How to claim Ayushman card benefits for surgery?

Hello,

The Ayushman card is issued under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY), a flagship government scheme designed to provide health coverage to the economically vulnerable sections of society.

Ayushman Card Benefits for Surgery

Yes, absolutely! The Ayushman card is specifically designed to provide significant financial benefits for various medical treatments, including a wide range of surgical procedures. Here's how you can benefit :

• Cashless Treatment : The Ayushman card allows you to avail cashless treatment, including surgeries, at any empanelled hospital across India. This means you do not have to pay anything out of pocket at the time of treatment.
• Comprehensive Coverage : The scheme covers hospitalization expenses up to ₹5 lakh per family per year. This includes not just the surgery cost but also pre-hospitalization expenses (up to 3 days), post-hospitalization expenses (up to 15 days), diagnostics, medicines, doctor's fees, room charges, and intensive care unit (ICU) charges.
• Wide Range of Surgeries : Over 1,949 medical packages are covered under Ayushman Bharat, which includes numerous surgical procedures across specialties such as :

  
  

  • Cardiology (e.g., bypass surgery, angioplasty)
  • Orthopedics (e.g., joint replacements, fracture repairs)
  • General Surgery (e.g., appendectomy, hernia repair)
  • Oncology (cancer surgeries)
  • Urology (e.g., kidney stone removal)
  • Neurosurgery
  • And many more complex and critical surgeries.
• Family Floater Basis: The ₹5 lakh coverage is on a family floater basis, meaning all eligible members of the family can utilize this amount collectively.

How to Avail Benefits for Surgery :

• Eligibility Check : Ensure your family is covered under the Ayushman Bharat PM-JAY scheme. Eligibility is primarily determined by the Socio-Economic Caste Census (SECC) 2011 data for rural and urban areas.
• Empanelled Hospital : Choose a hospital that is empanelled under the Ayushman Bharat scheme. You can usually find a list of these hospitals on the official PM-JAY website or through HexaHealth.
• Verification Process : At the hospital, you will need to present your Ayushman card, e-card, or Aadhaar card for verification. The hospital's Ayushman Mitra (scheme facilitator) will assist you with the admission and cashless claim process.

How HexaHealth Can Help You with Ayushman Bharat Benefits for Surgery

HexaHealth is committed to making quality healthcare accessible. We can assist you in several ways :

• Eligibility Check : We can help you quickly check if you are eligible for the Ayushman Bharat scheme.
• Hospital Network : We have a wide network of empanelled hospitals in India. We can help you find the best hospital for your specific surgery that accepts the Ayushman card.
• Seamless Process : Our dedicated team will guide you through the entire cashless claim process, from admission to discharge, ensuring a hassle-free experience.
• Expert Consultation : We can connect you with top surgeons and specialists who perform surgeries covered under Ayushman Bharat.
• Financial Guidance : Beyond Ayushman Bharat, if needed, we can also help you understand other financial assistance options.

We are here to support you in accessing the best possible treatment with your Ayushman card. Please feel free to reach out to us if you have any further questions or need assistance.

Wishing you relief, safety, and speedy recovery ahead.
Warm regards,
Team HexaHealth