Ayushman Card Treatment List 2026: Covered Diseases, Surgeries and Packages
Ayushman Bharat PM-JAY provides cashless access to listed secondary and tertiary hospital-care packages for eligible beneficiaries. Coverage is based on the applicable Health Benefit Package, the patient’s medical condition, hospital empanelment, available speciality, pre-authorisation requirements and state-level scheme rules.
Last Updated: July 20, 2026
Quick Answer
The Ayushman Card does not contain one simple universal disease list that automatically guarantees every treatment. PM-JAY uses treatment packages covering specified medical conditions, surgeries, day-care procedures and hospital services.
Covered specialities may include cardiology, cancer care, general surgery, orthopaedics, neurosurgery, kidney and urinary treatment, paediatrics, obstetrics, burns management, ophthalmology, ENT and other secondary or tertiary hospital services.
The exact package list can differ according to the state, hospital and current package master. Before planned admission, ask the empanelled hospital to confirm the exact package name, package code, required pre-authorisation and included services.
Table of Contents
- What is a treatment package?
- What may be covered?
- Major medical specialities
- Heart treatment
- Cancer treatment
- Orthopaedic treatment
- Kidney and urinary treatment
- Brain and spine treatment
- Women and child treatment
- Eye and ENT treatment
- General surgery
- Burns and emergency care
- Pre-existing conditions
- What a package may include
- What may not be covered
- How to check a package
- Pre-authorisation process
- Hospital treatment process
- Hospital demands payment
- Frequently asked questions
What Is an Ayushman Card Treatment Package?
A Health Benefit Package is a defined group of medical services connected with a particular disease, condition, operation, procedure or hospital-care requirement.
Rather than paying every hospital charge separately, PM-JAY generally processes approved care according to specified package rules and rates.
A package may define:
- The medical condition or procedure covered
- The speciality under which the package is booked
- Whether hospital admission is required
- Whether the package is surgical, medical or day-care
- Whether pre-authorisation is required
- Which hospital facilities must be available
- Which tests, medicines or implants are included
- The approved package rate
- The permitted length or type of hospital care
- Follow-up or post-hospitalisation requirements
What May Be Covered Under PM-JAY?
PM-JAY primarily supports listed secondary and tertiary hospital care for eligible beneficiaries. Coverage may include inpatient, surgical, specified medical and applicable day-care treatment.
Inpatient Treatment
Approved hospital care requiring admission for a listed medical or surgical condition.
Operations and Procedures
Listed surgeries and procedures performed at an appropriately empanelled hospital.
Selected Day-Care Procedures
Procedures that may not require a traditional overnight hospital stay but are listed under an applicable package.
Related Follow-Up Care
Follow-up services included within an approved package according to its current rules.
Major Ayushman Card Treatment Specialities
The national and state package masters may include treatment across a wide range of medical and surgical specialities.
| Medical Speciality | Examples of Treatment Areas | Important Condition |
|---|---|---|
| Cardiology | Heart-related medical and interventional care | Hospital must have the required cardiac speciality and package |
| Cardiothoracic Surgery | Specified heart and chest surgeries | Specialised surgical facility and approval may be required |
| Medical Oncology | Specified cancer-related medicines and treatment cycles | Package and treatment protocol must apply |
| Surgical Oncology | Approved cancer surgeries | Hospital must be empanelled for the required oncology service |
| Radiation Oncology | Specified radiotherapy-related care | Required equipment and package must be available |
| Orthopaedics | Fractures, bone and joint procedures | Implant and package rules may apply |
| Neurosurgery | Brain, spine and nervous-system surgery | Specialised facility and pre-authorisation may be required |
| Nephrology | Specified kidney-related hospital care | Package availability depends on the hospital and state |
| Urology | Urinary-system and related surgical procedures | Medical necessity and package rules apply |
| General Surgery | Listed abdominal, soft-tissue and other surgical procedures | The exact condition must match a supported package |
| Obstetrics and Gynaecology | Specified maternity and women’s hospital treatment | Coverage depends on the relevant package and state rules |
| Paediatrics | Covered hospital treatment for children | Age, diagnosis and hospital facility requirements apply |
| Ophthalmology | Specified eye surgeries and hospital procedures | The hospital must be empanelled for the relevant package |
| ENT | Specified ear, nose and throat procedures | Package-specific conditions apply |
| Burns Management | Hospital treatment for eligible burn conditions | Severity and facility requirements may apply |
| General Medicine | Specified non-surgical inpatient conditions | Admission and package criteria must be satisfied |
Heart Treatment Under Ayushman Card
Cardiac packages may cover specified hospital treatment when the patient is medically eligible and the hospital is empanelled for the relevant cardiac speciality.
