How to proceed with PMJAY card for knee surgery?

Hi,

Thank you for reaching out.

If your father's knee replacement surgery is scheduled at Sancheti Hospital, Pune, and the hospital is empanelled under Ayushman Bharat (PM-JAY), he can avail cashless treatment, provided he is eligible under the scheme and the procedure is covered under the approved PM-JAY package.

Steps to Avail PM-JAY Benefits

1. Inform the Hospital: During the admission or pre-admission process, inform the hospital that your father is an Ayushman Bharat (PM-JAY) beneficiary.

2. Visit the Ayushman Mitra Desk: Most PM-JAY empanelled hospitals have an Ayushman Mitra (Arogya Mitra) desk to assist patients with the verification and admission process.

3. Submit the Required Documents: Keep the following documents ready:

   • Ayushman Bharat (PM-JAY) Card

   • Aadhaar Card or any other valid government-issued ID proof

4. Eligibility Verification: The Ayushman Mitra will verify your father's eligibility through the PM-JAY portal.

5. Pre-Authorization Approval: Once eligibility is confirmed, the hospital will submit a pre-authorization request for the surgery. After approval, the treatment can proceed under the PM-JAY scheme.

6. Cashless Treatment: The approved package generally covers eligible expenses such as:

   • Surgery charges

   • Hospital stay

   • Doctor's fees

   • Diagnostic tests

   • Medicines and consumables covered under the package

7. Discharge: At the time of discharge, ensure you receive the discharge summary and all relevant documents from the hospital.

Important Points to Remember

• Carry the original PM-JAY Card and Aadhaar Card during hospital visits.

• Stay in touch with the Ayushman Mitra for updates on the approval process.

• If you have any questions regarding the coverage or documentation, you can discuss them with the hospital's PM-JAY help desk before the surgery.

How HexaHealth Can Help You

If you need any assistance during the PM-JAY process, HexaHealth is here to support you by:

• Guiding you through the Ayushman Bharat (PM-JAY) cashless treatment process.

• Helping you understand the required documents and eligibility criteria.

• Coordinating with the hospital, if required, to ensure a smoother treatment journey.

• Providing end-to-end support from admission to discharge.

To Help You Better, Kindly Share the Following Details:

• City name

• Medical concern/Treatment needed

• Has the PM-JAY verification been completed at the hospital?

• Has the surgery been scheduled or is it already completed?

• Are you facing any issue with PM-JAY approval, documentation, or the cashless process?

Based on these details, HexaHealth will be happy to guide you through the next steps and help ensure a smooth cashless treatment experience.

Warm regards,
Team HexaHealth

Useful Links:

• Ayushman Bharat Website 

• HexaHealth Ayushman Bharat Hospitals List