Quick Navigation
- What is Ayushman Bharat?
- Who is eligible
- Documents needed
- Cardiology & Heart Surgery
- Orthopedics & Joint Replacement
- Cancer & Oncology
- Neurosurgery & Spine
- Kidney & Urology
- Gastroenterology
- Maternity & Gynecology
- General & Laparoscopic Surgery
- Pediatric & Other Specialties
- Package amount table
- How to claim free surgery
- Free surgery at Hope Hospital Nagpur
- FAQs
What is Ayushman Bharat (PMJAY)?
Ayushman Bharat — Pradhan Mantri Jan Arogya Yojana (PMJAY) is the world's largest government-funded health insurance scheme. Launched in 2018 by the Government of India, it provides cashless hospitalization up to Rs. 5 lakh per family per year for secondary and tertiary medical care at empaneled hospitals across India.
Under PMJAY, 12.34 crore eligible families (about 55 crore people) receive free treatment for 1,949 medical procedures across 27 specialties — including all major surgeries like heart bypass, kidney transplant, cancer chemotherapy, knee replacement, brain surgery, and more.
Key Facts About Ayushman Bharat 2026
- Cover amount: Rs. 5 lakh per family per year (no per-individual sub-limit)
- Cashless: Zero out-of-pocket cost at empaneled hospitals
- Procedures covered: 1,949 (all major surgeries + chemotherapy + dialysis + maternity)
- Hospitals empaneled: 30,000+ across India (1,800+ in Maharashtra)
- Recent expansion: All citizens above age 70 now automatically eligible (since Oct 2024) regardless of income
- Pre-existing diseases: Covered from day 1
- 3 days pre + 15 days post-hospitalization expenses covered
Who is Eligible for Ayushman Bharat in 2026?
Three main eligibility categories:
1. Families identified by SECC 2011
The Socio-Economic Caste Census 2011 identified families in deprivation categories. Most rural BPL families and urban occupation-based workers (street vendors, construction labour, domestic help, etc.) are automatically eligible.
2. Senior Citizens 70 years and above (New from Oct 2024)
All Indian citizens aged 70+ are now automatically covered under PMJAY, regardless of income or social category — known as the "Ayushman Vandana Yojana" expansion. They get a separate Rs. 5 lakh top-up.
3. State-Specific Scheme Beneficiaries
Several states converged their existing schemes with PMJAY. Maharashtra residents also benefit from MJPJAY (Mahatma Jyotirao Phule Jan Arogya Yojana), which extends coverage to additional families (yellow & orange ration card holders) and provides Rs. 1.5 lakh additional cover for renal diseases.
How to Check Your Eligibility
Online
Visit pmjay.gov.in → "Am I Eligible" → enter mobile + Aadhaar to instantly verify
Helpline
Call 14555 or 1800-111-565 — toll-free, 24/7, multiple languages
At Hospital
Visit Hope Hospital Nagpur — the insurance desk checks eligibility on the spot, free
CSC Center
Any Common Service Center (CSC) can verify and issue your Ayushman card
Documents Needed for Free Surgery
Bring these documents on the day of admission or OPD visit:
- Aadhaar card of the patient (mandatory for biometric verification)
- Ayushman Bharat card / e-card / PMJAY ID number (digital copy on phone is acceptable)
- Ration card or family ID (for family relationship verification)
- Doctor's prescription / referral recommending the surgery
- Previous medical records: reports, X-rays, scans, blood tests, discharge summaries
- Mobile number registered for PMJAY (for OTP verification)
Important — Pre-Authorization Required
For planned surgery, the hospital must submit a pre-authorization request to the State Health Authority (SHA) along with diagnosis, package code, estimated cost, and supporting reports. Approval typically takes 6-48 hours. For emergencies, treatment starts immediately and pre-auth is processed in parallel.
