Is kidney transplant covered under PM-JAY Ayushman Bharat?

Dear Pankaja N ji,

Kidney transplant surgery is a major treatment, and the cost depends on the hospital, the patient's condition and the donor arrangements.

Yes, PM-JAY provides cashless treatment for approved procedures at authorised hospitals, subject to the scheme's rules.

What is the actual cost of a kidney transplant?

• Under Ayushman Bharat: The general PM-JAY benefit is up to ₹5 lakh per eligible family per year. The amount and services covered for a kidney transplant depend on the applicable package and approval.
  
  
• Hospital expenses: Ask whether the approved package includes the transplant operation, hospital stay, ICU care, medicines and donor-related expenses.
  
  
• After the transplant: Regular check-ups, blood tests and medicines to prevent rejection of the new kidney are important. Ask the hospital which follow-up expenses are covered and for how long.

Do not assume you will have to pay the difference between a hospital's usual price and the approved package rate. Before admission, request a written explanation of what is covered and whether any separate expenses may apply.

How to Check Ayushman empanelled hospital?

1. Open the official PM-JAY hospital search portal
2. Select your state.
3. Select your district.
4. First check the overall list of empanelled hospitals in your district.
5. Select Government or Private, if the option is available.
6. Select the relevant speciality, such as Urology or Nephrology, if available.
7. Search for the exact hospital name.
8. Enter the captcha, if shown.
9. Click Search and confirm that the hospital's empanelment is active.
10. Contact the hospital's Ayushman Mitra desk and confirm that it is authorised for kidney transplantation under PM-JAY, that the transplant package is available, and that the required approval can be obtained.

Which documents should you carry?

• Ayushman Bharat PM-JAY card or beneficiary details.
• Aadhaar card or another valid identity document.
• Kidney specialist's prescription and medical reports.
• Blood tests, kidney function reports and dialysis records, if applicable.
• Previous hospital records, scans and treatment summaries.
• Donor's identity documents and medical reports, if a living donor is being considered.
• Referral letter, if required by the hospital.

The transplant team will also explain the required donor compatibility tests and legal authorisation process. A kidney transplant can proceed only after the necessary medical and legal approvals.

Please share your city and state, and let us know whether the patient is currently on dialysis and whether a donor has been identified. We can guide you on checking the relevant hospitals and scheme details.

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