Is Fistula Surgery Covered Under Ayushman Bharat Scheme?

Hello,

Yes, anal fistula surgery is  covered under Ayushman Bharat PM-JAY.

How to Check an Ayushman Hospital

Before going to the hospital, follow these steps

1. Open the official PM-JAY Hospital Finder.

2. Select your State.

3. Select your District.

4. Search for the hospital by name.

5. Check that the hospital's PM-JAY empanelment is currently active.

6. Select/check General Surgery or the relevant speciality.

Documents Required

Take these documents with you

• Ayushman Bharat/PM-JAY card or e-Ayushman card

• Aadhaar card or valid ID proof

• Doctor's prescription

• Fistula examination/diagnostic reports, if available

• MRI/fistulogram or other scan reports, if already done

• Previous treatment records

• Previous hospital discharge summary, if available

• Recent blood-test reports, if available

The hospital's Ayushman desk may ask for additional documents during eligibility verification and package approval.

What Treatment Be Needed?

The surgeon will first examine the fistula and determine its location and complexity. Depending on the case, treatment include fistulotomy, seton placement, LIFT or another suitable procedure. MRI may be advised in some complex or recurrent cases.

Please do not choose laser surgery or any particular procedure only because it is advertised as better. The surgeon should decide the appropriate procedure after examination.

How HexaHealth Can Help

HexaHealth is not a hospital. We can help you connect with experienced general surgeons/proctologists at partner hospitals, assist with consultation and appointment booking, and guide you regarding Ayushman documentation and treatment coordination.

Please share your city and state and, if you already have a hospital in mind, its name. We can then help you identify a suitable Ayushman partner hospital for fistula treatment.

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