Cardiology & Cardiac Surgery — Covered Procedures
All major cardiac procedures FREE under PMJAY
- Coronary Artery Bypass Grafting (CABG)
- Off-pump Coronary Bypass (OPCAB)
- Coronary Angioplasty with Stent (PCI)
- Primary Angioplasty for Heart Attack
- Coronary Angiography (diagnostic)
- Valve Replacement (Aortic, Mitral)
- Pacemaker Implantation
- ICD / CRT-D Implantation
- Balloon Mitral Valvotomy (BMV)
- Heart Failure Management
- ASD / VSD Closure (Septal Defects)
- Pediatric Cardiac Surgery
- Cardiac Catheterization
- Electrophysiology (EP) Study & Ablation
At Hope Hospital's Zion Cardiac Hospital, all these procedures are performed cashless under PMJAY by experienced interventional cardiologists and cardiac surgeons. Read our heart attack emergency guide for warning signs.
Orthopedics & Joint Replacement — Covered Procedures
Joint replacement & spine surgery FREE under PMJAY
- Total Knee Replacement (TKR)
- Total Hip Replacement (THR)
- Partial Knee Replacement
- Revision Joint Replacement
- Hemi-arthroplasty (Hip)
- Spine Surgery (Decompression, Fusion)
- Microdiscectomy (Slipped Disc)
- Laminectomy (Spinal Stenosis)
- Vertebroplasty / Kyphoplasty
- Open Reduction Internal Fixation (ORIF)
- Closed Reduction with Plaster
- Arthroscopic Surgery (Knee, Shoulder)
- Arthroscopic Ligament Repair (ACL, PCL)
- Fracture Fixation (long bone, pelvis)
- Amputation (post-trauma, diabetic)
- Treatment of Osteomyelitis
Hope Hospital's orthopedic team — led by Dr. B.K. Murali (MS Ortho, 19+ years, 5,000+ surgeries) — performs knee replacement and hip replacement cashless under PMJAY. Read our back pain & slipped disc guide.
Cancer (Oncology) — Covered Procedures
Comprehensive cancer treatment FREE under PMJAY
- Surgical Oncology — Tumor Excision
- Modified Radical Mastectomy (Breast Cancer)
- Hysterectomy for Cancer (Cervical, Endometrial)
- Radical Prostatectomy (Prostate Cancer)
- Colorectal Cancer Surgery
- Lung Cancer Surgery
- Head & Neck Cancer Surgery
- Thyroidectomy (Thyroid Cancer)
- Whipple Procedure (Pancreatic Cancer)
- Liver Resection (Liver Cancer)
- Gastrectomy (Stomach Cancer)
- Bone Marrow Biopsy
- Chemotherapy (all protocols, all cycles)
- Radiation Therapy (External Beam, IMRT)
- Brachytherapy
- Targeted Therapy & Immunotherapy
- Palliative Care & Pain Management
- Cancer Diagnostic Tests (PET, MRI, Biopsy)
At Hope Hospital's Nagpur Cancer Institute, multidisciplinary cancer care is fully covered under PMJAY. Chemotherapy is reimbursed per protocol/cycle — eligible patients pay zero.
Neurosurgery & Spine — Covered Procedures
Brain & spine surgery FREE under PMJAY
- Brain Tumor Surgery (Craniotomy)
- Aneurysm Clipping
- Mechanical Thrombectomy (Stroke)
- Intravenous Thrombolysis (tPA)
- Burr Hole Surgery
- Hydrocephalus Surgery (VP Shunt)
- Epilepsy Surgery
- Spinal Cord Injury Management
- Spinal Tumor Removal
- Disc Surgery (Cervical, Lumbar)
- Decompressive Craniectomy
- Head Injury Surgery
- DBS (Deep Brain Stimulation)
- Craniosynostosis Repair
- Neurorehabilitation
Hope Hospital's Hope Neurology unit performs emergency thrombolysis for stroke and brain tumor surgery cashless under PMJAY, with on-site Neuro ICU.
