Is robotic surgery covered under the Ayushman Bharat scheme?

Hello,

No, robotic surgery as a specific category is not universally covered under the Ayushman Card, but the basic medical procedure itself is covered. This is a real, officially recognized ga in fact, at least one state (Gujarat) has launched its own separate top-up scheme specifically because robotic surgery costs beyond what PM-JAY covers were going unpaid for patients.

The Ayushman Bharat scheme (PM-JAY) pays for fixed treatment packages, and it does not have a separate, dedicated budget for advanced "robotic charges." The exact coverage depends on the approved PM-JAY package, hospital, and procedure.

How Does Ayushman Coverage Work?

• The main medically required treatment is covered if it is included in an approved PM-JAY package.
• PM-JAY package rates generally include hospitalisation, doctors' fees, OT charges, medicines, implants and other treatment-related expenses included in the package.
• However, you should not assume that a separate robotic or technology charge will be paid by Ayushman.
• Whether a robotic-assisted technique can be provided under the applicable package must be confirmed by the hospital's Ayushman desk.

If Robotic Surgery Isn't Covered, There Are Fallback Options

• Some states have launched their own separate top-up schemes for gaps like this (as Gujarat has for robotic surgery and organ transplants specifically)  worth asking your State Health Agency if something similar exists where you live.

How to Check Before Treatment

1. Visit a PM-JAY-empanelled hospital.
2. Go to the Ayushman Mitra/Ayushman help desk.
3. Show your Ayushman Card and medical reports.
4. Give the exact name of the treatment advised by the doctor.
5. Ask whether the procedure has an applicable PM-JAY package.
6. Specifically ask whether the robotic approach is covered under that package.
7. Ask whether any robotic or technology charges are payable separately.
8. Confirm whether pre-authorisation has been approved.
9. Ask for clarification of any amount that the hospital says you must pay.
10. If there's a genuine coverage gap, ask about state-specific top-up schemes or RAN assistance.
11. Proceed with treatment only after understanding the coverage and payment requirements.

How to Check the Hospital

1. Open the official PM-JAY Hospital Search portal.
2. Select your State.
3. Select your District.
4. Select the Hospital Type Government or Private.
5. Select the relevant Speciality for the required treatment.
6. Enter the hospital name, if you already have one in mind.
7. Enter the Captcha.
8. Click Search.
9. Check whether the hospital is currently listed as PM-JAY empanelled.
10. Contact the hospital's Ayushman Mitra/help desk and specifically ask whether the robotic-assisted approach is covered under the applicable package, or if a separate/additional amount would be charged for it.

Documents to Carry

Keep these documents ready:

• Ayushman Bharat PM-JAY Card
• Aadhaar Card or valid government ID
• Doctor's prescription
• Medical reports and scans
• Previous treatment records
• Blood test reports, if available
• Written recommendation for robotic treatment, if provided
• Income/BPL certificate, if applying for RAN assistance

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