Hello,

When hernia surgery is advised, it is natural to be concerned about treatment expenses and whether the Ayushman Bharat – PMJAY scheme will cover the costs. Many patients want to know how much they may need to pay personally.

Is Hernia Surgery Covered Under the Ayushman Card?

Yes, if :

• The patient is eligible under Ayushman Bharat – PMJAY
• The hospital is empanelled under PMJAY
• Hernia surgery is medically necessary
• The required package approval is completed

then eligible hernia surgery packages may be available under cashless treatment at PMJAY-empanelled hospitals.

How Much Expense Does the Patient Have to Bear?

If the hernia surgery package is approved under PMJAY and the treatment is received at a PMJAY-empanelled hospital, the eligible package expenses are generally covered by the scheme.

However, the exact out-of-pocket expense, if any, may depend on :

• The approved PMJAY package
• Hospital policies
• Additional services or items not covered under the package
• Medical condition and treatment requirements

The hospital's Ayushman help desk can provide the most accurate information for your specific case before admission.

Which Doctors Usually Treat Hernia?

Treatment is usually managed by :

• General Surgeon
• Laparoscopic Surgeon
• Gastro Surgeon

Doctors may recommend :

• Physical examination
• Ultrasound (if required)
• Blood tests
• Other pre-operative investigations

Documents Usually Required

Please keep these documents ready :

• Ayushman / PMJAY card
• Aadhaar card
• Doctor prescription
• Investigation reports
• Previous treatment records (if available)

How to Check PMJAY Hospitals?

Verification Steps

• Visit Ayushman Bharat Official Portal
• Open the "Find Hospital" section
• Select :
  • State
  • District
  • Specialty – General Surgery

Typical Symptoms of a Hernia

• A visible bulge or lump in the abdomen or groin area, which might become more prominent when coughing, straining, or standing.
• Pain or discomfort in the affected area, especially when bending over or lifting.
• Aching sensation or a feeling of heaviness.
• Sometimes, no symptoms at all, discovered during a routine check-up.

Understanding Hernia Treatment Options

Surgical Intervention : Hernia repair is primarily a surgical procedure. The goal of surgery is to push the bulging tissue back into place and strengthen the weakened area of the muscle wall.

• Open Surgery : Involves a single incision near the hernia site.
• Laparoscopic Surgery : A minimally invasive procedure using small incisions and a camera.

How HexaHealth Can Assist You

• Ayushman Bharat Assistance : We can help you verify your eligibility and understand the complete coverage for hernia surgery under your Ayushman Bharat card.
• Hospital Network : HexaHealth partners with numerous hospitals across India that are empaneled under the Ayushman Bharat scheme, ensuring you receive quality care without financial burden.
• Expert Consultation : We can connect you with experienced surgeons specializing in hernia repair, guiding you through both open and laparoscopic surgical options.
• Seamless Experience : From booking appointments to hospital admission and discharge, our team provides end-to-end support, making your treatment journey hassle-free. Our aim is to provide access to high-quality treatment with benefits like cashless claims and dedicated care coordinators.

If you or your family member needs assistance with hernia surgery and leveraging the Ayushman Bharat scheme, please feel free to reach out to us.

Wishing the patient a smooth treatment journey and speedy recovery.
Warm regards,
Team HexaHealth