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HealAssist

Ayushman Bharat

Ayushman Bharat PM-JAY is the world's largest health assurance scheme, providing a health cover of ₹5 lakhs per family per year for secondary and tertiary care hospitalization. In Gurugram, many top eye hospitals are empanelled to provide cashless treatments for conditions like Cataract, Glaucoma, and Retinal disorders under this scheme.

About

Scheme Details

Ayushman Bharat PM-JAY is the world's largest health assurance scheme, providing a health cover of ₹5 lakhs per family per year for secondary and tertiary care hospitalization. In Gurugram, many top eye hospitals are empanelled to provide cashless treatments for conditions like Cataract, Glaucoma, and Retinal disorders under this scheme.

Coverage

Scheme Benefits

Health coverage of ₹5 Lakhs per family per year.

Cashless and paperless access to services at empanelled hospitals.

Coverage of pre-hospitalization (3 days) and post-hospitalization (15 days) expenses.

No restriction on family size, age, or gender.

All pre-existing conditions are covered from day one.

Portability across India at any empanelled hospital.

Process

How to Avail Benefits

1

Visit the Ayushman Mitra desk at the empanelled hospital.

2

Verify eligibility using your PMJAY card or Aadhaar number.

3

Undergo medical diagnosis and pre-authorization request sent by hospital.

4

Receive treatment upon approval (Cashless).

5

Discharge and follow-up (Hospital claims payment directly from Govt).

Documentation

Documents Needed

  • Ayushman Bharat (PMJAY) Golden Card.
  • Aadhaar Card or Rational Card for Identity Proof.
  • Doctor's referral / Consultation Slip (if applicable).
Questions

Frequently Asked Questions

Is cataract surgery covered under Ayushman Bharat?▼
Cataract surgery is covered under Ayushman Bharat PM-JAY at empanelled hospitals, and the scheme pays the hospital its package rate. What that package includes, and whether your hospital settles it cashless, depends on the hospital — check with your HealAssistant before you are admitted.
How do I know if I am eligible?▼
You can check your eligibility on the official PMJAY website (mera.pmjay.gov.in) using your mobile number or Ration Card number.
Do I need to pay anything at the hospital?▼
At a hospital empanelled for CASHLESS treatment, an eligible beneficiary settles nothing with the hospital for what the scheme covers. A hospital empanelled only for reimbursement will ask you to pay and claim the money back afterwards — so check which kind yours is before you go.
Are multifocal lenses covered?▼
Typically, the scheme covers standard monofocal lenses. Premium lenses like multifocal or toric may require out-of-pocket payment for the difference, depending on the hospital's policy, but strictly speaking, the scheme covers the standard procedure.
Can I use my Ayushman card in Gurugram if I am from another state?▼
Yes, Ayushman Bharat offers portability, so you can avail treatment in Gurugram hospitals even if your card was issued in another state like Bihar or UP.
Next Steps

Find empanelled hospitals

Search for hospitals empanelled under this scheme in your city.