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ODISHA GOVT DIRECTS FREE PRE & POST HOSPITALISATION UNDER AB-PMJAY/GJAY
ADVISORY ON FREE PRE & POST HOSPITALISATION UNDER AB-PMJAY/GJAY
State Health Assurance Society, H&FW Dept – Letter No. 1279 Dated 01.06.2026
Reference
Letter No. 1279
Department
H&FW / SHAS
Issued By
CEO, SHAS
Addressee
All Empanelled Hospitals
Issue Identified
Illegal Charging
Hospitals charging for covered services
Beneficiary Protection
100% Free
No charges for pre/post hospitalisation
Action Warning
Strict Action
Deviation will be taken seriously
STRICT ADHERENCE MANDATORY
All empanelled hospitals are hereby requested to strictly adhere to the scheme guidelines and refrain from charging money from beneficiaries for any service covered in the package cost. Any deviation will be taken seriously.
Coverage Period & Services
Expenses covered under the AB-PMJAY/GJAY package cost without any charges to beneficiaries:
Pre-Hospitalisation
3 Days
Before Admission
Consultation, Diagnostics, and Medications up to 3 days before getting admitted in the same hospital where treatment under AB-PMJAY/GJAY is initiated.
Consultation, Diagnostics, and Medications up to 3 days before getting admitted in the same hospital where treatment under AB-PMJAY/GJAY is initiated.
Post-Hospitalisation
15 Days
After Discharge
Consultation, Medicines, Diagnostics, and Post-Operative Care from the date of discharge up to 15 days. Follow-up visits and diagnostics evaluation must be done free of cost.
Consultation, Medicines, Diagnostics, and Post-Operative Care from the date of discharge up to 15 days. Follow-up visits and diagnostics evaluation must be done free of cost.
Key Directives to Empanelled Hospitals
- Pre-Hospitalisation Coverage: Expenditure incurred by beneficiary for consultation, diagnostics, and medications up to 3 days before admission is included in the package cost. Applicable only to expenses made in the same hospital where treatment is initiated.
- Post-Hospitalisation Coverage: Expenses from date of discharge up to 15 days for consultation, medicines, diagnostics, and post-operative care are covered in the package cost.
- Medication Provision: Hospitals must procure required medications and provide them to the beneficiary free of cost.
- Follow-up Visits: If diagnostics evaluation and follow-up visits are needed within 15 days post-discharge, they must be done free of cost by the hospitals.
- No Charging: The beneficiary should not be charged for any pre and post-hospital expenses covered under the package.
- Surgery Complications: In case of surgery, post-operative complications and readmission linked to the treatment are to be covered under the earlier package cost.
- Strict Compliance: Any deviation from these guidelines will be taken seriously by SHAS and the Health & Family Welfare Department.
To Whom It Is Addressed
- All Empanelled Hospitals: Under AB-PMJAY/GJAY across Odisha.
- CDM & PHOs: For information and necessary action at district level.
- Nodal Officers: All sections and District Coordinators of SHAS for information and necessary action.
- Commissioner-cum-Secretary: H&FW Department for kind information.
Frequently Asked Questions
What is covered under pre-hospitalisation?
Consultation, diagnostics, and medications up to 3 days before admission in the same hospital where AB-PMJAY/GJAY treatment is initiated. These expenses are included in the package cost.
What is covered under post-hospitalisation?
From the date of discharge up to 15 days, expenses for consultation, medicines, diagnostics, and post-operative care are covered. Follow-up visits and diagnostics must be done free of cost.
Can hospitals charge beneficiaries for these services?
No. Empanelled hospitals are strictly prohibited from charging beneficiaries for any pre-hospitalisation or post-hospitalisation services covered under the AB-PMJAY/GJAY package cost.
What happens if a hospital violates these guidelines?
SHAS has warned that any deviation from these guidelines will be taken seriously. Empanelled hospitals must strictly adhere to the advisory or face disciplinary action.
Are post-operative complications covered?
Yes. In case of surgery, post-operative complications and readmission linked to the treatment are to be covered under the earlier package cost — no additional charges to the beneficiary.
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