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HealAssist

How government scheme rates work on HealAssist

Quick answer

The rate on a HealAssist scheme page is the lowest package rate currently offered across the empanelled hospitals we can see for that scheme — an indication of the going rate, not a quote from one hospital. Confirm the actual package rate and your eligibility with the hospital before treatment.

Government health schemes pay hospitals a fixed package rate for each listed procedure. HealAssist publishes those rates for central and state government schemes so you can see roughly what a procedure is settled at before you walk into a hospital.

What exactly is the rate HealAssist shows?

It is the lowest package rate currently on offer across the empanelled hospitals HealAssist can see for that scheme and procedure, with a count of how many hospitals sit behind it. It is a guide to the going rate — not a price quoted to you by a specific hospital, and not a promise of what any one hospital will charge.

Rates change as hospitals and schemes revise their agreements, and the figure on the page is not stamped with the date it was last refreshed. Treat it as an indication and confirm the current rate before treatment.

Does the scheme rate mean I pay nothing at the hospital?

Only where the hospital is empanelled for cashless treatment under your scheme. A hospital can be empanelled in one of two ways, and the difference decides who pays the bill on the day.

Under a cashless empanelment, the hospital bills your scheme directly for covered items. Under a reimbursement-only empanelment, you pay the hospital yourself and claim the money back afterwards. Items your scheme does not cover are payable by you in either case.

Scheme rate questions

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