Are dermatology conditions covered under the PMJAY scheme?

Dear Sir/Mam,

Thank you for reaching out with your question about Pradhan Mantri Jan Arogya Yojana (PMJAY), also known as Ayushman Bharat. It's a significant government scheme providing health coverage to vulnerable families.

Dermatology Services Under PMJAY

PMJAY primarily focuses on covering secondary and tertiary care hospitalizations, which means it covers medical and surgical treatments that require admission to a hospital. While routine dermatology consultations or cosmetic procedures are generally not covered, certain dermatology-related conditions might be eligible if they lead to hospitalization or require specific surgical interventions.

What Might Be Covered:

• Severe Skin Infections: If a severe skin infection, like cellulitis or abscess, requires hospitalization for intravenous antibiotics or surgical drainage.
• Certain Skin Cancers: Diagnosis and treatment of malignant skin conditions, including biopsies and surgical removal, if they necessitate inpatient care.
• Severe Burns: Treatment for extensive burns, including reconstructive surgeries, which often require prolonged hospital stays.
• Connective Tissue Diseases: Management of severe autoimmune skin conditions (e.g., Pemphigus, Steven-Johnson syndrome) that require hospitalization for specialized treatment.
• Reconstructive Surgeries: Surgeries to correct disfigurements resulting from skin diseases, injuries, or previous treatments, if they are medically necessary and fall under PMJAY packages.

What is Generally Not Covered:

• Outpatient consultations for minor skin issues.
• Cosmetic dermatology procedures (e.g., anti-aging treatments, hair transplant).
• Routine check-ups or medication prescriptions for chronic but stable skin conditions that do not require hospitalization.

The key factor for coverage under PMJAY is whether the dermatology condition requires hospitalization or a pre-defined surgical package. It's always recommended to confirm with a PMJAY empanelled hospital or the official helpline for specific treatment eligibility.

How to Check Ayushman-Empanelled Hospitals (Step-by-Step)

1. Visit: https://hospitals.pmjay.gov.in

2. Select State

3. Select District

4. Choose Hospital Type → Hospital

5. Click Search
   You will get the list of hospitals where dermatology services can be done under Ayushman.

How HexaHealth Can Support You

• Eligibility Check: We can help you understand if your family is eligible for the Ayushman Bharat scheme.
• Hospital Network: HexaHealth has a network of empanelled hospitals where you can avail of PMJAY benefits for covered treatments.
• Guidance & Assistance: Our team can guide you through the process of availing benefits under government schemes for your medical needs.
• Doctor Consultation: We can connect you with specialists who can assess your condition and advise on the most appropriate course of action, aligning with PMJAY guidelines where applicable.