Hello,

An Ayushman card provides health insurance coverage under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme, offering financial protection for various medical treatments. The surgery you mentioned, "PBC Neck and Rt Leg Release + SSG," refers to a reconstructive plastic surgery performed to release tightened skin (contractures) in the neck and right leg, often after severe burns, followed by a skin graft (SSG) to cover the treated area and help restore function.

Is Plastic Surgery Covered Under the Ayushman Card?

Yes, if :

• The patient is eligible under Ayushman Bharat – PMJAY
• The hospital is empanelled under PMJAY
• The procedure is medically necessary
• Package approval is completed

then selected reconstructive and plastic surgery procedures may be available under cashless treatment at eligible hospitals.

Coverage may include :

• Hospital admission
• Surgery charges
• OT expenses
• Doctor consultation during admission
• Hospital stay
• Basic investigations related to treatment

Final approval depends on :

• Patient eligibility
• Hospital empanelment
• PMJAY package verification
• Plastic surgeon assessment
• Procedure eligibility under the scheme

What About PBC Neck and Right Leg Release + SSG?

Procedures such as :

• Contracture release surgery
• Reconstructive plastic surgery
• Skin grafting (SSG – Split Skin Graft)
• Neck or limb release procedures

may be considered for coverage if they are medically indicated and fall under an approved PMJAY package.

The final confirmation can only be provided after review of the patient's diagnosis, medical records, and hospital package eligibility.

Which Doctors Usually Perform These Procedures?

Treatment is usually managed by :

• Plastic surgeon
• Reconstructive surgeon
• Burn and wound care specialist
• General surgeon in selected cases

Doctors may recommend :

• Physical examination
• Blood tests
• Imaging studies if required
• Pre-operative assessment

These investigations help determine the exact treatment plan.

Documents Usually Required

Please keep these documents ready :

• Ayushman / PMJAY card
• Aadhaar card
• Medical reports
• Doctor prescriptions
• Discharge summaries or previous treatment records
• Procedure recommendation documents

These documents help with eligibility verification and treatment approval.

How to Check PMJAY Hospitals?

Verification Steps

• Visit Ayushman Bharat Official Portal
• Open the “Find Hospital” section
• Select :
  • State
  • District
  • Specialty – Plastic Surgery / General Surgery

Nearby PMJAY empanelled hospitals can be checked there.

How HexaHealth Can Assist

• Scheme Guidance : We can help you understand the specifics of Ayushman Bharat coverage for your particular surgery.
• Hospital Network : HexaHealth can connect you with top hospitals in your area that are empanelled under the Ayushman Bharat scheme and have experienced plastic surgeons specializing in reconstructive procedures.
• Pre-authorization Support : Our team can assist you with the necessary documentation and pre-authorization process required to avail benefits under your Ayushman card.
• Seamless Experience : We aim to make your treatment journey smooth, from consultation to post-operative care, ensuring you receive the best possible treatment without financial stress.

For more detailed information and to verify coverage for your specific case, it is always recommended to consult with the chosen empanelled hospital or contact the Ayushman Bharat helpline.

Wishing the patient comfort, healing, and a smooth recovery ahead.
Warm regards,
Team HexaHealth