Emergency Quota (EQ): Drop medical/urgent proof in the DCM's drop box to confirm waitlisted tickets.

Indian Railways provides significant fare concessions for patients suffering from severe and chronic illnesses who need to travel to out-of-station healthcare facilities for treatment, surgery, or periodic check-ups.

Unlike the senior citizen concession (which remains suspended as of 2026), these medical concessions are fully active and offer discounts ranging from 50% to 100% on the base fare.

 

Here are the rules, eligible diseases, and the discount structures for medical patients.

1. Eligible Diseases & Discount Percentages

The amount of concession depends on the disease and the class of travel. In most cases, the discount also applies to one accompanying escort/attendant. 

Note: The discount applies to the base fare only. Reservation charges and superfast surcharges must be paid in full. 

A. Cancer Patients

• 100% discount in Sleeper Class & 3AC. 
• 75% discount in 2nd Class, 1st Class, and AC Chair Car. 
• 50% discount in 1AC & 2AC. 
• Escort Rule: The escort receives a 75% discount across most classes, except in 1AC/2AC where they get 50%. 

B. Heart & Kidney Patients

(Traveling for heart surgery, kidney transplant, or dialysis)

• 75% discount in 2nd Class, Sleeper, 1st Class, 3AC, and AC Chair Car. 
• 50% discount in 1AC & 2AC. 
• Escort Rule: The escort receives the exact same discount percentage as the patient. 

C. Thalassemia & Hemophilia (Severe/Moderate) Patients

• 75% discount in 2nd Class, Sleeper, 1st Class, 3AC, and AC Chair Car. 
• 50% discount in 1AC & 2AC (Thalassemia only). 
• Escort Rule: The escort receives the exact same discount percentage as the patient. 

D. Tuberculosis (TB) & Non-Infectious Leprosy Patients

• 75% discount in 2nd Class, Sleeper, and 1st Class. 
• Escort Rule: The escort receives the exact same discount percentage as the patient. 

E. AIDS Patients

(Traveling to nominated ART Centres for treatment/check-up)

• 50% discount restricted to 2nd Class only. 

F. Other Covered Conditions

• Ostomy Patients: 50% discount on Monthly/Quarterly Season Tickets (MST & QST) for any purpose of travel. 
• Sickle Cell & Aplastic Anemia: 50% discount in Sleeper, AC Chair Car, 3AC, and 2AC classes.

 

2. How to Claim the Medical Concession

You cannot book these concessional tickets online through the standard IRCTC portal. The process must be done physically. 

A. Obtain the Official Medical Certificate:

You must get a specific Railway Concession Certificate (IRCA-prescribed Form) signed by the Head of Department of the treating hospital (e.g., Oncologist for cancer, Nephrologist for kidney, or Civil Surgeon).

B. Ensure Certificate Accuracy:

The certificate must explicitly state the disease, confirm the patient is traveling for treatment or a check-up, and confirm that an escort is necessary (to claim the escort discount).

C. Visit the PRS Counter:

Go to a major Passenger Reservation System (PRS) ticket counter. Medical concessions are generally not issued at small local stations.

D. Fill the Reservation Form:

Fill out the standard physical reservation form. Note the specific concession code for the disease (e.g., Code 04 for Cancer, Code 16 for Kidney) in the concession column.

E. Submit and Book:

Submit the reservation form along with the original signed medical certificate and your government ID to the booking clerk to receive the discounted ticket.

3. Important Rules to Remember:

• Route Restrictions: The concession is strictly valid only for the outward journey from your home station to the hospital station, and the return journey from the hospital back home. You cannot use it to travel to other cities. 
• Certificate Validity: Most hospital certificates are valid for one year. For chronic conditions requiring frequent travel (like dialysis), you will need to renew the certificate annually at the same hospital. 
• General Diseases Excluded: Standard chronic conditions like asthma, diabetes, or hypertension are not covered under these rules. 

 

Beyond the specific diseases and discount percentages, there are a few important administrative and operational rules regarding Indian Railways medical concessions. These rules govern how the journey must be conducted and which trains you can use. 

Here are the remaining details you need to know about medical patient concessions on Indian Railways:

1. Exemption from the Minimum Distance Rule

Normally, general railway concessions (such as those for students or youth) require the journey to be a minimum of 300 km. Medical patients are completely exempt from this rule. A patient travelling for treatment or check-ups can claim the concession regardless of how short the distance is between their home station and the hospital station.

2. No "Break of Journey" Allowed

When travelling on a medical concession ticket, you are not permitted to break your journey en route. For example, if you are travelling from Patna to Delhi for treatment, you cannot decide to get off at Kanpur for two days and then resume your journey to Delhi on the same ticket. The journey must be continuous, unless the break is a natural event (such as a missed connection due to a late-running train).

