Is Laparoscopic Hernia Surgery Fully Covered Under the Ayushman Bharat PM-JAY Scheme?

Hello,

Yes, laparoscopic hernia surgery is covered under Ayushman Bharat PM-JAY.

Which Hernia Procedures Are Covered?

The National Health Authority's PM-JAY package list includes Groin Hernia Repair under General Surgery. It specifically lists :

• Inguinal hernia – open repair

• Inguinal hernia – laparoscopic repair

• Femoral hernia – open repair

• Femoral hernia – laparoscopic repair

The listed package also includes the specified polypropylene mesh under the package.

PM-JAY also has an official treatment guideline for inguinal hernia.

What Not Be Covered?

Routine OPD care is generally not covered under PM-JAY. Cosmetic treatment and certain other excluded services are also outside the scheme.

For hernia treatment, expenses may also need separate confirmation if they involve something outside the approved package, such as:

• A non-standard or special material not included in the package

• Room upgrade or upgraded accommodation

• Treatment that is not part of the approved hernia package

• Services or procedures unrelated to the covered treatment

Do not pay any additional amount without first asking the hospital to explain why it is being charged and whether it is outside the PM-JAY package.

How to Check the Ayushman Empanelled Hospital?

1. Open the official PM-JAY Hospital Search portal.

2. Select your State.

3. Select your District.

4. Select Government or Private Hospital.

5. Select General Surgery or the relevant specialty.

6. Enter the exact hospital name.

7. Complete the Captcha, if shown.

8. Click Search.

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

10. Visit the hospital's Ayushman Mitra/PM-JAY desk with your diagnosis and doctor's treatment advice. Ask them to confirm the exact laparoscopic hernia package, mesh coverage and whether pre-authorization is required.

You can also check the overall list of PM-JAY empanelled hospitals in your district. PM-JAY allows eligible beneficiaries to receive treatment outside their home state at empanelled hospitals under portability.

Documents to Carry

• Ayushman Card

• Aadhaar Card

• Doctor's prescription or surgical advice

• Ultrasound/CT scan or other hernia reports, if available

• Blood test reports

• Previous hospital or treatment records

• Current medicines and medical history

• Mobile phone for verification/OTP, if required

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