Does Ayushman Bharat cover treatment for pemphigus and connective tissue diseases?

Hello,

Yes, treatment for pemphigus and some connective tissue diseases is covered under Ayushman Bharat PM-JAY

What Treatment Be Covered?

• Hospitalisation: Treatment for a severe flare-up, complications, or a serious condition requiring admission may be covered under an applicable package.

• Hospital treatment expenses: For an approved package, the covered expenses can include hospitalisation-related treatment, investigations, medicines, nursing and doctor charges as specified under the package.

• Pre- and post-hospitalisation: Applicable expenses before and after hospitalisation may be covered according to the PM-JAY package rules.

• Pre-existing disease: PM-JAY does not generally impose a waiting period for pre-existing conditions, subject to scheme eligibility and the applicable package.

What Not Be Covered?

• Routine OPD treatment: Regular consultations, follow-ups and medicines for a condition that does not require hospitalisation may not be covered.

• Cosmetic treatment: Treatment done only to improve appearance, without a medical need, is generally not covered.

How to Check Ayushman Empanelled Hospital?

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

2. Select your State.

3. Select your District.

4. Choose Government or Private Hospital.

5. Select Dermatology or the relevant specialty, if available.

6. Search for the exact hospital name.

7. Complete the captcha, if shown.

8. Click Search.

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

10. Visit the hospital's Ayushman Mitra/PM-JAY desk with the diagnosis and doctor's treatment plan. Ask them to check whether the specific pemphigus or connective tissue disease treatment is covered under an applicable PM-JAY package and whether pre-authorisation is required.

You can also check your district's list of PM-JAY empanelled hospitals.

Documents to Carry

• Ayushman Card

• Aadhaar Card or another valid identity document

• Dermatologist/rheumatologist's prescription

• Diagnosis and biopsy or other investigation reports, if available

• Previous medical and hospital records

• Current medicines and prescriptions

• Doctor's advice for hospitalisation, if recommended

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