Examples of cardiac treatment areas may include:
- Specified coronary diagnostic and interventional procedures
- Approved angioplasty-related packages
- Selected heart surgeries
- Valve-related surgical treatment
- Specified pacemaker-related procedures
- Hospital care for serious cardiac conditions
- Other listed cardiology or cardiothoracic packages
Cancer Treatment Under Ayushman Card
Cancer-related packages may be available under medical oncology, surgical oncology or radiation oncology, depending on the diagnosis, stage, treatment protocol and hospital facilities.
Coverage may involve:
- Specified cancer surgeries
- Applicable chemotherapy or medical oncology packages
- Specified radiation-treatment packages
- Required hospital investigations included in the approved package
- Medicines or consumables included under the package rules
- Approved inpatient cancer treatment
- Applicable follow-up packages
Orthopaedic Treatment Under Ayushman Card
Orthopaedic packages may cover specified bone, joint, fracture and musculoskeletal procedures.
Examples may include:
- Selected fracture treatment and fixation procedures
- Specified joint-related surgeries
- Approved bone and soft-tissue procedures
- Selected spine-related procedures under the appropriate speciality
- Specified implant-based treatment
- Hospital care following serious injury where a package applies
Kidney and Urinary Treatment
Kidney and urinary-system treatment may fall under nephrology, urology, general surgery or another relevant speciality.
Possible treatment areas include:
- Specified kidney-related inpatient treatment
- Approved dialysis-related services where applicable
- Selected urinary obstruction or stone procedures
- Specified prostate or bladder procedures
- Approved urological surgeries
- Other listed nephrology or urology packages
Brain, Nerve and Spine Treatment
Neurosurgery and related packages may support specified brain, nerve and spine procedures at hospitals with the required specialists and facilities.
Examples may include:
- Specified brain surgeries
- Selected head-injury procedures
- Approved spinal surgeries
- Specified nerve-related procedures
- Hospital care for serious neurological conditions
- Other listed neurosurgical treatment packages
Women’s Health, Maternity and Child Treatment
Applicable packages may be available under obstetrics, gynaecology, neonatology, paediatrics or related specialities.
Possible areas include:
- Specified maternity-related hospital care
- Approved delivery-related packages
- Selected gynaecological surgeries
- Specified high-risk pregnancy treatment
- Hospital treatment for eligible newborn conditions
- Specified paediatric medical or surgical care
Eye and ENT Treatment
Specified ophthalmology and ear, nose and throat procedures may be covered when an applicable package is available.
Examples may include:
- Specified cataract-related procedures
- Selected eye surgeries
- Approved ear procedures
- Specified nose and sinus procedures
- Selected throat-related surgeries
- Other listed ophthalmology or ENT packages
General Surgery and Other Hospital Procedures
General surgery may include a broad range of listed operations. Coverage depends on the exact diagnosis, procedure and hospital empanelment.
Possible treatment areas may include:
- Selected abdominal surgeries
- Specified hernia-related procedures
- Approved gallbladder-related procedures
- Selected appendix-related surgery
- Specified soft-tissue operations
- Approved surgical treatment for certain infections or injuries
- Other procedures listed under the applicable package master
Burns, Trauma and Emergency-Related Treatment
PM-JAY package systems may include specified burns, trauma and emergency hospital care. The patient’s condition, severity and required hospital facilities determine which package may apply.
