Is VSD Surgery for a 4-Month-Old Baby Available Under the Ayushman Bharat Card?

Dear Prabhas Ranjan ji,

Yes, a 4-month-old baby with VSD (Ventricular Septal Defect) is eligible for treatment under the Ayushman Bharat PM-JAY scheme. VSD is a condition in which there is a hole in the wall separating the lower chambers of the heart. Some babies need surgery, while others may only need regular monitoring. A paediatric cardiologist and paediatric cardiac surgeon will decide the right treatment based on the baby's condition.

Ayushman Bharat PM-JAY provides eligible families with cashless hospital treatment up to ₹5 lakh per family per year. VSD surgery is listed in certain state scheme packages, but coverage depends on the applicable package, the baby's eligibility and whether the hospital is currently empanelled and authorised to provide this treatment. Please check these details with the hospital before admission.

How to Check Ayushman empanelled hospital?

1. Visit the official Ayushman Bharat hospital search portal.
2. Select the state where you want your baby to receive treatment.
3. Select the district.
4. Check the overall list of Ayushman-empanelled hospitals in that district.
5. Select the hospital type, such as Government or Private.
6. Choose the relevant specialty, such as Paediatric Cardiology or Cardiothoracic and Vascular Surgery (CTVS), depending on the options available.
7. Enter the hospital's name if you have a particular hospital in mind.
8. Enter the captcha and click Search.
9. Check whether the hospital is currently empanelled under PM-JAY.
10. Contact the hospital's Ayushman Mitra or scheme desk and ask whether VSD surgery for a 4-month-old baby is covered under an available package. Ask about pre-authorisation and whether any expenses would remain payable by the family.

Which documents should you carry?

• Baby's Ayushman Bharat card, if issued.
• Baby's birth certificate or other available birth record.
• Parent's Aadhaar card or another accepted identity document.
• Ration card or other family beneficiary documents, if required.
• Paediatric cardiologist's prescription and treatment recommendation.
• Echocardiogram (2D Echo) report showing the VSD.
• ECG, chest X-ray and other heart investigation reports, if available.
• Previous hospital records, prescriptions and discharge summaries.
• Any referral letter or pre-authorisation documents requested by the hospital.

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