Is Cashless Treatment Available for Rubber Band Ligation in Bangalore?

Dear Ujjwal Jangra ji,

Yes, you able to get cashless treatment for Rubber Band Ligation (RBL) in Bangalore, but coverage depends on your health insurance policy or Ayushman Bharat (PM-JAY) eligibility. Rubber Band Ligation is a procedure used to treat piles (haemorrhoids). Since it is generally performed as a short outpatient procedure, cashless approval depends on whether your insurer or government scheme covers the procedure under an eligible day-care or surgical package.

Cashless treatment through private health insurance

Many health insurance policies cover eligible day-care procedures, but Rubber Band Ligation is not automatically covered under every policy. Check the following points:

• Day-care coverage: Check whether your policy specifically covers Rubber Band Ligation or the relevant piles treatment package.
• Waiting period: Piles treatment may have a waiting period under individual policies. The applicable period depends on your policy terms.
• Network hospital: Choose a hospital in your insurance company's network.
• Pre-authorisation: The hospital's insurance or TPA desk must send a cashless approval request to your insurer before the procedure.
• Final approval: Cashless treatment is available only after the insurer approves the claim. Non-payable expenses may still have to be paid by you.

Cashless treatment through Ayushman Bharat (PM-JAY)

Yes, Ayushman Bharat may cover eligible piles-related surgical treatment under its approved packages. However, Rubber Band Ligation is not automatically covered just because piles treatment is included. Its eligibility depends on the applicable package, treatment requirements and hospital approval.

• The patient must be eligible for the Ayushman Bharat scheme.
• The hospital must be actively empanelled under PM-JAY in Karnataka.
• The hospital must offer the relevant approved piles treatment package.
• The hospital's Ayushman Mitra must confirm whether Rubber Band Ligation can be performed under that package.
• A quick OPD procedure without eligible hospital admission or package approval not qualify for cashless treatment.

What documents are required?

• Aadhaar Card or valid identity proof
• Ayushman Bharat Card, if applicable
• Health insurance policy card, if applicable
• Doctor's prescription and diagnosis
• Proctoscopy or other investigation reports, if available
• Previous medical records and treatment reports
• Insurance policy details and pre-authorisation documents, if applicable

What should you do to get cashless treatment?

1. Consult a general surgeon or proctologist for examination.
2. Ask the doctor whether Rubber Band Ligation is suitable for your condition.
3. Check whether your hospital is empanelled with your insurance company or PM-JAY.
4. Visit the hospital's insurance or Ayushman help desk with your documents.
5. Ask the hospital to confirm the applicable day-care or surgical package.
6. Get written cashless pre-authorisation or scheme approval before proceeding with the treatment.

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