Is Hip Replacement Surgery Covered Under the Ayushman Bharat Scheme?

Dear Rohit Sadanand Rahate ji,

Yes, hip replacement treatment is available under the Ayushman Bharat (PM-JAY) scheme.

What are the benefits of Ayushman Card for hip replacement?

• Cashless treatment: Eligible patients can receive treatment without paying separately for services covered under the approved package.
• Hip replacement procedure: The surgery may be covered if it is medically required and included in the approved package.
• Hospital expenses: Eligible surgeon fees, operation theatre charges and hospital stay may be included in the package.
• Medicines and investigations: Required medicines, diagnostic tests and other services may be covered according to package rules.
• Annual health cover: PM-JAY provides eligible families with health cover of up to ₹5 lakh per year for covered hospital treatments. This is the overall family cover, not a separate amount for hip replacement.

How to Check Ayushman empanelled hospital?

Follow these steps to find a hospital offering hip replacement under Ayushman Bharat

1. Visit the official Ayushman Bharat Empanelled Hospital Search Portal.
2. Select your state.
3. Select your district.
4. View the list of PM-JAY empanelled hospitals in your district.
5. Select the hospital type, such as Government or Private.
6. Choose the relevant specialty, such as Orthopaedics, if available.
7. Search for the exact hospital name.
8. Enter the captcha displayed on the screen.
9. Click on Search.
10. Check whether the hospital's empanelment is active. Contact its Ayushman help desk to confirm whether hip replacement is available under an approved package, whether the implant is included and whether prior authorization is required.

Documents required for hip replacement treatment

• Ayushman Bharat Card, if available.
• Aadhaar Card or another valid photo ID.
• Doctor's prescription and orthopaedic consultation papers.
• X-ray, MRI, CT scan or other relevant reports, if available.
• Blood test and other investigation reports, if available.
• Previous treatment records or hospital discharge summaries, if applicable.
• Referral letter, if required by the hospital.

Consult an orthopaedic specialist to confirm whether hip replacement is necessary. Then visit an empanelled hospital with your Ayushman Card and medical reports. Ask the hospital to verify your eligibility and obtain package approval before treatment.

Please share your city and state so we can help you find suitable hospitals in your area that may provide hip replacement treatment under the Ayushman Bharat scheme.

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