CAPF Medical Facilities & Ayushman CAPF Scheme 2026
Comprehensive guide to the Ayushman CAPF cashless healthcare scheme covering serving personnel, veterans, and their dependent family members.
Ayushman CAPF Healthcare System & Medical Facilities
To guarantee uninterrupted, high-quality medical care to over 10 lakh paramilitary personnel and their families scattered across remote border posts and conflict zones, the Ministry of Home Affairs (MHA) launched the pan-India Ayushman CAPF Healthcare Scheme in partnership with the National Health Authority (NHA).
This modernized healthcare framework blends internal regimental medical infrastructure (Unit Medical Inspection Rooms, 50-bed and 100-bed Composite Hospitals) with the nationwide network of 24,000+ private and government empanelled hospitals under the PM-JAY and CGHS ecosystem.
1. Key Entitlements & Coverage Architecture
| Healthcare Feature | Service Entitlement | Beneficiary Scope |
|---|---|---|
| Inpatient Hospitalization (IPD) | 100% Cashless Treatment (No Financial Ceiling) | Serving personnel, spouse, dependent children, dependent parents. |
| Outpatient Care (OPD) | Direct digital reimbursement via Ayushman CAPF mobile app | Prescriptions, diagnostic investigations & chemist bills. |
| Composite Hospitals | Force-run specialized healthcare centers (CRPF, BSF, ITBP bases) | Free consultation, diagnostics, surgical procedures, and pharmacy. |
| Post-Retirement Coverage | CGHS Lifelong Pensioner Card + Ayushman CAPF convergence | Veterans and surviving spouses for lifetime cashless care. |
2. How to Avail Inpatient Admission & Referral Protocols
For regular or planned medical treatments, personnel follow a simple digital workflow:
- Step 1: Obtain Referral: Visit the local Unit Doctor (MI Room), Composite Hospital, or nearest CGHS Wellness Centre to obtain a formal digital referral.
- Step 2: Present Ayushman CAPF E-Card: At the empanelled private hospital desk, present the digital Ayushman CAPF card with biometric or OTP authentication.
- Step 3: Cashless Treatment: Surgery, room rent, intensive care (ICU), implants, and medications are billed directly to the government without out-of-pocket payment.
- Emergency Situations: In sudden life-threatening crises (stroke, road trauma, heart attack), prior referral is waived. Treatment begins immediately upon presenting the service ID or card.
Calculate Live CAPF Salary & Allowances
Customize rank, basic pay, city category (X/Y/Z), and risk allowances for CRPF, BSF, CISF, ITBP, SSB, Assam Rifles, or NSG.
Frequently Asked Questions
1. What is the Ayushman CAPF Healthcare scheme and who is covered?
Ayushman CAPF is a joint initiative of the Ministry of Home Affairs (MHA) and the National Health Authority (NHA). It provides 100% cashless, paperless medical treatment across 24,000+ empanelled private and government hospitals pan-India. It covers all serving personnel of CRPF, BSF, CISF, ITBP, SSB, Assam Rifles, NSG and their eligible dependents (spouse, children, and dependent parents).
2. Is there an annual expenditure cap under Ayushman CAPF?
No. Unlike the PM-JAY scheme for civilians which has a ₹5 Lakh limit, the Ayushman CAPF scheme provides unlimited, completely cashless inpatient treatment with no annual expenditure cap for all serving personnel and eligible dependents.
3. How does OPD claim reimbursement work on the Ayushman CAPF portal?
For outpatient consultations, diagnostic laboratory tests, and purchased medicines, personnel submit their medical prescription and GST billing vouchers directly through the Ayushman CAPF mobile application or web portal. The approved claim amount is electronically transferred directly into the soldier's salary bank account within 30 to 45 days.
4. Can personnel seek emergency treatment in non-empanelled hospitals?
Yes. In life-threatening emergencies, acute cardiac conditions, or critical polytrauma accidents, CAPF personnel and their families can be admitted immediately to any nearest private or government hospital without prior referral. Emergency medical reimbursement claims are subsequently submitted with an emergency certificate issued by the treating doctor.
Explore CAPF Information Hubs
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CAPF Medical Care Ecosystem: Ayushman CAPF Scheme & Hospital Network
Ensuring first-rate, cashless healthcare for over 10 lakh serving personnel and their dependent family members across the Central Armed Police Forces (CAPFs)—CRPF, BSF, CISF, ITBP, SSB, NSG, and Assam Rifles—is an overarching priority of the Ministry of Home Affairs (MHA). Through the nationwide rollout of the Ayushman CAPF Scheme (administered jointly with the National Health Authority - NHA), personnel now access seamless digital cashless treatments across thousands of empanelled tertiary hospitals nationwide.
1. Key Pillars of the Ayushman CAPF Medical Scheme
- Digital Health Card: Every serving personnel and each recognized dependent receives an individual Ayushman CAPF Electronic Card containing an embedded NHA ID.
- Cashless Inpatient (IPD) Care: Full cashless hospitalization across all empanelled private and government hospitals under the Ayushman Bharat PM-JAY and CGHS network without needing prior cash deposits.
- Outpatient (OPD) Reimbursement via IT Portal: Outpatient consultations, lab diagnostics, and pharmacy expenses incurred at non-empanelled centres can be submitted digitally via the dedicated TMS (Transaction Management System) portal for paperless direct bank transfer reimbursement.
- Composite Hospitals & Unit Dispensaries: Backed by dedicated CAPF Composite Hospitals (100 to 200 bed multi-specialty centres located across Group Centres) and Unit Medical Inspection (MI) rooms.
2. Medical Referral & Emergency Protocol
The operational protocol for accessing specialized treatment depends on clinical urgency:
| Category | Standard Procedure | Referral Requirement |
|---|---|---|
| Emergency Treatment | Immediate admission to nearest hospital (empanelled or non-empanelled). | No prior referral required. Emergency certificate from hospital validates claims. |
| Planned Treatment (Serving Staff) | Specialist consultation and admission at empanelled hospital. | Referral slip issued by Force Medical Officer / Composite Hospital. |
| Dependent Family Members | Direct access to empanelled CGHS/PM-JAY hospitals in native district. | Online referral from nearest district government hospital or CGHS centre. |
3. Post-Retirement Healthcare for CAPF Veterans
Upon superannuation, CAPF retirees are eligible to enroll in the Central Government Health Scheme (CGHS) for life by making a one-time 10-year contribution based on their retired pay level, or draw the monthly Fixed Medical Allowance (FMA) if residing in non-CGHS districts.
Q1: Who qualifies as a dependent under Ayushman CAPF?
Spouse, legitimate children (sons up to 25 years or until employed; daughters until married/employed), and dependent parents whose combined monthly income is below ₹9,000 plus DA.
Q2: Can bills for medicines purchased outside be reimbursed?
Yes. If prescribed medicines are unavailable at unit dispensaries, original bills and doctor's prescriptions can be uploaded onto the Ayushman CAPF portal for online reimbursement.