Does Ayushman Bharat Card Cover Retinopathy Treatment?

Dear Priya Ji,

Yes, retina-related treatment is covered under Ayushman Bharat (PM-JAY). The required treatment falls under an approved PM-JAY package, and it is provided at a currently empanelled hospital. PM-JAY covers listed secondary and tertiary-care hospitalisation, including approved day-care and surgical procedures. 

How to Check Retina Treatment Under Ayushman Card

1. Visit the PM-JAY Hospital Finder.

2. Select your State and District.

3. Select Ophthalmology/Eye Care as the relevant specialty.

4. Search for currently PM-JAY-empanelled hospitals.

5. Visit the hospital's Ayushman Help Desk/Ayushman Mitra.

6. Show the patient's eye examination, doctor's prescription and relevant reports.

7. Ask the hospital to verify whether the specific retina treatment/procedure is covered under the applicable PM-JAY package.

8. Confirm the cashless approval before starting the treatment.

Documents Required

• Ayushman Bharat Card

• Aadhaar Card/valid ID

• Eye specialist's prescription

• Retina/eye examination reports

• OCT, fundus or other reports, if available

• Previous medical records

• Diabetes-related reports, if the retina problem is due to diabetes

How HexaHealth Can Assist You

HexaHealth can help you with

• Hospital Selection: Identify a suitable PM-JAY-empanelled partner hospital according to your location and retina condition.

• Retina Specialist Consultation: Help you connect with an experienced ophthalmologist/retina specialist.

• Treatment Guidance: Help you understand the treatment recommended based on your reports.

• Ayushman Guidance: Guide you regarding eligibility, hospital verification and the cashless process.

• Appointment Support: Assist with scheduling your consultation.

• Document Guidance: Help you understand which reports and documents to carry.

• Hospital Coordination: Assist with coordinating your consultation and treatment journey.

Please tell us your city/state and the exact retina problem (for example, diabetic retinopathy, retinal detachment, retinal bleeding, etc.). We can then guide you regarding a suitable nearby PM-JAY partner hospital and retina specialist.

Wishing you and your family good health always.
Warm regards,
Team HexaHealth