Nephrology & Urology — Covered Procedures
Kidney transplant & dialysis FREE under PMJAY
- Kidney Transplant (Donor + Recipient)
- Hemodialysis (chronic, regular sessions)
- Peritoneal Dialysis
- CAPD (Continuous Ambulatory Peritoneal Dialysis)
- AV Fistula Creation
- ESWL Lithotripsy (Stone Crushing)
- Ureteroscopy (URS) with Laser
- RIRS (Retrograde Intrarenal Surgery)
- PCNL (Percutaneous Nephrolithotomy)
- TURP (Prostate Surgery)
- Cystoscopy
- Nephrectomy (Kidney Removal)
- Pyeloplasty
Hope Hospital — partner of NephroPlus India's leading dialysis chain — offers cashless kidney transplant, dialysis, and stone removal under PMJAY.
Gastroenterology & GI Surgery — Covered Procedures
Gallbladder, hernia, liver, GI surgery FREE under PMJAY
- Laparoscopic Cholecystectomy (Gallbladder Removal)
- Laparoscopic Appendectomy
- Hernia Repair (Inguinal, Umbilical, Hiatal)
- Endoscopy (Diagnostic & Therapeutic)
- Colonoscopy (Diagnostic & Polyp Removal)
- ERCP (Bile Duct Stone Removal)
- Hemorrhoidectomy (Piles Surgery)
- Fistula-in-Ano Surgery
- Fissurectomy
- Liver Surgery
- Pancreatic Surgery
- Anastomosis (Bowel)
- Bariatric / Weight-Loss Surgery (select cases)
- Inflammatory Bowel Disease Management
Obstetrics, Gynecology & Maternity — Covered Procedures
Pregnancy, delivery & women's health FREE under PMJAY
- Normal Delivery (Vaginal)
- C-Section Delivery (LSCS)
- Painless Delivery (Epidural)
- High-Risk Pregnancy Management
- Antenatal Care & Investigations
- NICU Care (Newborn)
- Hysterectomy (Abdominal & Laparoscopic)
- Myomectomy (Fibroid Removal)
- Ovarian Cyst Removal
- Diagnostic Hysteroscopy & Laparoscopy
- Endometriosis Surgery
- PCOD/PCOS Management
- Ectopic Pregnancy Surgery
- Tubal Ligation
Hope Hospital's maternity unit provides cashless delivery, C-section, and gynecology surgery under PMJAY, with on-site NICU.
General & Laparoscopic Surgery — Covered Procedures
All major general surgeries FREE under PMJAY
- Appendectomy
- Hernia Repair (all types)
- Thyroid Surgery
- Breast Surgery (Lumpectomy, Mastectomy)
- Pilonidal Sinus Surgery
- Lipoma / Cyst Excision
- Wound Debridement & Skin Grafting
- Trauma Surgery
- Abscess Drainage
- Burns Management & Skin Grafting
- Varicose Vein Surgery
- Lymph Node Biopsy
Pediatric, ENT, Ophthalmology & Other Specialties
Children, ENT, eye & other specialties FREE under PMJAY
- Pediatric Surgery (Cleft Lip, Cleft Palate, Hernia, Hydrocele)
- Pediatric Cardiac Surgery (ASD, VSD, PDA)
- Neonatal Care (NICU)
- ENT — Tonsillectomy, Adenoidectomy
- ENT — Mastoidectomy, Septoplasty (DNS Correction)
- ENT — Sinus Surgery (FESS)
- Cataract Surgery (Phacoemulsification + IOL)
- Glaucoma Surgery
- Retinal Detachment Surgery
- Vitrectomy
- Plastic Surgery — Cleft Lip/Palate
- Burns Reconstruction
- Dermatology Procedures
- Psychiatric & De-addiction Care
- Mental Health Inpatient Care
Sample Ayushman Bharat Package Amounts (2026)
Package amounts vary based on procedure complexity, hospital tier (Tier 1/2/3 cities), and additional implants/devices. Below are common procedures with indicative cover under PMJAY (Maharashtra/Nagpur):
| Procedure | Specialty | Package Amount (Rs.) |
|---|---|---|
| Total Knee Replacement (Unilateral) | Orthopedics | 80,000 – 1,20,000 |
| Total Hip Replacement (Unilateral) | Orthopedics | 90,000 – 1,40,000 |
| Spine Surgery (Microdiscectomy) | Orthopedics / Neuro | 60,000 – 1,10,000 |
