Does Ayushman Bharat cover pacemaker implantation surgery in Medanta Gurugram?

Hello,

Yes, what the Ayushman desk told you can be correct for Medanta Gurugram. Under Ayushman Bharat PM-JAY, every treatment or implant is not automatically covered at every empanelled hospital. Coverage depends on the specific PM-JAY package, hospital empanelment and the applicable package/implant rules.

A pacemaker procedure itself is listed in the national PM-JAY package list, with specific,

• Single Chamber Permanent Pacemaker
• Double Chamber Permanent Pacemaker
• Temporary Pacemaker:

Therefore, it is not correct to say that pacemaker implantation is completely excluded from PM-JAY everywhere it has clearly defined national package codes and rates. However, Medanta Gurugram may currently not be accepting the applicable pacemaker package or implant under its PM-JAY arrangement.

Bypass and angioplasty also have their own specific PM-JAY packages, so the fact that they are accepted does not automatically mean that pacemaker implantation will also be available at the same hospital.

How to Check PM-JAY Coverage

1. Open the official PM-JAY Hospital Search portal.
2. Select State as Delhi for medanta.
3. Select District.
4. Select Government/Private Hospital.
5. Select Cardiology as the specialty.
6. Enter Medanta The Medicity.
7. Complete the Captcha, if shown.
8. Click Search.
9. Check that the hospital's PM-JAY empanelment is active.
10. Ask the Ayushman Mitra/PM-JAY desk to confirm the exact pacemaker package (single or double chamber, as relevant) and implant/device coverage for the patient's condition, and whether the package rate matches the national figures above.

You can also check the current district-wise empanelled hospital list published by Haryana. The state website also provides separate lists for active, inactive, suspended and de-empanelled hospitals.

Documents to Carry

• Ayushman Card
• Aadhaar Card/valid ID
• Cardiologist's prescription
• ECG reports
• Echocardiography report
• Angiography reports, if done
• Other cardiac investigation reports
• Previous medical records and discharge papers
• Current medicines list

Most importantly, if the cardiologist considers the pacemaker medically urgent, please do not delay necessary treatment only to complete the coverage verification.

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