Is Heart Blockage Surgery Covered Under the Ayushman Card for a 75-Year-Old?

Hello,

Yes, your 75-year-old grandfather can be eligible for the Ayushman Bharat PM-JAY senior citizen benefit, called Ayushman Vay Vandana, regardless of his income. Under the current scheme, all citizens aged 70 years and above are eligible for coverage, subject to the scheme rules. Age is verified through the date of birth/age recorded in Aadhaar.

For a heart problem where there is a blockage in the blood vessels supplying the heart, the doctor advise treatment such as angioplasty with a stent, bypass surgery, or another procedure depending on the blockage and overall condition. Whether the exact procedure is covered under PM-JAY depends on the applicable health package and the hospital's empanelment.

The Ayushman Vay Vandana benefit provides up to ₹5 lakh cover per year. For a family that was already covered under PM-JAY, a person aged 70 or above gets an additional top-up cover of up to ₹5 lakh per year for themselves, which is not shared with family members below 70. Other eligible senior citizens aged 70+ receive up to ₹5 lakh per year on a family basis.

How to check a hospital for heart treatment

1. Open the official PM-JAY Hospital Search portal.

2. Select your State.

3. Select your District.

4. Select Government Hospital or Private Hospital.

5. Select the relevant specialty, such as Cardiology/Cardiovascular Surgery, if available.

6. Enter the exact hospital name.

7. Complete the Captcha, if shown.

8. Click Search.

9. Check that the hospital's PM-JAY empanelment is active and that the required heart treatment/package is available.

10. Visit the hospital's Ayushman Mitra/PM-JAY desk with your grandfather's medical reports and treatment advice. Ask them to confirm whether the exact procedure advised by the cardiologist is covered and whether pre-authorisation is required.

You can also check the overall PM-JAY empanelled hospital list for your district.

Documents to carry

For Ayushman Vay Vandana enrolment, Aadhaar is the key document, and Aadhaar-based e-KYC is mandatory. A separate Ayushman card is issued to eligible senior citizens aged 70 years and above.

For hospital treatment, also carry :

• Grandfather's Ayushman Card, if already issued

• Aadhaar Card

• Mobile phone for OTP/verification, if required

• Cardiologist's prescription and treatment advice

• ECG reports

• 2D Echo report

• Angiography/CT angiography report, if done

• Blood test reports

• Previous hospital records and discharge summaries

• Current medicines list

There is no waiting period for the 70+ Ayushman Vay Vandana benefit, so eligible senior citizens can access treatment from the first day of enrolment.

If your grandfather is having severe or increasing chest pain, difficulty breathing, sweating, fainting, or sudden weakness, please take him to an emergency department immediately rather than waiting for Ayushman verification.

If you share your grandfather's city, state and the heart treatment advised by the doctor (for example, angioplasty/stent or bypass surgery), we can guide you on what type of PM-JAY empanelled hospital to check.

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