Is kidney stone surgery covered under the PMJAY Yojana scheme?

Hello,

Kidney stone surgery involves various procedures to remove kidney stones that cannot pass naturally. It can cause severe pain and discomfort.  It is natural to want to know whether the surgery can be done using your Ayushman Bharat PMJAY Card.

Is Kidney Stone Surgery Covered Under PMJAY?

Yes, if :

• The patient is eligible under Ayushman Bharat – PMJAY

• The hospital is PMJAY empanelled

• The surgery is medically required

• The required package approval is obtained

then kidney stone treatment and eligible surgical procedures may be available on a cashless basis under the scheme.

Which Procedures May Be Covered?

Depending on the stone size, location, and doctor's assessment, treatment may include : 

• RIRS (Retrograde Intrarenal Surgery)

• URSL/URS

• PCNL

• DJ Stenting

• Other approved urology procedures

Final approval depends on :

• Patient eligibility

• Hospital empanelment status

• PMJAY package availability

• Urologist's assessment

Which Doctor Should You Consult?

Treatment is usually managed by :

• Urologist

• Kidney Stone Specialist

What Should You Confirm With the Hospital?

Please ask

• Is PMJAY active in the hospital?

• Is kidney stone surgery available?

• Is the procedure covered under PMJAY?

• Is cashless treatment possible?

• Is pre-authorisation required?

Documents Usually Required

• Ayushman / PMJAY Card

• Aadhaar Card

• Ultrasound/CT Scan reports

• Doctor prescription

• Previous medical records

How to Check PMJAY Hospital Status?

Verification Steps

• Visit Ayushman Bharat Official Portal

• Open the "Find Hospital" section

• Select :

  • State

  • District

  • Specialty – Urology

Alternative Verification

• Call the Ayushman Bharat Helpline: 14555

• Contact the hospital's Ayushman Help Desk directly

• Verify kidney stone surgery package availability before admission

Common Symptoms of Kidney Stones

Before considering surgery, it's important to recognize the symptoms of kidney stones. These can include

• Severe pain in the side and back, below the ribs (often referred to as renal colic)
  
  
• Pain that radiates to the lower abdomen and groin
  
  
• Pain that comes in waves and fluctuates in intensity
  
  
• Painful urination
  
  
• Pink, red, or brown urine (indicating blood in urine)
  
  
• Cloudy or foul-smelling urine
  
  
• Nausea and vomiting
  
  
• Persistent urge to urinate
  
  
• Fever and chills if an infection is present (alarming symptom)
  
  
• Inability to pass urine (alarming symptom)

Surgical Treatment Options for Kidney Stones

When stones are too large to pass on their own, or cause severe pain, blockage, or infection, surgery may be recommended. Some common surgical procedures include

• Extracorporeal Shock Wave Lithotripsy (ESWL) : This non-invasive procedure uses shock waves to break kidney stones into tiny pieces that can then be passed in the urine. It's often suitable for smaller stones.
  
  
• Ureteroscopy (URS) : A thin, lighted scope is passed through the urethra and bladder into the ureter to locate and remove or break up stones using a laser. This is effective for stones in the ureter or lower kidney. HexaHealth connects you with specialists who use advanced laser technology for precise and minimally invasive URS procedures, ensuring faster recovery.
  
  
• Percutaneous Nephrolithotomy (PCNL) : For very large or complex kidney stones, a small incision is made in the back to directly access the kidney and remove the stone. This procedure offers a high success rate for significant stone burdens. With HexaHealth, you can access experienced surgeons who perform PCNL with minimal discomfort and comprehensive post-operative care.
  
  

How HexaHealth Can Help with Kidney Stone Surgery and PM-JAY

Navigating healthcare can be complex, especially with government schemes. HexaHealth is here to simplify your journey

• Expert Consultation : We can connect you with top urologists and nephrologists specializing in kidney stone management, helping you understand your condition and the best treatment options.
  
  
• PM-JAY Assistance: Our team can guide you through the eligibility criteria and the process of availing cashless treatment for kidney stone surgery under the Ayushman Bharat Yojana. We help identify empanelled hospitals and manage the documentation.
  
  
• Hospital and Doctor Selection: We assist in choosing the right hospital and surgeon that meet your specific needs and are covered under PM-JAY, ensuring quality care.
  
  
• Seamless Treatment Journey: From initial consultation to post-operative care, HexaHealth provides end-to-end support, managing appointments, hospital admissions, and all necessary paperwork.

Tips for Kidney Stone Prevention and Post-Surgery Care

• Stay well-hydrated by drinking plenty of water throughout the day.
  
  
• Reduce sodium intake and avoid high-oxalate foods if you have calcium oxalate stones.
  
  
• Follow your doctor's dietary recommendations based on the type of stone you have.
  
  
• Regular follow-ups after surgery are crucial to monitor recovery and prevent recurrence.

Please reach out to HexaHealth for personalized guidance on your kidney stone treatment journey and to understand how you can benefit from the PM-JAY scheme.

Please share your city and hospital name if you would like help checking PMJAY availability for Kidney stone surgery.

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