Almost every family that walks into a cancer clinic asks the same question within the first few minutes, usually before they ask about the treatment itself: how will we pay for this? It is a fair question and it deserves a plain answer. This page sets out what is actually accepted at Batra Hospital, what each scheme requires of you, and the handful of avoidable errors that cost patients real money.
The one thing worth knowing before anything else: for every government scheme, permission must be obtained before planned treatment begins. Radiotherapy is planned treatment. Starting first and applying later is the most common way patients end up paying out of pocket for care that would otherwise have been covered.
The short versionWhat is accepted, and for whom
| Scheme | Who it is for | What it needs from you |
|---|---|---|
| CGHS | Central Government employees and pensioners, and their dependents | Valid CGHS card, referral from your wellness centre or CMO, and prior permission for radiotherapy |
| ECHS | Ex-servicemen and their registered dependents | ECHS smart card, referral from your nearest Polyclinic, and sanction before treatment starts |
| DGEHS | Delhi Government employees and pensioners | DGEHS card, dispensary referral, and prior permission for planned treatment |
| Ayushman Bharat (PM-JAY) | Eligible beneficiaries — radiation and surgical oncology only at this hospital | PM-JAY card or verified eligibility, plus package-based pre-authorisation |
| Private insurance | Anyone holding a health or mediclaim policy | Policy card and schedule, and a pre-authorisation raised with your TPA |
| ESI | Insured workers covered under the ESI scheme | ESI entitlement and referral through the scheme |
Batra Hospital is also empanelled with a long list of government bodies and public-sector employers — among them Northern Railways, Delhi Police, Delhi Jal Board, NTPC, ONGC, IOC, the Reserve Bank of India, State Bank of India and several universities. If you work for a large public employer, it is worth asking your own department before assuming you must claim privately.
Government schemesWhy the paperwork comes first
CGHS, ECHS and DGEHS work on broadly the same logic. You are entitled to treatment at an empanelled hospital, the hospital bills the scheme directly at rates the scheme sets, and in exchange the scheme wants to authorise the treatment before it happens. For a consultation or an ordinary investigation this is light. For radiotherapy — which runs over several weeks and involves planning scans, simulation and daily sessions — it is not.
The practical consequence is that the referral and the permission letter are not administrative afterthoughts. They are the first step of treatment. A patient who arrives with reports but no referral has not lost anything permanent, but they have usually lost a week.
What to bring, whichever scheme you are on:
- Your scheme card — CGHS card, ECHS smart card, or DGEHS card
- The referral from your wellness centre, Polyclinic or dispensary
- The prior permission or sanction letter for radiotherapy, obtained before treatment begins
- All diagnostic reports, biopsy results and imaging, including anything done elsewhere
- Records of any treatment already received — surgery notes, chemotherapy details
We do not publish the rates for any of these schemes here, and you should be cautious of any site that does. Scheme rates are set and periodically revised by the government, not by the hospital, and a figure copied onto a webpage is out of date the moment it changes.
Ayushman BharatPM-JAY, and an important limit
Ayushman Bharat PM-JAY has been accepted at Batra Hospital for the past several months — but specifically through the radiation oncology and surgical oncology departments. This is a department-level arrangement, not a hospital-wide one, and the distinction matters. A patient who needs a treatment sitting outside those two departments may find PM-JAY does not apply here even though the hospital does accept the scheme.
PM-JAY also works differently from CGHS or ECHS. Rather than reimbursing what is done, it pays defined packages — a surgical package, a chemotherapy package, a radiotherapy package — and the package your diagnosis falls into determines what is covered. Whether your specific treatment maps onto an available package is a question best answered by looking at your actual reports, not in the abstract.
If you hold a PM-JAY card, send your reports before making the journey. It takes us very little time to tell you plainly whether your treatment falls under a package here, and it saves you a wasted trip if it does not.
Private insuranceWhat actually determines your cover
Radiotherapy and cancer treatment are covered under most standard health insurance and mediclaim policies sold in India. Patients are often surprised by this, having assumed cancer was excluded. It generally is not.
What varies — and varies enormously — is the shape of your particular policy. Four things decide what you actually receive:
- Sum insured. Cancer treatment is not cheap, and a policy sized for a hospital stay may not stretch across a full course of treatment.
- Room-rent capping. This one catches people out. Many policies cap the daily room rent, and if you occupy a room above that cap, some insurers proportionately reduce the entire claim — not just the room charge.
- Sub-limits and exclusions. Some policies limit specific treatments or specify waiting periods before certain conditions are covered.
- Waiting periods. A recently purchased policy may not yet cover a condition, particularly one that could be argued to pre-date the policy.
None of this is decided by the hospital or by the treating doctor. It is decided by the contract you hold with your insurer, which is why a blanket promise about what your policy covers would be worthless. The policy document has to be read.
Insurers and TPAs empanelled at Batra Hospital
Cashless treatment can be arranged through the following, subject to your policy's own terms:
If your insurer is not on this list, that does not mean treatment is impossible. It means the cashless route is unavailable and you would claim by reimbursement instead — paying the hospital and claiming back afterwards. This is slower and demands that you keep every bill, prescription and discharge summary, but it is a normal route and a great many patients use it.
PracticalThe mistakes that cost patients money
Over the years the same avoidable errors recur:
- Starting treatment before permission is granted. Under a government scheme this can convert a fully covered treatment into an out-of-pocket one. Nothing else on this list costs as much.
- Assuming cancer is excluded and never checking. Some patients pay privately for treatment their policy would have covered, because they never asked.
- Ignoring the room-rent cap. Choosing a higher category of room than the policy allows can proportionately reduce the whole claim, not merely the room charge.
- Leaving pre-authorisation until the day of admission. It takes time. Started late, it delays treatment rather than the paperwork.
- Not keeping the paper. For any reimbursement claim, the bills, prescriptions, reports and discharge summary are the claim. Losing them loses the money.
How we helpSend the details before you come
The most useful thing you can do is send your scheme card or insurance policy details, along with your reports, before your first visit — through the contact form or on WhatsApp. Two things then happen: we can tell you plainly what applies to your case, and where a pre-authorisation or permission is needed, the process can be started rather than waiting on your arrival.
You will get a straight answer, including when the answer is that a particular scheme does not cover your treatment here. That is more useful to you than an encouraging one.
Dr. Bhatnagar was an invited panelist on “Rethinking Insurance Models: Tailoring Coverage for Evolving Cancer Therapies” at the IHW Council Cancer Summit 2024, New Delhi. Scheme rules and policy terms change; this page describes the position as it stands and is not a substitute for confirming your own entitlement.