During an emergency:
- Seek immediate medical assistance
- Inform the hospital about the Ayushman beneficiary status
- Ask for the hospital’s Ayushman help desk
- Provide the card and accepted identity document when practical
- Request beneficiary verification
- Ask whether the hospital has an applicable emergency package
- Keep copies of reports, estimates and payment documents
Are Pre-Existing Diseases Covered?
Eligible PM-JAY beneficiaries may receive treatment for applicable pre-existing medical conditions from the beginning of their coverage, subject to the condition being included in an available package and all hospital-level requirements being satisfied.
However, the following still need confirmation:
- The patient is currently an eligible beneficiary
- The proposed care is part of a listed or approved package
- The hospital is empanelled for the required speciality
- Medical admission or procedure criteria are satisfied
- Required pre-authorisation is approved
- The service is not excluded under applicable rules
What May Be Included in an Approved Package?
Package rates are generally designed to bundle treatment-related hospital expenses. The exact inclusion depends on the package.
| Possible Included Component | How It May Apply |
|---|---|
| Registration and hospital charges | Included according to the approved package rules |
| Doctor and specialist fees | Hospital professional fees connected with the covered treatment |
| Room or ward charges | Covered accommodation category defined by the scheme |
| Nursing services | Required nursing care during the approved hospital stay |
| Operation-theatre charges | Applicable costs for an approved surgical procedure |
| ICU or intensive care | Included when medically necessary and supported by the package |
| Medicines and consumables | Items included within the approved treatment package |
| Diagnostic investigations | Required tests connected with the approved hospital treatment |
| Implants or devices | Included or controlled according to package-specific rules |
| Patient food | Hospital food during the approved stay where included |
| Pre-hospitalisation care | Related expenses within the permitted package period |
| Post-hospitalisation care | Applicable follow-up, medicines or tests within package rules |
What May Not Be Covered?
Coverage depends on the national or state package master and the exact patient situation. The following should not automatically be assumed to be covered:
- Treatment at a non-empanelled hospital
- A service for which the hospital lacks the required speciality
- A procedure outside an approved package or permitted workflow
- Admission without medical necessity
- Routine outpatient consultation by itself
- Medicines purchased independently without a covered package
- Diagnostics performed independently without covered hospital care
- Optional room or service upgrades
- Non-medical personal expenses
- Items specifically excluded under national or state rules
- A package rejected during pre-authorisation
- False, duplicate or mismatched beneficiary use
How to Check Whether Your Treatment Is Covered
The most reliable practical method is to contact an empanelled hospital that provides the required speciality.
- Obtain a medical diagnosis or treatment recommendation.
- Identify the required medical speciality.
- Search the official empanelled hospital list.
- Select a hospital offering the relevant speciality.
- Call the exact hospital branch.
- Ask whether its Ayushman help desk is operating.
- Explain the diagnosis or proposed procedure.
- Ask whether an applicable PM-JAY package exists.
- Ask for the package name or code where available.
- Ask whether pre-authorisation is required.
- Ask which medical reports and identity documents are needed.
- Confirm whether the hospital is currently accepting the package.
- Visit the hospital for medical assessment and beneficiary verification.
How to Use the Ayushman Card for Treatment
- Find a currently empanelled hospital.
- Confirm that it offers the required speciality.
- Carry the Ayushman Card and accepted photo identity document.
- Carry prescriptions, scans and previous medical reports.
- Visit the hospital’s Ayushman or PM-JAY help desk.
- Ask the Arogya Mitra to verify the beneficiary record.
- Complete hospital-level identity authentication.
- Meet the appropriate doctor.
- Complete the required medical assessment.
- Ask which package applies.
- Allow the hospital to submit pre-authorisation where required.
- Confirm approval before planned treatment.
- Review any consent or treatment documents.
- Receive treatment under the approved package.
- Collect the discharge summary and follow-up instructions.
What If the Hospital Demands Payment?
Approved covered treatment is intended to be provided cashlessly within the applicable package. However, a payment request may arise when a service is outside the package, an upgrade is requested or approval is incomplete.
Before paying, ask:
- What is the exact package name?
- Has pre-authorisation been approved?
- Which service is said to be outside the package?
- Is the payment for an optional upgrade?
