Is Surgery for a Large Chest Lump Covered Under the Ayushman Bharat PM-JAY Scheme?

Hello,

Yes, your father's surgery is covered under the Ayushman Bharat (PM-JAY) scheme, provided the required surgery is available under an approved package and the hospital is currently empanelled under the scheme.

Since your father is 82 years old and already has an Ayushman card, his age will not prevent him from receiving eligible treatment. People aged 70 years and above are also eligible for Ayushman Vay Vandana benefits, irrespective of their income.

The orange-sized lump below his left arm, near the left side of his chest, needs to be examined by a doctor. It could be a lipoma (a fatty lump), cyst, enlarged lymph node or another type of growth. The exact diagnosis will decide what treatment or surgery is required.

How to Check Ayushman empanelled hospital?

Follow these steps to find a hospital where your father can receive treatment

1. Visit the official Ayushman Bharat hospital search portal.
2. Select your state.
3. Select your district.
4. Check the list of empanelled hospitals.
5. Select Government or Private hospital, as applicable.
6. Select General Surgery as the specialty, if available.
7. Enter the hospital name if you want to check a particular hospital.
8. Enter the captcha shown on the screen.
9. Click on Search.
10. Confirm with the hospital's Ayushman Mitra desk whether the hospital is actively empanelled and whether your father's recommended lump-removal surgery is covered under an approved package.

Steps to Get Cashless Treatment

1. Take your father to an empanelled hospital and consult a general surgeon.
2. The doctor will examine the lump and may advise an ultrasound, scan or biopsy, depending on the findings.
3. Ask the doctor to provide the diagnosis and treatment or surgery advice.
4. Visit the Ayushman Mitra help desk inside the hospital.
5. Show your father's Ayushman card and identity proof.
6. Submit the medical reports and doctor's prescription.
7. The hospital will check the applicable package and submit a pre-authorisation request, if required.
8. Once approved, eligible treatment expenses will be covered cashlessly according to scheme rules.

Documents Required

Please keep these documents ready

• Your father's Ayushman Bharat card.
• Aadhaar card or another valid government identity proof.
• Registered mobile number.
• Doctor's prescription and surgery or admission advice.
• Ultrasound, CT scan or other reports, if available.
• Biopsy or FNAC report, if already performed.
• Previous treatment records and discharge summaries, if any.

Please do not delay the doctor's examination because the lump is large. If it is growing quickly, painful, red or associated with fever, get it checked promptly. The doctor should decide whether surgery is needed and how urgently it should be done.

Please share your city and state, and let us know whether your father has already consulted a doctor or received a diagnosis such as lipoma. We can help you identify hospitals where you can check the availability of cashless treatment under Ayushman.

Wishing your father a speedy recovery and your family good health always.
Warm regards,
Team HexaHealth