| CABG (3-Vessel Bypass) | Cardiac Surgery | 1,10,000 – 2,00,000 |
| Coronary Angioplasty + Stent | Cardiology | 60,000 – 1,00,000 |
| Coronary Angiography (Diagnostic) | Cardiology | 10,000 – 15,000 |
| Pacemaker Implantation | Cardiology | 1,50,000 – 2,50,000 |
| Brain Tumor Surgery | Neurosurgery | 80,000 – 1,80,000 |
| Mechanical Thrombectomy (Stroke) | Neurosurgery | 4,50,000 – 5,00,000 |
| Kidney Transplant | Nephrology / Urology | 2,90,000 – 4,40,000 |
| Hemodialysis (per session) | Nephrology | 1,200 – 2,000 |
| ESWL Lithotripsy | Urology | 10,000 – 20,000 |
| RIRS / PCNL (Kidney Stones) | Urology | 30,000 – 65,000 |
| Laparoscopic Cholecystectomy | General Surgery | 20,000 – 35,000 |
| Hernia Repair (Mesh) | General Surgery | 15,000 – 30,000 |
| Modified Radical Mastectomy | Oncology | 40,000 – 70,000 |
| Chemotherapy (per cycle) | Oncology | 5,000 – 50,000 |
| Hysterectomy (Open / Laparoscopic) | Gynecology | 25,000 – 50,000 |
| Normal Delivery | Obstetrics | 5,000 – 9,000 |
| C-Section Delivery | Obstetrics | 9,000 – 15,000 |
| NICU Care (per day) | Pediatrics | 2,000 – 5,000 |
| Cataract Surgery (Phaco + IOL) | Ophthalmology | 6,500 – 25,000 |
| Tonsillectomy / Adenoidectomy | ENT | 9,000 – 18,000 |
Note: Package amounts are indicative and revised periodically by the National Health Authority (NHA). Tier-2 city packages (Nagpur) are typically 90% of Tier-1 (metro) rates. Hospitals cannot charge above the package amount from PMJAY beneficiaries.
How to Claim Free Surgery — Step by Step
Verify your eligibility
Check at pmjay.gov.in, call 14555, or walk into Hope Hospital with your Aadhaar — we'll verify on the spot, free.
Get a doctor's consultation
Visit the OPD. The doctor diagnoses your condition and recommends the appropriate procedure under PMJAY package.
Pre-authorization request
The hospital submits a pre-auth request to the State Health Authority with diagnosis, package code, supporting investigations. Approval typically takes 6–48 hours for planned surgery. Emergencies start treatment immediately.
Cashless admission
On approval, you're admitted cashless. No payment required at admission, during stay, or at discharge.
Surgery & treatment
Surgery is performed by the same specialist team that treats paying patients. Same OT, same medicines, same standard of care.
Discharge & follow-up
Discharge summary, prescription, and follow-up plan provided. Hospital bills PMJAY directly. You walk out without paying.
Free Surgery at Hope Hospital, Nagpur — Why Choose Us
Hope Hospital, Teka Naka, Kamptee Road, Nagpur, is empaneled under Ayushman Bharat (PM-JAY), MJPJAY, CGHS, ECHS and 20+ government health schemes. We've treated thousands of beneficiaries with zero out-of-pocket cost.
NABH Accredited
Central India's first NABH-accredited super specialty hospital — the highest quality benchmark
19+ Years Experience
5+ million patients served across Vidarbha, MP, Chhattisgarh
Dedicated PMJAY Desk
Walk-in verification, on-the-spot eligibility check, pre-auth processing in hours
24/7 Emergency
Cath Lab, Neuro ICU, Modular OT, Ambulance — round the clock
Have an Ayushman Bharat card? Get free treatment.
Walk in with your Aadhaar & scheme card. Our team verifies eligibility on the spot at zero cost.
071-22980073 +91-9823555053 Book AppointmentFrequently Asked Questions
Q: How many surgeries are covered under Ayushman Bharat PMJAY?