- Can the hospital provide a written estimate?
- Can the hospital provide an itemised bill?
- Can the Ayushman help desk explain the charge?
- Can the issue be recorded through an official complaint channel?
Documents to Carry for Treatment
- Ayushman Card in digital or printed form
- Aadhaar or another accepted photo identity document
- Active mobile phone
- Doctor’s prescription or referral
- Previous medical records
- Blood-test and laboratory reports
- X-ray, CT, MRI or ultrasound reports where relevant
- Previous discharge summaries
- Current medicine information
- Another document requested for hospital admission
Ayushman Treatment Helpline
Beneficiaries who need official PM-JAY guidance may contact the national toll-free helpline.
Keep the following information ready:
- Beneficiary name
- State and district
- Ayushman Card or beneficiary details
- Hospital name and exact branch
- Diagnosis or proposed treatment
- Package name or code, if provided
- Pre-authorisation status
- Reason given for rejection or payment demand
- Copies of estimates, bills and medical reports
Frequently Asked Questions
Which diseases are covered by the Ayushman Card?
PM-JAY uses medical and surgical treatment packages rather than one simple disease list. Coverage depends on the applicable package and hospital speciality.
Does the Ayushman Card cover heart treatment?
Specified cardiology and cardiac-surgery packages may be covered at an appropriately empanelled hospital.
Is cancer treatment covered?
Applicable medical, surgical and radiation oncology packages may be available depending on the diagnosis and hospital facilities.
Is kidney treatment covered?
Specified nephrology, dialysis-related and urology packages may be available according to current rules.
Is orthopaedic surgery covered?
Listed fracture, bone, joint and implant-related procedures may be covered when package requirements are satisfied.
Are pre-existing diseases covered?
Applicable pre-existing conditions may be treated from the beginning of beneficiary coverage, subject to package and hospital requirements.
Are medicines included?
Medicines connected with an approved package may be included according to that package’s rules.
Are diagnostic tests included?
Tests required for an approved hospital package may be included. Independent outpatient tests should not automatically be assumed covered.
Are implants included?
Specified implants may be included or regulated by package-specific rules, rates and quantity limits.
Is outpatient consultation covered?
PM-JAY mainly focuses on listed secondary and tertiary hospital care. Routine outpatient consultation alone should not automatically be assumed covered.
Can I receive treatment at any hospital?
Covered treatment must generally be obtained through an empanelled hospital with the required speciality and package.
Does every empanelled hospital provide every treatment?
No. Hospitals are empanelled for specific specialities, facilities and packages.
What is pre-authorisation?
It is an approval process in which the hospital submits medical and beneficiary information before specified treatment is provided.
Can package lists differ by state?
Yes. States may add packages, modify rates or apply additional rules under their scheme implementation.
Does having an Ayushman Card guarantee treatment?
No. Treatment depends on current eligibility, medical necessity, hospital empanelment, package availability and required approval.
What should I do if the hospital asks for money?
Ask for the exact package, approval status, written explanation and itemised bill. Contact the official support channel when necessary.
Final Words
The Ayushman Card treatment list is organised through Health Benefit Packages covering specified medical conditions, surgeries, day-care procedures and hospital services.
Before planned treatment, find an empanelled hospital with the required speciality and ask the Ayushman help desk to confirm the exact package, package code, included services and pre-authorisation requirement.
Do not assume that every disease, test, medicine or hospital service is automatically covered. Coverage depends on beneficiary eligibility, medical necessity, current package rules, hospital empanelment and approval.
Official Resources
Disclaimer
Wikisia is an independent informational website. It is not affiliated with the National Health Authority, AB PM-JAY, the Government of India, any State Health Agency or any hospital.
Treatment packages, package codes, rates, exclusions, pre-authorisation rules, hospital specialities and state-level coverage may change. Information on this page is provided for general educational purposes.
Always confirm the exact treatment package through an empanelled hospital’s authorised Ayushman help desk, the official hospital-search portal, National Health Authority or the applicable State Health Agency.
This article does not provide medical advice and does not guarantee beneficiary verification, package approval, cashless treatment, hospital admission or medical outcomes.