3. Restrictions on Premium Trains

Medical patient concessions (unlike certain disability concessions) are generally not valid on premium or special trains. You cannot use a medical concession to book discounted tickets on:

• Rajdhani Express 
• Shatabdi Express 
• Duronto Express 
• Vande Bharat Express 
• Gatimaan, Garib Rath, or Humsafar Express 

The discounts are only applicable on standard Mail, Express, and Passenger trains. (However, the concession is extended to the 2nd Class and AC Chair Car of Jan Shatabdi Express trains).

4. No Class Upgrades

If you book a concessional ticket in a lower class, you cannot upgrade it to a higher class during the journey, even if you are willing to pay the fare difference. The only exception is if a patient is eligible for a 1st Class concession; they are permitted to travel in AC 2-Tier by paying the concessional 1st Class fare plus the actual fare difference between 1st Class and AC 2-Tier.

5. Hospital Recognition is Mandatory

The concession form cannot be signed by a private doctor at a standalone clinic. The certificate must be issued by the Officer-in-Charge of a hospital or institute that is recognized by the Health Department of the Central Government or a State Government.

6. Season Tickets (MST/QST) Excluded for Most

While Indian Railways offers Monthly and Quarterly Season Tickets for daily commuters, medical patients cannot get a concession on these passes, with one specific exception: Ostomy patients. Ostomy patients are eligible for a 50% discount on Monthly Season Tickets (MST) and Quarterly Season Tickets (QST) for any purpose of travel. For all other covered diseases, the concession only applies to single-journey reserved tickets. 

 

7. The Cancer Patient & Emergency Quota

If you are travelling for urgent treatment and standard tickets are waitlisted, Indian Railways offers a lifeline:

• Cancer Patient Quota: Specific trains have a dedicated Cancer Patient Quota (often up to 12 seats/berths across specified classes) specifically set aside for patients and their attendants. 
• Emergency Quota (EQ): Patients travelling for scheduled medical examinations, hospital admissions, or follow-up treatments can apply for access to the Indian Railways Emergency Quota. 
• How to use it: You must submit your medical documents along with an application to the Chief Commercial Manager (CCM) or Senior Divisional Commercial Manager (Sr. DCM) of your railway zone to request that your waitlisted ticket be cleared under this quota. Note that while it gives you high priority, a confirmed seat is not strictly guaranteed.

 

8. The "Child Under 5" Escort Rule

On Indian Railways, children under the age of 5 travel entirely for free and do not require a ticket. However, what happens if the patient is a child under 5?

• In a unique exception to standard rules, even though the child patient travels for free, the attendant/escort accompanying the child is still eligible to claim the full escort concession.

 

9. Strict Certificate Validity Windows

You cannot keep a signed medical concession certificate indefinitely. You must book your physical tickets within a specific timeframe after the hospital issues the certificate:

• For Cancer Patients: The concession certificate is valid for one year from the date of issue. 
• For All Other Covered Diseases: The concession certificate is valid for only three months from the date of issue.

 

10. International Hospitals Are Excluded

To claim the concession, the medical certificate must be signed by an authorized doctor at a recognized hospital based in India. Documents, diagnoses, or appointment letters issued by foreign hospitals or international organizations are strictly not permissible for Indian Railways concessions.

 

11. The Missing Disease: Lupus Vulgaris

There is one specific condition grouped with Tuberculosis in the railway rulebook that we didn't mention.

• Lupus Vulgaris: Patients suffering from this condition (a form of tuberculosis of the skin) receive the exact same benefits as TB patients: a 75% discount in 2nd Class, Sleeper, and 1st Class, with the same discount applying to one escort.

 

12. The Tatkal Ban

Just like student concessions, medical concessions cannot be applied to Tatkal or Premium Tatkal tickets. If a patient has a sudden medical emergency and needs to travel immediately, they cannot get a discount on a Tatkal ticket; the system will automatically charge the full fare. This is why the aforementioned "Emergency Quota" (EQ) is so important for patients, as it operates within the standard fare structure.

13. Surcharges and GST are Not Discounted

It is important to understand exactly how the math works when buying the ticket. The 50% to 100% discount applies strictly to the base passenger fare.

• You must still pay 100% of the Reservation Fee, the Superfast Surcharge (if travelling on a Superfast train), and any applicable GST. Therefore, even a cancer patient receiving a "100% discount" in Sleeper Class will still have to pay a small amount at the counter for these additional fees.

 

14. Carrying the Original on the Train

While you submit a photocopy of the concession certificate to the booking clerk at the PRS counter to get the ticket, you must carry the original signed hospital certificate and your original photo ID during the actual train journey. If the Ticket Checking Staff (TTE) asks for it and you only have a photocopy, you will be penalized and treated as a passenger travelling without a ticket.

15. The "Only One Concession" Rule

Indian Railways strictly enforces a "no double-dipping" rule. Even if a passenger qualifies for multiple concessions (for example, if a patient is also a recognized journalist or a military veteran), they can only claim one concession per journey. The ticketing clerk will apply whichever single concession offers the highest discount.

 

With these final points on Lupus Vulgaris, Tatkal exclusions, and on-board verification, you now possess the complete, exhaustive guide to Indian Railways medical patient concessions!