Can Ayushman Bharat Card be used at KS Hegde Hospital Derlakatte for heart disease treatment?
Description
My aunty, 82 years old,suffering from heart disease,regular visiting KS Hegde derlakatte,but staff says ayushman card not applicable in this hospital. .kindly need proper answer
Hello,
We understand your concern. Justice K.S. Hegde Charitable Hospital, Derlakatte, is empanelled under the Ayushman Bharat (PM-JAY) scheme. This means the hospital can provide cashless treatment for eligible patients under the scheme. However, there are certain situations where the hospital staff may inform you that the Ayushman card is "not applicable."
Why Might the Hospital Say the Ayushman Card Is Not Applicable?
One of the most common reasons is:
| Situation | Explanation |
|---|---|
| Outpatient (OPD) Consultation | Ayushman Bharat (PM-JAY) does not cover regular OPD consultations, follow-up visits, routine check-ups, or medicines prescribed during OPD visits. The scheme mainly covers treatments that require hospitalisation (IPD) or approved daycare procedures. |
If your aunty is visiting the cardiologist for routine follow-ups related to her heart disease without being admitted to the hospital, the Ayushman card cannot be used for those OPD consultations.
When Can the Ayushman Card Be Used?
The Ayushman Bharat (PM-JAY) card can generally be used if:
-
Your aunty requires hospital admission for an eligible heart-related condition.
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The recommended treatment or procedure is covered under the PM-JAY package list.
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Her Ayushman card is active, and her identity is successfully verified at the hospital.
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The hospital obtains the necessary pre-authorisation, wherever required.
What Should You Do Next?
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Ask the hospital whether the treatment is being advised as an OPD consultation or requires hospital admission.
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Visit the hospital's Ayushman Bharat Help Desk (Arogya Mitra) to verify your aunty's eligibility and the applicable treatment package.
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If admission has been recommended but the benefit is still denied, request the reason in writing and ask the Ayushman Help Desk to verify the case.
How HexaHealth Can Assist You
At HexaHealth, we can help you:
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Understand whether the recommended heart treatment is covered under Ayushman Bharat.
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Guide you on the eligibility and documentation required.
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Help you connect with empanelled hospitals and specialists for cashless treatment, wherever applicable.
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Support you throughout your treatment journey.
We wish your aunty a speedy recovery and good health.
Warm regards,
Team HexaHealth
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