Ayushman Bharat Hospital List In Kerala

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, commonly known as PM-JAY, is India's flagship government health insurance scheme providing cashless hospitalisation coverage of up to five lakh rupees per family per year to eligible beneficiaries. The scheme covers a wide range of secondary and tertiary care hospitalisation procedures and is implemented through a network of empanelled public and private hospitals across the country.

For eligible families in Kerala and Andhra Pradesh, and indeed across all participating states, knowing which hospitals are empanelled under PM-JAY and how to access the official hospital list is the essential practical first step in using the scheme effectively. This guide explains what Ayushman Bharat is, how the hospital empanelment system works, how to find the official empanelled hospital list for Kerala, Andhra Pradesh, and other states, and what the experience of using PM-JAY at an empanelled hospital involves.

What Ayushman Bharat PM-JAY Is

PM-JAY is a government-funded health insurance scheme that provides eligible beneficiary families with coverage of up to five lakh rupees per family per year for hospitalisation expenses at empanelled hospitals. The scheme targets families identified as vulnerable based on Socio-Economic Caste Census data and other criteria specified by the National Health Authority, which administers the scheme.

The coverage under PM-JAY is cashless at empanelled hospitals. The beneficiary presents their PM-JAY card or Ayushman Bharat card at the hospital, the hospital verifies eligibility through the scheme's digital system, and the covered treatment is provided without any upfront payment from the beneficiary for covered expenses. The hospital subsequently claims the treatment cost from the scheme directly.

PM-JAY covers over fifteen hundred packages of defined procedures and treatments across medical specialities including surgery, medical management, day care procedures, and follow-up care after hospitalisation. The specific procedures covered and the package rates are defined by the National Health Authority and state health agencies.

The five lakh rupee coverage is per family rather than per individual, and it covers the entire family without a cap on the number of family members. There is no cap on family size, and pre-existing conditions are covered from the first day of scheme eligibility.

Kerala and Ayushman Bharat: The State-Level Implementation

State implementation of PM-JAY varies across India because the scheme allows states to top up the central government's coverage with their own state-funded components, creating state-specific schemes that run alongside or integrated with PM-JAY.

Kerala has its own state health scheme called Karunya Arogya Suraksha Padhathi, or KASP, which operates alongside PM-JAY and in some configurations provides integrated coverage for eligible Kerala families. The integration between PM-JAY and Kerala's state scheme means that eligible families in Kerala may access both the central government's PM-JAY benefits and the state's additional coverage through the same empanelled hospital network.

For Kerala residents seeking to access PM-JAY or the state health scheme, the relevant authority is the Kerala Government's State Health Agency, which manages the scheme's implementation in the state and maintains the empanelled hospital list for Kerala.

Andhra Pradesh and Ayushman Bharat: The State Scheme Context

Andhra Pradesh has historically operated its own state-funded health scheme called Dr. YSR Aarogyasri Health Care Trust, which provides significant health coverage to eligible families in the state. Andhra Pradesh's relationship with PM-JAY and the specific implementation arrangements have evolved over time as the state has balanced its own scheme with the central government's programme.

For Andhra Pradesh residents seeking cashless hospitalisation through government health scheme coverage, the relevant authority is the Aarogyasri Health Care Trust, which manages scheme empanelment, beneficiary eligibility, and the hospital network in Andhra Pradesh.

How to Find the Official Empanelled Hospital List

The official and authoritative source for the list of hospitals empanelled under PM-JAY or any state-specific scheme is the relevant government digital infrastructure, not third-party websites or directories that may contain outdated information.

For PM-JAY specifically, the National Health Authority maintains a hospital finder tool on the official PM-JAY website. Through this official tool, users can search for empanelled hospitals by state, district, hospital type (public or private), and available speciality, producing a current and official list of hospitals that are active in the PM-JAY network at the time of the search.

This hospital finder is the most reliable tool for confirming whether a specific hospital in Kerala, Andhra Pradesh, or any other state is currently empanelled and active in the PM-JAY network. The empanelment status of hospitals can change as hospitals are added, suspended, or removed from the network over time, making the official real-time tool more reliable than any static list that may have been compiled at an earlier point.

For Kerala's KASP component, the Kerala State Health Agency's official website provides information on empanelled hospitals and scheme benefits specific to Kerala's implementation.

For Andhra Pradesh's Aarogyasri component, the Aarogyasri Health Care Trust's official website provides information on empanelled hospitals and scheme benefits specific to the state's implementation.

