Is it legal for a hospital to refuse Ayushman Card?

If the hospital is empanelled under PMJAY, it cannot legally refuse treatment for covered packages. This is a violation of their empanelment agreement. Non-empanelled hospitals are not obligated to accept the card.

What if the hospital says the treatment is not covered?

First verify yourself at pmjay.gov.in if the treatment falls under PMJAY packages. If it does, insist on treatment and quote the package name. If the hospital still refuses, call 14555 immediately. Some treatments genuinely may not be in the package list.

Can I file a complaint anonymously?

Yes, you can file anonymous complaints through the Ayushman Bharat app or PMJAY website. However, providing your details helps in faster resolution. All complaints are kept confidential, and the hospital is not told who filed the complaint during investigation.

What happens to hospitals that refuse Ayushman patients?

Hospitals found to be illegally refusing patients face: (1) Warning and notice from SHA/NHA, (2) Monetary penalties, (3) Temporary suspension of empanelment, (4) Permanent de-empanelment for repeat offenses. This ensures accountability.

Should I pay and claim reimbursement later?

Ideally, you should not have to pay at an empanelled hospital. However, in emergencies, if you must pay, keep all bills, receipts, and medical records. You can apply for reimbursement through the State Health Agency (SHA). This process takes time but is possible.

What if the Ayushman Mitra is not available at the hospital?

Every empanelled hospital must have an Ayushman Mitra or help desk during operating hours. If unavailable, ask hospital administration or the reception team. You can also call 14555 for immediate assistance in getting treatment started.

Ayushman Card Download

Hospital Refuses Ayushman Card?

Know your rights and take immediate action – here's your complete action plan

Updated: February 2025 4 min read

📞 Immediate Action: Call 14555

Toll-free PMJAY helpline • Available 24/7 • Multiple languages

Tell them: the hospital name, your Ayushman ID, and the reason for refusal. They will intervene immediately.

Your Rights as an Ayushman Beneficiary

Right to cashless treatment at any empanelled hospital for covered packages

Right to zero payment – no deposit, advance, or hidden charges

Right to equal treatment – no discrimination vs. paying patients

Right to file complaints without fear of retaliation

Right to emergency care – cannot be denied stabilization in emergencies

Step-by-Step Action Plan

Stay Calm & Verify

First check if the hospital is genuinely empanelled at pmjay.gov.in/hospital and if your treatment is in the package list

Ask for Written Reason

Request the hospital to state in writing why they are refusing. This creates a record for your complaint.

Call 14555 Immediately

The PMJAY helpline operator will contact the hospital directly and intervene. Keep your Ayushman Card number ready.

File a Formal Complaint

Use the Ayushman Bharat app or visit grievance.pmjay.gov.in to file a written complaint with details

Escalate if Needed

Contact District Magistrate, State Health Agency (SHA), or local MLA/MP if the issue persists

Common Reasons Hospitals Refuse (& What to Do)

"No beds available"

Ask for expected wait time. If beds exist for paying patients, this is discrimination. Report to 14555.

"System is down"

Hospital can do offline verification. Ask them to contact NHA. In emergencies, treatment must begin regardless.

"This treatment is not covered"

Verify at pmjay.gov.in. If the package exists, insist on treatment. If genuinely not in the list, explore other hospitals.

"Deposit/advance required"

Empanelled hospitals cannot charge Ayushman patients. This is a clear violation – report immediately.

"We don't accept Ayushman anymore"

If still listed on PMJAY portal, they must honor empanelment. Call 14555 for official verification.

Where to File Complaints

📞 PMJAY Helpline

Call 14555 (toll-free, 24/7)

📱 Ayushman Bharat App

File complaint with photos & details

🌐 Online Portal

grievance.pmjay.gov.in

🏛️ District Office

District Magistrate / CMO office

FAQs – Hospital Refusal

Related Guides

Find Empanelled Hospitals

Search verified hospitals near you

Private Hospitals

Private hospitals that accept Ayushman

Cashless Treatment

How cashless treatment works

Ayushman Card Benefits

Complete benefits and rights

Know Your Rights

Empanelled hospitals cannot refuse Ayushman Card for covered treatments.

Disclaimer: This guide is for empanelled hospitals only. Non-empanelled hospitals are not required to accept Ayushman Card. Call 14555 for case-specific guidance.