Is Retina Surgery Covered Under Ayushman Bharat (PM-JAY)

Hello,

Yes, retina surgery is covered under Ayushman Bharat Yojana (PMJAY). You can avail cashless retina surgery at a PMJAY-empanelled hospital after beneficiary verification and treatment package approval. 

What Is Covered Under Ayushman Bharat for Retina Surgery?

As per the approved PMJAY package, coverage may include :

• Ophthalmologist (Retina Specialist) consultation

• Pre-operative evaluation and diagnostic investigations 

• Retina surgery (as medically advised)

• Operation theatre charges

• Surgeon and anaesthetist charges

• Medicines and consumables during hospitalization

• Hospital stay (when medically required)

• Nursing care

• Post-operative follow-up as per the approved package 

Documents Required

• Ayushman Bharat (PMJAY) Card

• Aadhaar Card

• Doctor's prescription

• Eye examination reports (OCT, Fundus examination, Ultrasound or other relevant reports, if available)

• Previous medical records (if available)

How to Check Whether Retina Surgery Is Available Under PMJAY?

Online Verification

• Visit the PMJAY Hospital Finder.

• Select your :

  • State

  • District

  • Specialty : Ophthalmology

• Click Search to view PMJAY-empanelled hospitals.

• Contact the hospital's Ayushman Help Desk to confirm that the retina surgery package is available before admission. (NHA)

Common Symptoms Indicating a Need for Retina Surgery

• Sudden appearance of floaters (small spots or squiggly lines in your vision)
  
  
• Flashes of light in one or both eyes
  
  
• A dark curtain or shadow that progressively blocks your vision
  
  
• Blurred or distorted vision
  
  
• Gradual decrease in peripheral vision

Types of Retina Surgery

The specific type of surgery depends on the condition of your retina, such as a retinal detachment, macular hole, or diabetic retinopathy. Common surgical procedures include

• Vitrectomy : This involves removing the vitreous gel from the middle of the eye to access the retina. It's used for conditions like retinal detachment, macular holes, and severe diabetic retinopathy.
  
  
• Scleral Buckle : A silicone band is surgically attached to the outside of the eyeball to gently push the wall of the eye inward, helping to reattach a detached retina.
  
  
• Laser Photocoagulation : A laser is used to create tiny burns to seal retinal tears or to destroy abnormal blood vessels, often used for diabetic retinopathy or minor tears.
  
  
• Pneumatic Retinopexy : A gas bubble is injected into the eye to push a detached retina back into place, often combined with laser or cryopexy.

How HexaHealth Can Help with Retina Surgery

• Expert Surgeon Connect : HexaHealth can connect you with top ophthalmologists and retinal surgeons who specialize in various retina conditions.
  
  
• Advanced Facilities : We partner with hospitals equipped with state-of-the-art technology for precise and successful retina surgeries.
  
  
• Cashless Treatment : With HexaHealth, you can often avail cashless treatment options, making your medical journey smoother.
  
  
• Dedicated Care : Our team provides end-to-end support, from initial consultation to post-operative care, ensuring a hassle-free experience.

Kindly let us know :

• Your City and State.

• What is your retina condition or diagnosis? (For example, retinal detachment, diabetic retinopathy, macular hole, etc.)

Based on these details, we will help you connect with the most suitable experienced Retina Specialist and PM-JAY partner hospital for your treatment.

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