How to get hernia surgery covered by PMJAY Ayushman Card?

Hello,

A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. It's great that you're looking into using your PMJAY Ayushman Card for your hernia surgery. Here's how you can access this benefit

Yes, hernia surgery may be covered under Ayushman Bharat PM-JAY, provided you are eligible under the scheme, the hospital is PM-JAY empanelled, and the surgery is medically necessary as advised by the doctor.

How Can You Get Hernia Surgery Under PM-JAY?

Step 1: Check Your Eligibility

• Ensure your Ayushman Card is active and valid.

• Keep your Ayushman Card and Aadhaar Card ready.

Step 2 : Find a PM-JAY Empanelled Hospital

• Visit the Ayushman Bharat hospital search portal.

• Select your State and District.

• Choose General Surgery as the specialty.

• Check the list of PM-JAY empanelled hospitals.

Step 3 : Consult a Surgeon

• Visit the hospital and meet a General Surgeon.

• The doctor will examine you and confirm the type of hernia and whether surgery is required.

Step 4 : Document Verification

Usually required documents include :

• Ayushman / PM-JAY Card

• Aadhaar Card

• Doctor's prescription

• Ultrasound or other medical reports (if available)

• Previous medical records

Step 5  : Approval Process

• The hospital's Ayushman Help Desk will verify your eligibility.

• The required surgery package will be submitted for approval.

Step 6 : Cashless Treatment

• Once approved, the hernia surgery and hospitalization may be provided on a cashless basis under the PM-JAY package.

What May Be Covered?

Depending on the approved package :

• Surgeon consultation

• Pre-surgery investigations

• Hernia surgery procedure

• Hospital stay

• Medicines during hospitalization

• Nursing and related medical services

How to Verify a Hospital?

Verification Steps

1. Open the Ayushman Bharat hospital search page.

2. Select :

   • State

   • District

   • Specialty : General Surgery

3. Search for empanelled hospitals.

4. Contact the hospital's Ayushman Help Desk and confirm hernia surgery package availability.

Alternative Verification

• Call the Ayushman Helpline at 14555.

• Contact the hospital directly.

Hospital empanelment, treatment packages, and coverage availability may change over time. Therefore, please verify the latest details with the hospital before admission.

Understanding Hernia and Its Treatment

• Common Symptoms : A visible bulge (especially when standing or straining), pain or discomfort in the affected area, and a feeling of heaviness.
  
  
• Treatment : Hernia surgery is primarily a surgical procedure to repair the weakened muscle wall and return the organ to its proper place. This can be done through
  
  
  • Open surgery : A single, larger incision is made near the hernia, and the weakened muscle wall is repaired, often with a mesh.
    
    
  • Laparoscopic surgery : Several small incisions are made, and a laparoscope (a thin, lighted tube with a camera) and surgical instruments are used to repair the hernia, also often with a mesh. HexaHealth can help you find hospitals specializing in minimally invasive laparoscopic hernia repair, often leading to faster recovery times and less post-operative discomfort. 

How HexaHealth Can Assist You

• Eligibility Check : We can help you check your PMJAY Ayushman Card eligibility quickly.
  
  
• Hospital Network : We can connect you with top hospitals in your area that are empanelled under the Ayushman Bharat scheme and have experienced surgeons for hernia repair.
  
  
• Doctor Consultations : We can help you book appointments with leading general surgeons and surgical gastroenterologists.
  
  
• Seamless Process : Our team will guide you through the entire pre-authorization and admission process, ensuring a smooth and hassle-free experience for your surgery under Ayushman Bharat.
  
  
• Care Coordinator : You'll have a dedicated care coordinator to assist you at every step, from diagnosis to post-operative care.

Please reach out to us, and we'll be happy to guide you further and ensure you receive the best care for your hernia surgery under the Ayushman Bharat scheme.

Please share your city/state, and we can provide more specific guidance regarding nearby PM-JAY hospitals.

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