Is a Colonoscopy Covered Under the Ayushman Bharat Scheme?

Hello,

Yes, colonoscopy is covered under Ayushman Bharat Yojana (PMJAY),

But it is generally not covered as a standalone outpatient (OPD) test. If the colonoscopy is medically required as part of an approved hospitalization or day care treatment package at a PMJAY-empanelled hospital, it can be availed cashlessly after beneficiary verification and treatment package approval.

When Is Colonoscopy Covered Under PMJAY?

A colonoscopy covered when :

• It is performed during hospital admission as part of an approved PMJAY treatment package.

• It is required as a pre-operative or diagnostic investigation for an approved medical or surgical condition, such as lower gastrointestinal bleeding, colorectal diseases, or other eligible gastrointestinal conditions.

• The procedure is carried out at a PMJAY-empanelled hospital.

A standalone OPD colonoscopy without hospital admission is generally not covered under PMJAY.

What Is Covered Under the Approved Package?

Depending on the approved PMJAY package, coverage include :

• Gastroenterologist consultation

• Pre-procedure diagnostic investigations

• Colonoscopy procedure

• Medicines and consumables during hospitalization

• Day care or hospital stay (where applicable)

• Nursing care

• Post-procedure follow-up care

Documents Required

• Ayushman Bharat (PMJAY) Card

• Aadhaar Card

• Doctor's prescription

• Relevant medical reports (if available)

• Previous medical records (if available)

How to Check Whether Colonoscopy Is Available Under PMJAY?

Online Verification

• Visit the PMJAY Hospital Finder.

• Select your:

  • State

  • District

  • Hospital

How HexaHealth Can Assist You

• Ayushman Bharat Guidance: We help you understand the PMJAY eligibility and treatment process.

• Hospital Network: We connect you with trusted PMJAY-empanelled partner hospitals.

• Expert Consultation: We help you connect with experienced gastroenterologists.

• Treatment Coordination: We assist with hospital selection, appointments, documentation, and treatment planning for a seamless experience.

Please let us know which hospital you are referring to and the reason for the colonoscopy and tell your city and state, so we connect to experienced doctors.

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