Cashless Treatment

Insurance, MJPJAY & Ayushman Bharat — accepted

Osteon Orthopedic Hospital offers cashless treatment with all major health insurers and TPAs, and is empanelled for government schemes including MJPJAY and Ayushman Bharat PMJAY for eligible patients. Verification is simple — share your insurance card at your first consultation and our team handles the pre-authorization paperwork end-to-end.

How Cashless Works

From card to discharge — four simple steps

A clear, predictable path from your first consult to a cashless discharge. Most planned procedures move from card to confirmed cover in under 48 hours.

  1. Step 1

    Share your insurance card

    Bring your health insurance card, policy details and a photo ID to your first consultation. The front desk records your insurer and TPA so we can begin verification immediately — no extra trip required.

  2. Step 2

    We verify coverage with your TPA

    Our insurance desk contacts your TPA to confirm eligibility, sum insured, sub-limits and any co-pay clauses. You usually have a clear picture of what's covered within 24 to 48 hours.

  3. Step 3

    Pre-authorization submitted

    We submit the pre-auth request with your diagnosis, planned procedure, expected stay and implant details. Most planned orthopedic pre-auths are approved by the TPA within 24 to 48 hours of submission.

  4. Step 4

    Treatment with zero upfront payment

    Once approved, you complete surgery and your hospital stay with no out-of-pocket payment for covered items. Anything outside the policy — such as implant top-ups — is discussed transparently before the procedure, never at discharge.

Health Insurance Partners

All major insurance — cashless treatment

Osteon Orthopedic Hospital accepts cashless treatment from all major Indian health insurers and TPA networks. If your insurer or TPA isn't listed here, please ask — most other private insurers and TPA networks are also accepted.

  • Star Health Insurance
  • HDFC ERGO Health
  • ICICI Lombard Health
  • Bajaj Allianz Health
  • Niva Bupa Health
  • Care Health Insurance
  • New India Assurance
  • National Insurance
  • Oriental Insurance
  • United India Insurance
  • Aditya Birla Health
  • Manipal Cigna Health
  • Tata AIG Health
  • SBI General Health
  • Future Generali Health
  • Cholamandalam Health
  • Royal Sundaram Health

Third-Party Administrators

Major TPAs covered

  • MediAssist
  • Health India TPA
  • Paramount Health
  • Vidal Health
  • FHPL
  • Vipul MedCorp
  • Medi Assist Insurance TPA
  • Raksha Health
  • Family Health Plan (FHPL)
  • Other major TPAs

Don't see your insurer? Most other private insurers and TPAs are also accepted — confirm during booking and our front desk will verify in minutes.

Government Schemes

MJPJAY & Ayushman Bharat — empanelled

Eligible patients can access covered orthopedic care under Maharashtra's state scheme and the central government's flagship health protection scheme. Bring your scheme card during your first visit and our team will help you check eligibility and covered procedures.

State Scheme · Maharashtra

MJPJAY

Mahatma Jyotiba Phule Jan Arogya Yojana

Maharashtra government's state health assurance scheme for low-income and economically weaker families. Eligible orthopedic procedures — including specific joint replacement, fracture fixation and trauma surgeries — are covered at empanelled hospitals at no out-of-pocket cost to qualifying patients. Eligibility is checked through your ration card category.

Central Scheme · India

Ayushman Bharat PMJAY

Pradhan Mantri Jan Arogya Yojana

The central government's flagship health protection scheme offers up to ₹5 lakh of annual coverage per eligible family for secondary and tertiary care, including a broad list of orthopedic and surgical procedures. Eligibility is based on the PMJAY beneficiary list; bring your PMJAY/ABHA card and our team will verify and process the e-card flow.

Cashless Inclusions

What's typically included

Most planned orthopedic procedures under a standard policy cover the core treatment journey end-to-end. The exact list of inclusions depends on your policy schedule, sub-limits and chosen room category.

  1. Pre-operative consultation & investigations

    Specialist consultation, pre-anaesthetic checkup, diagnostic imaging (X-ray, MRI, CT) and the lab tests required to clear you for surgery.

  2. Hospital stay (room category as per plan)

    In-patient room charges in the category your policy allows — general, twin-sharing, single private or higher — including nursing care and standard hospital services.

  3. Surgery & surgeon fees

    Operating theatre charges, surgeon's professional fees and the assistant surgeon and surgical team fees for the approved procedure.

  4. Implant cost (up to policy limit)

    Standard implant cost is covered up to your policy's implant sub-limit. Premium or robotic-specific implants may have a top-up payable outside cover — always discussed up front.

  5. Anaesthesia & OT charges

    Anaesthetist's fees, anaesthesia consumables and operating theatre charges including disposables used during the procedure.

  6. Post-operative physiotherapy

    In-hospital physiotherapy sessions during your stay to begin mobilization, plus a structured early rehab plan you can continue with our partner physios after discharge.

  7. Follow-up visits in the recovery window

    Standard post-op review visits with Dr. Kalambe Patil during the recovery window covered by your policy — wound check, suture removal, X-ray review and rehab progression.

Common Questions

Insurance, simply explained

Which procedures are covered cashless?
Most planned orthopedic procedures qualify for cashless treatment under standard health insurance — including total knee replacement, total hip replacement, shoulder replacement, ACL/PCL reconstruction, arthroscopic meniscus and rotator cuff repair, spine procedures and fracture fixation. Exact coverage depends on your individual policy terms, sum insured and waiting periods. The front desk verifies your specific procedure with your insurer before admission.
How long does the approval take?
Most pre-authorization requests for planned orthopedic surgery are approved by the TPA within 24 to 48 hours of submission. Emergency admissions are handled in parallel — treatment begins immediately while the hospital insurance desk processes paperwork. We share every update with you so you always know where the approval stands.
What if my insurance doesn't fully cover the implant?
Many policies cap implant costs or specify allowed implant categories. If your chosen implant — for example a high-end robotic knee or ceramic hip — exceeds the policy limit, the difference is payable by you as a co-pay. We always discuss implant options and any expected out-of-pocket cost transparently before surgery so there are no surprises at discharge.
Do you also handle reimbursement claims (not cashless)?
Yes. If your insurer is not on a direct cashless tie-up or you prefer to claim reimbursement, the hospital provides itemized bills, the discharge summary, investigation reports and the doctor's certificate in the format your insurer requires. Our team can guide you on the documents needed for a smooth reimbursement claim.
Can I use MJPJAY or Ayushman Bharat for joint replacement?
Yes, eligible patients can use Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) and Ayushman Bharat PMJAY for covered orthopedic procedures, including certain joint replacement surgeries, fracture fixation and trauma care. Eligibility is based on your ration card category or PMJAY family list. Bring your scheme card during your first visit and our team will check eligibility and the list of covered procedures with you.

Bring your insurance card — we'll do the rest

Book a consultation and bring your insurance card or scheme card. Our team verifies coverage during your visit and walks you through every next step.

Call +91 86258 71468 or book online →
Pimple Saudagar, Pune 411027
osteonorthopedichospital@gmail.com
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