Is Cashless Treatment Available for Umbilical Hernia Repair in Kolkata?

Dear Suraj Sharma ji,

Yes, cashless treatment for umbilical hernia repair is available in Kolkata through private health insurance or an eligible Ayushman Bharat card. However, approval depends on your insurance policy or government scheme eligibility, the hospital's empanelment, and whether the procedure is covered under the applicable package.

Is umbilical hernia repair covered under health insurance?

Yes, it is generally covered when medically necessary, subject to your policy terms and conditions. An umbilical hernia occurs when tissue pushes through a weak area near the belly button. A doctor may recommend repair if the hernia causes pain, grows larger, or creates other problems.

Can you get umbilical hernia repair under the Ayushman Bharat card?

Yes, it is covered under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) if you are eligible and the required hernia repair procedure is included in the applicable package at an active empanelled hospital.

• Coverage limit: PM-JAY provides eligible families with cashless hospital treatment coverage of up to ₹5 lakh per year on a family-floater basis.
• Hospital requirement: The hospital must be empanelled under the scheme for the relevant treatment.
• Package approval: The hospital's Ayushman help desk must confirm that your specific umbilical hernia repair is covered and obtain the required approval.
• Eligible expenses: Covered treatment expenses are paid according to the approved package and scheme rules.
• Eligibility check: Having an Ayushman card alone does not guarantee approval for every procedure. Your eligibility and the applicable package must be verified.

How can you check an Ayushman empanelled hospital?

1. Open the official PM-JAY hospital search portal.
2. Select West Bengal as your state.
3. Select Kolkata as your district.
4. View the overall list of empanelled hospitals for the district.
5. Choose the appropriate hospital type, such as government or private.
6. Select the relevant specialty or treatment category, if available.
7. Search for the hospital you want to visit.
8. Complete the captcha, if requested, and click Search.
9. Check the hospital's current empanelment status and confirm whether it handles the required hernia treatment package.
10. Before admission, contact the hospital's Ayushman help desk to verify package availability and approval requirements.

What documents should you keep ready?

• Ayushman card or health insurance card.
• Aadhaar card or another accepted identity document.
• Doctor's prescription and advice for hernia repair.
• Ultrasound reports or other investigation results, if available.
• Previous medical records and prescriptions.
• For private insurance, your policy details and any documents requested by the insurer.

If you have private health insurance, call your insurer or TPA and confirm the hernia waiting period, network hospital status, and cashless approval process before admission. If you have an Ayushman card, verify your eligibility and ask the hospital's Ayushman help desk whether umbilical hernia repair is covered under the applicable package. Do not assume that cashless treatment is approved until confirmation is received.

Important: If you develop sudden severe pain near the hernia, vomiting, or a hernia bulge that becomes hard or cannot be pushed back in, seek urgent medical care.

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