1 | Choose the specialty (e.g., Cardiology, Neurology) |
| Step 2 | Select the disease package (by name or code) |
| Step 3 | Select the doctor responsible for treatment |
| Step 4 | Choose type of anesthesia if required |
| Step 5 | Add implant details if needed |
| Step 6 | Upload all necessary documents |
| Step 7 | Submit request for pre-authorization approval |
This entire process will be handled by the hospital’s staff or Ayushman Mitra. Patients do not need to perform these steps themselves. All updates and approvals are tracked through the hospital system and shared with the patient’s mobile number.
Can You Use Ayushman Card in Private Hospitals?
Yes, but with limitations. While many private hospitals are part of the Ayushman Bharat panel, not all treatment packages are available there. Some procedures are only allowed in government hospitals and can be done in private hospitals only after a referral.
Also, the cost covered under Ayushman scheme may vary based on the hospital category. That means one hospital may charge more or less than another, depending on their location, infrastructure, and services offered.
What Happens During Emergency Situations?
In medical emergencies, time is critical. The scheme has a fast-track system for such cases. Here’s what happens:
- The patient is admitted to the hospital without delay.
- The hospital immediately uploads the documents and sends the request to the insurance company.
- If no response comes from the insurance company within 6 hours, the treatment is assumed to be approved.
- The Pre-Authorization Code is instantly shared with the patient’s mobile number.
- Remaining documentation can be completed afterward.
This ensures that life-saving treatment does not get delayed due to formalities.
What If the Insurance Company Rejects the Claim?
Sometimes, the insurance company may reject the treatment request. In that case:
- The hospital and patient will be informed of the reason for rejection.
- If the patient disagrees, an appeal can be made for review.
This appeal process is also handled by the hospital or Ayushman Mitra, ensuring the patient doesn’t have to deal with insurance procedures directly.
Key Points to Remember for Ayushman Card Users in Delhi
- Ayushman card is not valid for OPD visits – hospital admission is required.
- Pre-authorization is needed before treatment starts, except during emergencies.
- Only one treatment package can be used at a time – surgical or non-surgical.
- Keep your documents ready on your mobile, including medical reports and ID proofs.
- Emergency care is streamlined, and patients will receive updates via SMS.
How to Check Your Hospital Eligibility?
If you want to check whether your nearby hospital is covered under the Ayushman scheme:
- Visit the official PM-JAY website or use the Ayushman Bharat App.
- Search for hospitals based on your location and specialty.
- You can also call the Ayushman Bharat helpline for information.
What Is ABHA and How It Helps?
ABHA (Ayushman Bharat Health Account) is a digital health card where you can store your medical history, reports, and doctor prescriptions in one place.
When using the Ayushman card, if you also have an ABHA ID, the hospital can access your medical records quickly. This makes the treatment process even smoother.
