How Do Cashless Cardiac and Diabetic Treatment Under Health Insurance?

Hello,

Yes, cardiac and diabetic treatment is covered under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY). If the patient is an eligible PM-JAY beneficiary, cashless treatment can be availed at a PM-JAY empanelled hospital after beneficiary verification and approval of the applicable treatment package.

PM-JAY covers hospitalization for eligible cardiac conditions. Depending on the approved treatment package and the patient's medical condition, coverage may include

• Consultation with an experienced Cardiologist.

• Diagnostic investigations such as ECG, 2D Echo, TMT, Angiography, and other medically required tests.

• ICU admission, if medically required.

• Angioplasty.

• Coronary Artery Bypass Grafting (CABG), when medically indicated.

• Medicines and consumables during hospitalization.

• Nursing care.

• Hospital stay.

• Follow-up care as per the approved PM-JAY package.

Is Diabetic Treatment Under PM-JAY

PM-JAY does not cover routine outpatient diabetes consultations or long-term medicines. However, it covers hospitalization for diabetes-related illnesses and complications that require inpatient treatment. Depending on the approved package, coverage include

• Consultation with an experienced Physician, Endocrinologist, or Diabetologist.

• Diagnostic investigations.

• Medicines during hospitalization.

• Treatment of diabetes-related complications requiring admission, such as diabetic foot, severe infections, kidney complications, or other eligible conditions.

• Hospital stay.

• Nursing care.

• Follow-up as per the approved treatment package.

Documents Required

• Ayushman Bharat (PM-JAY) Card.

• Aadhaar Card.

• Doctor's prescription.

• Relevant medical reports (ECG, 2D Echo, Angiography, blood sugar reports, HbA1c, etc., if available).

• Previous medical records (if available).

How to Check Whether the Treatment Is Available Under PMJAY?

Online Verification

• Visit the PMJAY Hospital Finder.

• Select your:

  • State

  • District

  • Specialty : Cardiology or General Medicine/Endocrinology (as applicable)

• Click Search to view PMJAY-empanelled hospitals.

• Contact the hospital's Ayushman Help Desk to confirm the availability of the required treatment package.

How HexaHealth Can Assist You?

• Ayushman Bharat Guidance : We help you understand PM-JAY eligibility, required documents, and the cashless treatment process.

• Partner Hospital Network : We connect you with suitable PM-JAY empanelled partner hospitals for cardiac and diabetic treatment.

• Experienced Specialists : We help arrange consultations with experienced Cardiologists, Endocrinologists, and Physicians.

• Treatment Support : We assist with hospitalization, treatment planning, and coordination throughout the patient's journey.

• End-to-End Assistance : From consultation to discharge and follow-up, HexaHealth supports you at every step.

Kindly let us know

• Which treatment do you require cardiac or diabetic?

• Your City and State.

• Do you already have a valid Ayushman Bharat (PM-JAY) Card?

Based on these details, we will help you connect with the most suitable experienced specialist and PM-JAY partner hospital for cashless treatment.

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