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Health Insurance & Wellness

Is Knee Replacement Covered Under Ayushman Bharat Yojana, This Is What Govt Says

Knee pain is a common problem in old age. It is curable, but the cost is often unaffordable for many senior citizens. Does the government cover knee surgery under the Ayushman Bharat Yojana? Here's what the government says

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Ayushman Bharat Yojana covers knee replacement surgery Photo: AI Generated
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Summary

Summary of this article

  • Knee pain is common in seniors but surgery can ease the pain

  • Knee replacement surgery costs Rs 1.5-3 lakh which is unaffordable to many seniors

  • AB-PMJAY covers knee surgery with Rs 5 lakh cashless support for elderly.

Knee pain is a common issue among the elderly. Many older adults gradually stop walking due to knee pain. Generally, the pain begins due to wear and tear of knee joints, known as Osteoarthritis, where the cartilage breaks down, resulting in the knee bones rubbing against each other while walking and resulting in stiffness. Knee replacement, which is a surgical procedure, offers a solution to this problem, in which the damaged bone is replaced with an artificial component made of metal and plastic. This relieves the pain significantly, and people can walk comfortably without pain. But the surgery is not affordable to many.

Parliamentarian Bajrang Manohar Sonwane raised this question in the Lok Sabha on December 5, 2025, saying that the replacement procedure is primarily available in private hospitals and costs around Rs 1.5 lakh-3 lakh, which patients from the economically weaker section cannot access due to affordability issues.

Knee Joint Pain

Prataprao Jadhav, Minister of State in the Ministry of Health and Family Welfare, gave a written reply to this, “Knee joint pain is an age-related degenerative disease, namely Osteoarthritis, which is treated conservatively with exercise and medicines. Some of the patients require knee joint replacement in the advanced stage of osteoarthritis.”

On the question of whether over 60 per cent of the senior citizens suffer from knee pain and need surgery, ans does the government plan to introduce or expand knee replacement in government hospitals, Jadhav replied, “Knee Joint Replacement facility is already available in most of the government hospitals.

Knee Replacement Surgery Under Ayushman Bharat Yojana

He said: “Under the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), eligible families receive cashless health coverage up to Rs 5 lakh per year for secondary and tertiary care, including procedures, such as knee replacement, through empanelled public and private hospitals.”

The government expanded the scheme in 2024 to all senior citizens (aged 70 years and above) in the country to provide insurance coverage up to Rs 5 lakh.

The minister said in the reply, “The scheme has been expanded to cover 60 million senior citizens of age 70 years and above belonging to 45 million families irrespective of their socio-economic status, under AB-PMJAY with Vay Vandana Card.”

The reply confirms that the Total Knee Replacement (TKR) surgery is covered under the AB-PMJAY scheme. The scheme overall covers a total of 1,961 medical procedures across 27 specialities. TKR is covered under the Orthopaedics speciality. It is provided both as a first-time knee replacement and also as a revision procedure for patients, where a corrective or repeat surgery is needed.

According to the reply, 159,000 senior citizens have been admitted to the hospitals for knee replacement surgeries as of November 26, 2025, and Rs 1,428.93 crore has been authorised for this under AB-PMJAY.

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