Types of Hospitals in the PM-JAY Network

The PM-JAY empanelled hospital network includes both public sector hospitals and private sector hospitals that have met the empanelment criteria established by the National Health Authority and the state health agency.

Public hospitals including government district hospitals, medical college hospitals, taluk hospitals, and government specialty hospitals are automatically eligible for empanelment and typically participate in the PM-JAY network. These hospitals typically have no room rent restriction for PM-JAY beneficiaries as the scheme's packages are defined to cover treatment costs.

Private hospitals that have applied for and met the empanelment criteria including infrastructure standards, specialist availability, accreditation, and other requirements can be empanelled in the PM-JAY network. Private hospital participation varies by district and state based on the local hospital landscape and the economics of the scheme package rates.

For PM-JAY beneficiaries, both public and private empanelled hospitals can be used for cashless treatment. However, the availability of specific procedures may vary between hospitals depending on the specialities available at each institution. The hospital finder tool shows the specialities available at each empanelled hospital, allowing beneficiaries to identify appropriate facilities for their specific treatment needs.

How to Check Eligibility and Get the PM-JAY Card

Eligibility for PM-JAY is based on the Socio-Economic Caste Census data and other criteria defined by the National Health Authority. Families listed in the eligible beneficiary database can check their eligibility through multiple channels.

The PM-JAY website and the Ayushman Bharat mobile application provide an eligibility check tool where a family member can enter their mobile number or ration card number to check whether they appear in the eligible beneficiary list.

Common Service Centres distributed across villages and urban localities provide assisted eligibility verification and PM-JAY card issuance support to beneficiaries who do not have digital access or need in-person assistance.

Empanelled hospitals also have an Ayushman Mitra, a designated hospital staff member, who assists PM-JAY beneficiaries with eligibility verification and the admission process at the hospital.

The PM-JAY or Ayushman Bharat card is issued to eligible family members and serves as the credential presented at the empanelled hospital to initiate cashless treatment. State health agencies in Kerala and Andhra Pradesh manage the card issuance process for their respective states within the scheme's overall framework.

The Cashless Treatment Experience at a PM-JAY Empanelled Hospital

For a PM-JAY beneficiary who needs hospitalisation at an empanelled hospital, the process of accessing cashless treatment involves several steps.

Upon arrival at the hospital, the beneficiary or their family member should inform the hospital that they wish to use their PM-JAY or Ayushman Bharat coverage. The hospital's Ayushman Mitra or the admissions team will verify the beneficiary's eligibility through the scheme's digital platform, check whether the required treatment is covered under the scheme's package list, and initiate the pre-authorisation process if required for the specific procedure.

Once eligibility is confirmed and the treatment is pre-authorised where required, the beneficiary is admitted and the covered treatment is provided at no cost for the covered expenses. The hospital is responsible for claiming reimbursement from the scheme.

For treatments that fall within the scheme's package coverage, the beneficiary's out-of-pocket cost for covered expenses should be zero. Any expenses that fall outside the scheme's covered package, such as medicines not included in the package list, additional tests, or treatment beyond the scheme's defined scope, may be chargeable to the beneficiary.

PM-JAY and Supplementary Health Insurance

For households that are eligible for PM-JAY and use the scheme for their basic hospitalisation needs, PM-JAY's five lakh coverage provides meaningful protection against the most common hospitalisation events. However, there are dimensions of health financial protection that PM-JAY does not address.

PM-JAY covers hospitalisation costs at empanelled hospitals. It does not cover outpatient consultations, day-to-day medicines, diagnostic tests outside the hospital context, or loss of income during a hospitalisation period. For households that face income disruption from a health event, PM-JAY does not replace the income that is lost while the primary earner is hospitalised or recovering.

For households above the PM-JAY eligibility threshold who do not qualify for the scheme, supplementary health insurance through a private health insurer provides the comparable cashless hospitalisation protection that PM-JAY provides to eligible families.

Exploring Health Insurance Options on Stashfin

For households who are not eligible for PM-JAY or who want to supplement their government health scheme coverage with additional private health insurance, Stashfin provides access to health insurance plan options from licensed insurers. Exploring what is available through the Stashfin app or website is a practical starting point for assessing health insurance options suited to your household's needs.

Insurance products are subject to IRDAI regulations and policy terms. Please read the policy document carefully before purchasing. Stashfin acts as a referral partner only.