Millions of families across India who rely on the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) for cashless medical care are preparing for one of the most consequential policy shifts since the flagship health assurance scheme was launched. Starting December 1, 2026, beneficiaries seeking free treatment for 112 specified medical conditions and surgical procedures may no longer be able to walk into empanelled private hospitals for those packages. Instead, the National Health Authority (NHA) has moved to reserve these 112 treatment packages exclusively for government hospitals, marking a major recalibration in how public funds are spent under the ₹5 lakh annual health cover. While the news has sparked immediate concern among Ayushman cardholders in metro cities as well as smaller districts across Uttar Pradesh, Uttarakhand, Maharashtra, Gujarat, Rajasthan, and Madhya Pradesh, health officials emphasise that the transition comes with important state-level nuances that every patient should understand before planning a hospital visit.

What Is the New Ayushman Bharat Rule Effective December 1, 2026?

Under the updated framework circulated by the National Health Authority, the central health agency has expanded the list of medical packages reserved solely for public healthcare institutions from 23 to 112. In an official communication sent to state health departments and State Health Authorities (SHAs) across the country, NHA Deputy Secretary Dr. Shailesh outlined that 89 additional treatment and surgical packages are being added to the existing 23 reserved packages. These 112 packages are scheduled to be integrated into the NHA’s digital Transaction Management System (TMS) from December 1, 2026. Once activated on the TMS portal, empanelled private hospitals in adopting states will not be able to raise pre-authorisation requests or claim reimbursements under AB-PMJAY for these specific procedures, effectively directing patients toward government district hospitals, community health centres, and state medical colleges.

Full List of 112 Diseases and Surgeries Shifted to Government Hospitals

For ordinary households, the biggest question is which everyday illnesses and planned surgeries are affected by this directive. According to the package breakdown shared with state authorities, the 112 reserved packages cut across seven major clinical specialties: Ophthalmology, Obstetrics and Gynaecology, General Surgery, General Medicine, Mental Health and Psychiatry, Orthopaedics, and Ear, Nose, and Throat (ENT) care. The list covers both routine day-care interventions and multi-day inpatient hospitalisations. In eye care, widely availed procedures such as cataract surgery (motiyabind) and glaucoma management are part of the reserved basket. In women’s health and maternity care, high-risk deliveries, hysterectomy (uterus removal surgery), and Medical Termination of Pregnancy (MTP) have been placed under the public-hospital category. General surgery and orthopaedic packages affected by the shift include fistula operations, cyst removals, diagnostic biopsies, and select routine surgical procedures. Furthermore, high-volume general medicine admissions—such as severe anaemia, alcoholic liver disease, hepatitis, pancreatitis, acute bronchitis, severe diarrhoea, and seasonal vector-borne illnesses like malaria and chikungunya—also feature on the list, alongside psychiatric care for anxiety, mood disorders, ADHD, stress management, and routine ENT treatments.

Will Private Hospitals Stop All Ayushman Card Treatments Across India?

A widespread misconception circulating on social media suggests that private hospitals are exiting the Ayushman Bharat network altogether, which is factually incorrect. AB-PMJAY covers more than 1,900 secondary and tertiary medical and surgical procedures across over 29,000 to 36,000 empanelled public and private hospitals nationwide. Complex tertiary care—including cardiac bypass surgeries, angioplasty, cancer chemotherapy and radiation, neurosurgery, kidney transplants, trauma care, and critical intensive care—remains open at empanelled private hospitals. Even more importantly, the NHA has clarified that while it is standardising the 112-package reservation on the national TMS platform from December 1, 2026, final implementation rests with individual state governments and their respective State Health Authorities. States retain full administrative discretion to evaluate whether their local government hospitals have sufficient specialist doctors, operating theatres, and bed capacity before dropping any of the 89 new packages from private facilities.

How Indian States Are Preparing for the December Transition

Across India, states are at varying stages of adopting public-sector package reservations. As many as 15 states and Union Territories—including Andhra Pradesh, Chandigarh, Chhattisgarh, Gujarat, Jammu and Kashmir, Karnataka, Kerala, Madhya Pradesh, Manipur, Meghalaya, Mizoram, Odisha, Punjab, Rajasthan, and Tamil Nadu—had already implemented partial reservations for select government-hospital packages prior to this nationwide push. Following the latest NHA directive, state health agencies in northern and western regions, including Uttarakhand and Uttar Pradesh, have initiated comprehensive capacity audits across district hospitals and government medical colleges. Hospital administrators at major public institutions, such as Government Doon Medical College Hospital in Dehradun, have been asked to submit detailed inventories of available surgical specialists, diagnostic equipment, and inpatient beds to ensure patients do not face long waiting lists once private-hospital claims for these 112 packages are phased out. Alongside the package revision, authorities have also tightened grievance procedures under the scheme, stipulating that formal complaints alleging medical negligence or improper treatment against doctors must now be submitted on a ₹10 affidavit.

Why Did the Government Restrict These 112 Packages to Public Hospitals?

Healthcare policy analysts and public health administrators point to two primary drivers behind the NHA’s decision: financial sustainability and public infrastructure strengthening. Over the past several years, government data tabled in Parliament showed that a substantial share of the 11.69 crore hospital admissions authorised under AB-PMJAY—roughly 6.74 crore admissions—took place in private hospitals, leading to heavy claim outflows for relatively standard procedures like cataract surgeries, seasonal fevers, and routine deliveries. By routing these 112 high-volume treatments back to government hospitals, the Centre aims to curb inflated billing and package misuse in the private sector while ensuring that Ayushman claim reimbursements flow directly into public hospitals. Under AB-PMJAY guidelines, government hospitals use earned claim funds to upgrade medical equipment, maintain wards, and incentivise clinical staff, creating a self-sustaining cycle that improves local healthcare quality for low-income families.

Step-by-Step Guide for Ayushman Cardholders Before Hospital Admission

For beneficiaries planning a scheduled surgery or seeking urgent medical admission after December 1, 2026, verifying package eligibility beforehand can prevent sudden out-of-pocket expenses. Patients and their attendants should first visit the official NHA portal at beneficiary.nha.gov.in or pmjay.gov.in to check the active empanelled hospital directory for their specific state and district. Before travelling to a private hospital for eye surgery, maternity care, or general medicine admission, families should speak directly with the dedicated Ayushman Mitra helpdesk stationed at every empanelled facility or call the 24×7 national toll-free helpline at 14555 or 1800-111-565. Confirming whether your state’s Health Authority has moved that specific treatment to government hospitals ensures you arrive at the right facility with your Aadhaar card and Ayushman card, guaranteeing uninterrupted, zero-cost cashless treatment when you need it most.