Is ACL Ligament Surgery Available Free of Cost Under the Ayushman Card?

Hello,

Yes, ACL ligament reconstruction is covered under the Ayushman Bharat PM-JAY scheme. The official PM-JAY package list includes “Reconstruction of Cruciate Ligament with implant and brace” for the anterior cruciate ligament (ACL). The listed package includes the specified implant and brace.

Proper Steps to Get ACL Treatment Through Ayushman Card

1. Open the official PM-JAY Hospital Search portal.

2. Select your State.

3. Select your District.

4. Select Government or Private Hospital.

5. Select Orthopaedics or the relevant specialty.

6. Enter the exact hospital name.

7. Complete the Captcha, if shown.

8. Click on Search.

9. Check that the hospital's PM-JAY empanelment is active.

10. Visit the hospital's Ayushman Mitra/PM-JAY desk with your ACL diagnosis and doctor's treatment advice. Ask them to confirm that ACL reconstruction is covered, the implant and brace are included, and whether pre-authorization is required.

The official PM-JAY system provides treatment through empanelled hospitals, and treatment can also be taken outside the beneficiary's home state at an empanelled hospital under portability.

Documents You Should Carry

• Ayushman Card

• Aadhaar Card

• Doctor's prescription or orthopaedic consultation

• MRI report of the knee

• X-ray reports, if available

• Blood test reports, if advised

• Previous treatment or hospital records

• Current medicines and medical history

• Mobile phone for verification, if required

What Is Covered in the ACL Package?

The official package list includes :

• ACL reconstruction

• The applicable implant for ACL reconstruction

• Brace specified under the package

The exact package and included items should be confirmed with the hospital before admission.

What Not Be Covered?

Expenses outside the approved PM-JAY package may not be covered. For example, ask the hospital specifically about:

• Any special or additional implant not included in the package

• Non-covered investigations or services

• Room upgrade

• Treatment unrelated to the approved ACL package

PM-JAY generally covers treatment according to approved packages, and a room upgrade can result in treatment expenses not being covered under the scheme.

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