Is treatment under a government scheme completely free for me?

The scheme pays the hospital its package rate for what the scheme covers. Whether that leaves anything for you depends on your hospital’s empanelment, the package, and what your treatment actually needs. Ask before you are admitted — that is a question with a real answer, and it is your HealAssistant’s job to get it.

The hospital says it is empanelled but wants me to pay. Why?

Probably because it is empanelled for reimbursement, not cashless. That means you pay and claim the money back. Tell your HealAssistant before you pay — it is worth knowing whether a cashless hospital is available to you instead.

Is the rate on the scheme page what my hospital will charge?

It is the rate the scheme pays, seen across the empanelled hospitals HealAssist can see — not a quote from one hospital. For a hospital-specific number, get a quote.

What you pay under a government scheme

Last reviewed 14 July 2026

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Quick answer

A government scheme pays the hospital a published package rate for a covered procedure. If the hospital is empanelled for cashless, it settles with the scheme directly. If it is empanelled only for reimbursement, you pay the hospital and claim the money back yourself — so check which one your hospital is before you go.

A government scheme is not a discount — it is a payer. It agrees a rate with the hospital and pays it. What that leaves for you depends on two things, and both are worth checking before you are admitted rather than after.

The scheme pays a package rate

Each scheme publishes a rate per procedure. HealAssist shows you that rate and how many empanelled hospitals it can see it at — which is why the number on a scheme page is a rate, not a quote for a named hospital.

What the package covers is the scheme’s decision. Anything the scheme does not cover is not paid by the scheme — and that is the first place a bill grows.

Cashless is not automatic — check your hospital’s empanelment

A hospital can be empanelled for cashless treatment, for reimbursement, or for both. Only a cashless empanelment means the hospital settles with your scheme. On a reimbursement-only empanelment, you pay the hospital yourself and claim the money back afterwards — with your own money, for as long as the claim takes.

What can still cost you money

Anything outside the scheme package. Items the scheme does not cover, a room above what the package allows, or treatment at a hospital that is not empanelled for your scheme at all — each of those is settled between you and the hospital.

HealAssist does not calculate your personal out-of-pocket cost. No figure you see on a scheme page is a promise about your bill — it is what the scheme pays, not what you owe. Ask your HealAssistant to walk you through what the scheme covers at your hospital, for your procedure, before you are admitted.

Scheme cost questions

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What you pay under a government scheme

The scheme pays a package rate

What can still cost you money

Scheme cost questions

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