Does the Ayushman Card Cover Spine Surgery?

Dear Deepika Dhar ji,

Yes, spine surgery is covered under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) .The scheme covers several spine-related surgeries under approved treatment packages at PM-JAY empanelled government and private hospitals.

Coverage depends on your spine condition, the type of surgery required, and the approved PM-JAY package. Before surgery, the hospital will verify your eligibility and obtain the necessary pre-authorisation.

Which Spine Surgeries Are Covered?

Depending on your medical condition, PM-JAY cover approved procedures such as

• Surgery for slipped or herniated disc.

• Spine decompression surgery.

• Laminectomy.

• Discectomy or Microdiscectomy.

• Spinal fusion surgery.

• Surgery for spinal fractures.

• Surgery for spinal deformities such as scoliosis or kyphosis.

• Surgery for certain spinal tumours and other eligible spine conditions.

The exact procedure covered depends on the doctor's recommendation and the approved PM-JAY treatment package.

Symptoms That Require Spine Surgery

Doctor recommend surgery if you have

• Severe back or neck pain that does not improve with treatment.

• Pain spreading to the arms or legs.

• Numbness or tingling in the hands or feet.

• Muscle weakness.

• Difficulty walking or maintaining balance.

• Loss of bladder or bowel control (medical emergency).

• Spine injury or fracture.

• Difficulty performing daily activities because of persistent pain.

Treatment Options Before Surgery

Spine surgery is usually recommended only when other treatments do not provide sufficient relief.

Doctor first advise

• Medicines for pain and inflammation.

• Physiotherapy.

• Lifestyle and activity modifications.

• Epidural or nerve block injections (when appropriate).

If symptoms continue or nerve compression becomes severe, surgery may be the most suitable treatment option.

What Is Covered Under PM-JAY?

Eligible beneficiaries receive coverage for

• Spine surgery under approved PM-JAY packages.

• Hospital admission and room charges.

• Operation theatre charges.

• Anaesthesia charges.

• Standard implants used as per the approved package.

• Medicines and consumables during hospitalisation.

• Diagnostic investigations included in the approved package.

• ICU care, if required.

• Pre-hospitalisation and post-hospitalisation care as per PM-JAY guidelines.

How to Avail Spine Surgery Under Ayushman Bharat

Follow these steps

• Visit a PM-JAY empanelled hospital with a Neurosurgery or Orthopaedics department.

• Meet the Ayushman Mitra (Help Desk).

• Carry your Ayushman Card and Aadhaar Card.

• The specialist will examine your condition and review your MRI or other investigations.

• The hospital will submit a pre-authorisation request for approval.

• Once approved, eligible spine surgery can be performed under the PM-JAY scheme.

How to Check Whether the Hospital Accepts Ayushman Bharat (PM-JAY)?

Before surgery, verify whether the hospital is empanelled under PM-JAY.

Online Verification

• Visit the PM-JAY Hospital Finder.

• Select:

  • State

  • District

  • Hospital Name (or Orthopaedics/Neurosurgery specialty).

• Click Search.

• Confirm that the hospital is PM-JAY empanelled.

How HexaHealth Can Assist You

• Ayushman Bharat Guidance: We help you understand PM-JAY eligibility, coverage, and the spine surgery approval process.

• Specialist Consultation: We help connect you with experienced spine surgeons, neurosurgeons, and orthopaedic specialists.

• Hospital Selection: We help you find PM-JAY empanelled and HexaHealth partner hospitals for spine treatment.

• Treatment Guidance: We explain the available treatment options, surgery, recovery process, and expected outcomes.

• Documentation Support: We guide you on the documents required for PM-JAY verification and pre-authorisation.

• Appointment Assistance: We help coordinate consultations, surgery planning, and hospital appointments.

Please share:

• Your spine condition (such as slipped disc, spinal stenosis, fracture, or another diagnosis).

• Your city and state.

Based on these details, we can help you find a suitable HexaHealth partner hospital or PM-JAY empanelled hospital and guide you through the next steps.

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