PMJAY covers 1,949 medical procedures across 27 specialties — cardiology, oncology, orthopedics, neurosurgery, nephrology, gastroenterology, OB-GYN, ENT, ophthalmology, plastic surgery, and pediatrics. Cover is up to Rs. 5 lakh per family per year, fully cashless.
Q: What surgeries are free under Ayushman Bharat at Hope Hospital Nagpur?
Free under PMJAY at Hope Hospital: knee/hip replacement, spine surgery, CABG, angioplasty, cancer surgery & chemotherapy, brain tumour surgery, kidney transplant, dialysis, laparoscopic gallbladder, hernia, hysterectomy, normal/C-section delivery, and 200+ procedures.
Q: What is the Ayushman Bharat package amount for major surgeries?
Sample PMJAY packages: Knee replacement Rs. 80,000–1,20,000 · Hip Rs. 90,000–1,40,000 · CABG Rs. 1,10,000–2,00,000 · Angioplasty + stent Rs. 60,000–1,00,000 · Kidney transplant Rs. 2,90,000–4,40,000 · Hysterectomy Rs. 25,000–50,000. Family cover: Rs. 5 lakh/year.
Q: Who is eligible for Ayushman Bharat in 2026?
Families identified under SECC 2011 (mostly BPL rural + occupation-based urban workers). From Oct 2024, all citizens aged 70+ are automatically covered regardless of income. Maharashtra residents also get MJPJAY. Verify at pmjay.gov.in or call 14555.
Q: What documents are needed for free surgery under Ayushman Bharat?
(1) Aadhaar card, (2) Ayushman Bharat card / e-card / PMJAY ID, (3) Ration card, (4) Doctor's prescription, (5) Previous medical records. At Hope Hospital, our insurance team verifies on the spot, free.
Q: Can I get free heart bypass surgery (CABG) under Ayushman Bharat in Nagpur?
Yes. CABG is fully covered under PMJAY (Rs. 1,10,000–2,00,000 package). Hope Hospital's Zion Cardiac Hospital performs cashless CABG, angioplasty, and emergency cardiac care for eligible patients.
Q: Is kidney transplant covered under Ayushman Bharat?
Yes. Kidney transplant is covered with a package of Rs. 2,90,000–4,40,000 covering donor surgery, recipient surgery, ICU, post-transplant medications. Hope Hospital (with NephroPlus partnership) is empaneled for cashless transplant.
Q: How long does Ayushman Bharat verification take at Hope Hospital?
On-the-spot, typically 15–30 minutes for eligibility verification. State Health Authority pre-authorization for surgery takes 6–48 hours. For emergencies, treatment starts immediately.
Q: Can I use Ayushman Bharat for chronic conditions like dialysis & chemotherapy?
Yes. Chronic procedures like hemodialysis (per session) and chemotherapy (per cycle) are covered under PMJAY. As long as the family's Rs. 5 lakh annual cover is available, sessions continue uninterrupted.
Q: Can I get treatment at Hope Hospital if I have an Ayushman card from another state?
Yes. Ayushman Bharat is a national portable scheme — you can avail cashless treatment at any empaneled hospital across India, including Hope Hospital Nagpur, regardless of which state issued your card.
Q: Are pre-existing diseases covered under Ayushman Bharat?
Yes. All pre-existing diseases are covered from day 1 of enrollment — there is no waiting period.
Q: What's the difference between PMJAY and MJPJAY?
PMJAY is the central scheme (Rs. 5 lakh family cover, nationwide). MJPJAY is Maharashtra state's scheme (additional cover for state residents). Most Maharashtra empaneled hospitals — including Hope Hospital — accept both. The two schemes are converged, so eligible patients get combined coverage.
Related Reading
- Ayushman Bharat Hospitals in Nagpur — Empaneled List
- Kidney Transplant Cost in Nagpur 2026
- Knee Replacement Cost in Nagpur 2026
- Best Heart Hospital in Nagpur — CABG & Angioplasty
- Best Cancer Hospital in Nagpur
- All Insurance & Empanelment List at Hope Hospital
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