Kidney Stones Surgery: Is it Covered by ABHA Health Insurance?

Hello,

Kidney stone surgery is covered under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) scheme. Eligible beneficiaries can avail of cashless treatment for kidney stone removal at any empanelled hospital across India. The scheme covers various procedures, including non-invasive treatments like lithotripsy and surgical interventions such as ureteroscopy and percutaneous nephrolithotomy (PCNL), depending on the medical necessity.

Steps to Avail Kidney Stone Surgery Under Ayushman Bharat

1. Verify Eligibility:

   • Ensure your brother is a registered beneficiary under the Ayushman Bharat scheme.

   • Check eligibility on the PM-JAY Beneficiary Portal.

2. Locate an Empanelled Hospital:

   • Use the PM-JAY Hospital Finder to find empanelled hospitals in Mahabubnagar or nearby areas.

3. Prepare Necessary Documents:

   • Ayushman Bharat card or PM-JAY family ID

   • Aadhaar card

   • Previous medical reports, including MRI, CT scan, and ultrasound

4. Visit the Hospital:

   • Approach the Ayushman Bharat helpdesk at the hospital.

   • Present the necessary documents and discuss your brother's condition.

5. Undergo Pre-Authorization Process:

   • The hospital will initiate the pre-authorization request under the Ayushman Bharat scheme.

   • Upon approval, the treatment will proceed without any out-of-pocket expenses.