Is NGS Myeloid Panel or Myeloma FISH Test Covered Under PMJAY?

Dear D. K. Soni ji,

NGS Myeloid Panel aur Myeloma FISH test ki coverage Ayushman Bharat PM-JAY scheme mein automatically confirm nahi hoti. Ye specialised genetic/molecular tests hain. Agar aap sirf OPD mein doctor ki prescription par ye tests karwana chahte hain, toh inka cashless coverage milna generally difficult ho sakta hai.

Lekin agar patient cancer ke treatment ke liye PM-JAY empanelled hospital mein admit hai, toh treating oncologist aur hospital ka Ayushman department check kar sakta hai ki in tests ko kisi approved treatment package ya add-on investigation ke through cover karne ki request bheji ja sakti hai ya nahi. Final approval scheme ke rules aur package availability par depend karega.

NGS Myeloid Panel aur Myeloma FISH test ke liye kya coverage mil sakti hai?

• OPD testing: Sirf OPD mein prescription lekar laboratory mein NGS ya FISH test karwane par PM-JAY cashless coverage automatically nahi milti.
• Hospitalisation ke dauran: Agar patient approved cancer treatment ke liye hospital mein admit hai, toh doctor hospital ke through test ki coverage ke liye pre-authorisation request bhejne ki possibility check kar sakte hain.
• Bone Marrow Biopsy: Bone marrow biopsy aur specialised genetic tests alag investigations hain. Biopsy ka coverage milne ka matlab yeh nahi hai ki NGS aur FISH tests bhi automatically covered honge.
• Final approval: Test karwane se pehle hospital ke Ayushman Mitra se confirm karein ki specific test approved package mein included hai ya nahi. Approval ke bina cashless coverage assume na karein.

Aapko aage kya karna chahiye?

1. Apne treating haematologist ya oncologist se poochhein ki NGS Myeloid Panel ya Myeloma FISH test medically necessary hai ya nahi.
2. Doctor ki prescription aur test recommendation lekar PM-JAY empanelled hospital ke Ayushman Mitra desk par jaayein.
3. Hospital se poochhein ki kya ye tests ongoing inpatient cancer treatment package ya kisi applicable add-on package ke under cover ho sakte hain.
4. Hospital se pre-authorisation aur written confirmation lein ki test ka kharcha cashless approve hua hai ya nahi.
5. Agar test cover nahi hota, toh hospital se test ka estimated cost aur available government hospital/lab options ke baare mein poochhein.

In details se aapko PM-JAY ke under test coverage verify karne ke liye sahi guidance di ja sakti hai.

Wishing you and your family good health always.
Warm regards,
Team HexaHealth