For many families in Gopalganj and nearby districts, the cost of an operation is a big worry. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) was started by the Government of India so that eligible families can get hospital treatment without paying from their own pocket for the services the scheme covers. Below, we explain step by step how to use your Ayushman card for surgery, from checking your name to meeting our Ayushman help desk.
What is Ayushman Bharat PM-JAY?
PM-JAY is a government health scheme. Eligible families get cashless cover of up to Rs 5 lakh per family per year for hospital treatment at empanelled hospitals. "Empanelled" means a hospital is listed under the scheme. "Cashless" means that for covered treatment, the payment is settled between the scheme and the empanelled hospital, not by the patient.
The scheme works through fixed treatment packages. Each covered operation or illness has a package with its own rules, and each hospital is empanelled only for certain specialities. So whether your treatment is covered depends on the package rules, the specialities a hospital is empanelled for, and your eligibility.
Step 1: Check if your family is eligible
Eligibility is decided by the government from its own lists, not by any hospital. You can check it in these ways:
- Visit the official beneficiary portal beneficiary.nha.gov.in and search using the details it asks for, such as your Aadhaar number.
- Call the national helpline 14555.
- Visit your nearest Common Service Centre (CSC), or ask at the Ayushman help desk of an empanelled hospital.
Step 2: Get your Ayushman card made
If your family is eligible but you do not have a card yet, you can get one through the official Ayushman app using Aadhaar-based e-KYC, or at a Common Service Centre. Our Ayushman help desk can also guide you.
- Each eligible family member should have his or her own card.
- Keep your Aadhaar linked to a working mobile number, as an OTP is often needed.
- Make the card while you are well. Do not wait for an emergency.
Step 3: Senior citizens aged 70 and above
From 2024, the scheme was extended to all senior citizens aged 70 years and above, regardless of family income, through the Ayushman Vay Vandana card. If a parent or grandparent in your family is 70 or older, they can apply through the Ayushman app or the beneficiary portal, or ask at a CSC. Check the latest rules on the official portal or on 14555.
Step 4: Come to our hospital and meet our help desk
At Dr. R.K. Thakur Hospital, Gopalganj, we are empanelled under the scheme and have an Ayushman Bharat help desk (sahayata kendra). As of mid-2025, our empanelment covers general surgery and laparoscopic surgery packages, such as operations for gallbladder stones, hernia, hydrocele and appendix. For treatment in other specialities, please check with our help desk first, because empanelment can change over time.
- First see the doctor in the OPD. The doctor examines you and, based on your tests, decides what treatment you need.
- Then meet our Ayushman help desk with your documents. Our staff check your eligibility and identity, usually through Aadhaar-based verification.
- Our help desk checks whether your treatment falls under a package for which we are empanelled, and explains what is covered.
- For planned surgery, we send the required details to the scheme for approval (pre-authorisation), as per the scheme's process.
- Once approval comes, admission and surgery go ahead as planned by our surgeon.
Documents to carry
- Ayushman card, or the card number or e-card on your phone
- The patient's Aadhaar card
- A mobile phone linked to the patient's Aadhaar, for OTP
- All old reports, prescriptions and discharge papers
- Any other document the help desk asks for
Important points to remember
- Coverage is not automatic. It depends on the package rules, our empanelment and your eligibility. Our help desk checks each case.
- OPD visits are generally not covered. PM-JAY is mainly for treatment that needs admission. Please ask our help desk what applies to you.
- Ask before admission. If anything is unclear, please ask our help desk before you are admitted, not after.
- Keep your papers safe, including the discharge summary.
- For doubts or complaints about the scheme, you can call the national helpline 14555.
Common questions from families
We are from another district or from UP. Can we use the card here?
PM-JAY cards can generally be used at empanelled hospitals outside your home district, and the scheme allows portability across states. Families from Siwan, Saran, the Champarans, or Kushinagar and Deoria in UP can ask our help desk to confirm the rules for their case.
What if we do not have the card at the time of admission?
If your family is eligible but the card has not been made, please ask our help desk whether verification can be done. It is still best to get the card made in advance.
When to see a doctor
Do not wait for a card before seeing a doctor. Get examined soon if you have severe or repeated belly pain, repeated vomiting, a swelling in the groin or scrotum, jaundice (yellow eyes), blood in the urine or stool, or a lump that is growing. The paperwork can be sorted out alongside. In an emergency, go straight to the nearest emergency.
Patients from Gopalganj, Siwan, Chhapra and nearby districts can consult Dr. Rajnish Kumar Thakur, our founder and chief surgeon, in our OPD and meet our Ayushman help desk on the same visit. Our empanelment covers general and laparoscopic surgery packages, such as laparoscopic gallbladder stone surgery. Please confirm your own case with our help desk before admission.
If you are planning surgery, also read our checklist for patients coming from far and the Ayushman Bharat page. You can read about gallbladder stone surgery, hernia repair and hydrocele surgery on our procedure pages. To check with our help desk before you travel, please call or WhatsApp us on +91 72739 94786.
