Does Ayushman Card Cover One Stent for Heart Treatment, and What About the Cost of the Second Stent?

Dear Kishun dev ray ji,

Agar doctor ne bataya hai ki patient ko 2 stent lagne hain aur 1 stent Ayushman card se hoga, lekin doosre stent ke liye ₹1.5 lakh cash dena hoga, to bina proper clarification ke payment na karein.

Ayushman Bharat PM-JAY angioplasty treatment empanelled hospital mein cashless package ke through diya jata hai. Scheme ke package mein zaroori medicines, consumables aur medically required implants ka coverage bhi hai, lekin exact coverage applicable package aur state rules par depend karti hai.

Doosre stent ke liye ₹1.5 lakh maangne ke kya reasons ho sakte hain?

1. Special ya high-end stent ka reason ho sakta hai

Kabhi-kabhi doctor kisi particular type ya brand ke stent ko recommend kar sakte hain. Lekin sirf is wajah se ki stent mehenga hai, patient ko turant ₹1.5 lakh cash dena zaroori hai, aisa assume nahi karna chahiye.

Hospital se clearly poochein :

• Doosre stent ka exact naam aur type kya hai?

• Ye stent Ayushman package mein covered hai ya nahi?

• Agar covered nahi hai, to iska written reason kya hai?

• Kya Ayushman package ke andar koi alternative approved stent available hai?

2. Ayushman benefit limit ka issue ho sakta hai

PM-JAY mein eligible family ko aam taur par ₹5 lakh per family per year tak ka cover milta hai.

Agar family ne pehle hi is saal Ayushman ke through treatment liya hai, to available balance ka issue ho sakta hai. Lekin hospital ko pehle ye clearly explain karna chahiye ki ₹1.5 lakh kis reason se patient se maanga ja raha hai.

Isliye sirf doctor ke kehne par ye assume na karein ki Ayushman limit khatam ho gayi hai. Ayushman Mitra se beneficiary balance aur package status verify karwayein.

3. Hospital se clarification lena bahut zaroori hai

PM-JAY ka purpose eligible beneficiaries ko empanelled hospitals mein cashless treatment dena hai. NHA ke information ke according empanelled hospital mein Arogya Mitra beneficiary ko admission aur claim process mein help karta hai.

Isliye hospital ke Ayushman Mitra se written clarification maangein ki :

• 1st stent kaunse package mein approve hua hai?

• 2nd stent ke liye ₹1.5 lakh kyun maanga ja raha hai?

• Kya 2 stents medically required hain?

• Kya dono stents Ayushman package/pre-authorisation mein include hain?

• Agar doosra stent covered nahi hai, to exact rule ya reason kya hai?

• Kya koi additional cash payment officially allowed hai?

Abhi aapko kya karna chahiye?

Patient ko agar chest pain, severe breathing problem, sweating, fainting, ya condition suddenly worsen ho rahi hai, to treatment ko delay na karein. Emergency mein treating cardiologist ki advice ko priority dein.

Agar patient stable hai, to payment karne se pehle AIIMS Patna ke Ayushman desk/Ayushman Mitra se poori details confirm karein aur ₹1.5 lakh ki demand ka written breakup maangein.

Sirf “doosra stent Ayushman mein nahi hai” kehne par cash dene ke bajay pehle package, stent type, approval aur payment rule verify karna safer rahega.

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