Does Ayushman card cover vascular surgery costs fully or partially?

Hello

Blood vessel-related conditions can affect circulation, cause pain, swelling, ulcers, or other serious health issues. If your doctor has advised vascular surgery, it is natural to ask whether the treatment can be done through the Ayushman Bharat , PMJAY scheme and whether the entire cost will be covered.

Can Vascular Surgery Be Done Through Ayushman Card?

Yes, selected vascular surgery procedures may be covered under Ayushman Bharat  Card if :

• The patient is eligible under PMJAY

• The hospital is PMJAY empanelled

• The procedure is medically necessary

• The required package approval is obtained

PMJAY includes packages under Cardio-thoracic & Vascular Surgery, among other specialties.

Is the Treatment Fully Covered or Partially Covered?

In PMJAY-approved hospitals, covered procedures are generally provided on a cashless basis under the approved package. PMJAY package rates are designed to include :

• Hospital admission

• Surgeon fees

• Operation theatre charges

• Nursing care

• Medicines during hospitalization

• Diagnostic tests related to the procedure

• Hospital stay

• Certain pre- and post-hospitalization expenses

These costs are bundled into the approved package.

However, the final coverage depends on :

• The exact vascular condition

• The approved PMJAY package

• Hospital empanelment status

• Medical evaluation and authorization

Which Conditions May Require Vascular Surgery?

Doctors may recommend vascular surgery for conditions such as :

• Varicose veins

• Peripheral artery disease

• Blocked blood vessels

• Certain aneurysms

• Other circulation-related disorders

The exact treatment plan depends on the patient's diagnosis and specialist evaluation.

Which Doctor Should You Consult?

Treatment is usually managed by :

• Vascular Surgeon

• Cardio-thoracic & Vascular Surgeon

• Interventional Specialist

Doctors may recommend :

• Doppler ultrasound

• CT angiography

• Blood tests

• Other vascular investigations

Documents Usually Required

Please keep ready :

• Ayushman / PMJAY card

• Aadhaar card

• Medical reports

• Doctor prescriptions

• Previous treatment records (if available)

How to Check PMJAY Hospitals?

Verification Steps

• Visit Ayushman Bharat Official Portal
• Open the "Find Hospital" section
• Select :
  • State
  • District
  • Specialty

Nearby PMJAY empanelled hospitals can be checked there.

Total or Partial Cost Coverage 

• The Ayushman Card aims to cover the total cost of the approved treatment package, including vascular surgery, up to the maximum limit of ₹5 lakh per family per year.
• If the total cost of the procedure and associated care falls within this ₹5 lakh limit, it is entirely covered, making the treatment cashless for the beneficiary.
• However, if the treatment cost exceeds the ₹5 lakh annual limit, the beneficiary would be responsible for the amount beyond this cap.

How HexaHealth Can Assist You 

• Ayushman Card Support : We can help you understand your eligibility, verify your Ayushman Card details, and guide you through the process of availing benefits for vascular surgery.
• Empanelled Hospitals : We can connect you with top hospitals in your city that are empanelled under the Ayushman Bharat scheme and offer excellent vascular surgery facilities.
• Expert Consultations : Get access to experienced vascular surgeons and specialists for consultation and treatment planning.
• Seamless Treatment Journey : From hospital selection and appointment booking to discharge, HexaHealth supports you at every step to ensure a smooth and hassle-free experience.

Wishing you good health and a smooth treatment journey ahead.
Warm regards,
Team HexaHealth