Is hernia surgery covered by insurance and how much is covered?

Dear Santosh Wadhawan Ji,

Yes, hernia surgery is covered under Ayushman Bharat Yojana (PMJAY). she can avail cashless hernia surgery at a PMJAY-empanelled hospital after beneficiary verification and treatment package approval.

How Much Is Covered?

Under Ayushman Bharat (PMJAY), eligible families receive health insurance coverage of up to ₹5 lakh per family per year for approved secondary and tertiary care treatments. The actual amount covered for hernia surgery depends on the PMJAY package applicable to your mother's condition and the type of surgery performed, and the hospital submits the claim as per the approved package rates.

What Is Covered Under Ayushman Bharat for Hernia Surgery?

As per the approved PMJAY package, coverage include

• General Surgeon consultation

• Pre-operative evaluation and diagnostic investigations

• Hernia surgery (Open or Laparoscopic, as medically advised)

• Operation theatre charges

• Surgeon and anaesthetist charges

• Surgical mesh (as covered under the approved PMJAY package)

• Medicines and consumables during hospitalization

• Hospital stay

• Nursing care

• Post-operative follow-up care

Documents Required

• Ayushman Bharat (PMJAY) Card

• Aadhaar Card

• Doctor's prescription

• Relevant medical reports (if available)

• Previous medical records (if available)

How to Check Whether Hernia Surgery Is Available Under PMJAY?

Online Verification

• Visit the PMJAY Hospital Finder.

• Select your:

  • State

  • District

  • Specialty: General Surgery

• Click Search to view PMJAY-empanelled hospitals.

How HexaHealth Can Assist You

• Ayushman Bharat Guidance: We help you understand the PMJAY eligibility and treatment process.

• Hospital Network: We connect you with trusted PMJAY-empanelled partner hospitals offering hernia surgery.

• Expert Consultation: We help you consult with experienced general surgeons.

• Treatment Coordination: We assist with hospital selection, appointments, documentation, and treatment planning for a seamless experience.

Please let us know your city and state. We will help you connect with an experienced doctor and the best PMJAY-empanelled hospital for her treatment.

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