Is Cataract Surgery Covered Under the Ayushman Card, and How Long Does It Take to Become Eligible?

Hello,

Yes. Cataract treatment is included under Ayushman Bharat PM-JAY.

However, getting cataract treatment under Ayushman Card depends on three things:

1. The patient must be eligible for PM-JAY.

2. The hospital must be currently empanelled under PM-JAY.

3. The hospital must have the relevant ophthalmology/cataract package available.

Is there a waiting period?

For a person who is already eligible for PM-JAY, there is no fixed rule that they have to wait for several years before getting cataract treatment. PM-JAY covers pre-existing diseases, and eligible beneficiaries can use the scheme at empanelled hospitals for covered packages.

So, if the patient is currently eligible and the cataract package is available at an empanelled hospital, treatment can generally be taken without waiting for 1, 2, 3 or more years.

If the person is not eligible for PM-JAY, there is also no standard rule saying they will automatically become eligible after a certain number of years. Eligibility depends on the applicable government beneficiary criteria/database, not on completing a waiting period.

How to check whether a hospital can provide cataract treatment under Ayushman

1. Open the official PM-JAY hospital search.

2. Select the State.

3. Select the District.

4. Choose Government or Private Hospital.

5. Select the relevant speciality, such as Ophthalmology.

6. Enter the hospital's exact name, if known.

7. Enter the captcha, if displayed.

8. Click Search.

9. Check whether the hospital is currently shown as PM-JAY empanelled and whether ophthalmology services are listed.

10. You can check overall empanelled list of hospitals of your district.

Documents to keep ready

• Ayushman Card/e-card

• Aadhaar card or valid government ID

• Doctor's prescription/eye consultation report

• Cataract diagnosis or eye examination report

• Previous medical records

• Eye test/scan reports, if advised

• List of current medicines

• Any previous discharge or treatment papers

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