Is knee replacement surgery covered under the Ayushman Bharat scheme?

Dear Ankur Sharma ji

Yes. Total Knee Replacement (TKR) is included under the Ayushman Bharat PM-JAY treatment framework under Orthopaedics.

When Can Knee Replacement Be Required?

Knee replacement is generally considered when severe knee arthritis or joint damage causes

• Persistent or severe knee pain

• Difficulty walking or climbing stairs

• Significant stiffness

• Difficulty performing daily activities

• Pain affecting sleep or quality of life

• Severe joint damage on X-ray

• Insufficient improvement with medicines, physiotherapy and other non-surgical treatments

The orthopaedic surgeon will decide whether total or partial knee replacement is appropriate after examining the patient and reviewing the X-ray and medical history.

How to Check Ayushman Coverage for Knee Replacement

Before going to the hospital, follow these steps

1. Open the official PM-JAY hospital search portal.

2. Select your State.

3. Select your District.

4. Search the exact hospital name.

5. Check whether the hospital's PM-JAY empanelment is currently active.

6. Check whether Orthopaedics/Joint Replacement services are available.

What Documents Should You Carry?

When visiting an Ayushman-empanelled hospital for knee replacement, carry

• Ayushman Bharat Card / e-Ayushman Card

• Aadhaar Card or valid ID proof

• Orthopaedic doctor's prescription

• Recent knee X-ray/MRI reports

• Previous treatment records

• Previous discharge summary, if available

• Recent blood test reports, if available

• Current medication list

• Records of any previous knee surgery, if applicable

These documents help the hospital verify the beneficiary and assess the patient's medical requirement.

Important Precautions Before Knee Replacement

If surgery has been advised

• Do not delay evaluation if pain and mobility are getting worse.

• Continue only those exercises recommended by your doctor or physiotherapist.

• Avoid high-impact activities that increase knee pain.

• Maintain a healthy weight if applicable.

• Keep diabetes and blood pressure under good control before surgery.

• Inform the surgeon about all medicines, especially blood thinners.

• Do not stop blood-thinning or other regular medicines without your doctor's advice.

• Get the pre-operative tests recommended by the surgeon.

If the patient has severe swelling, redness, fever, sudden inability to bear weight, or severe pain after an injury, seek prompt medical evaluation.

We can help you connect with experienced orthopaedic and joint-replacement doctors at partner hospitals and assist with consultation and treatment coordination.

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