Ayushman Bharat Expands: Free ₹5 Lakh Health Insurance for Senior Citizens Over 70

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The Union Cabinet’s groundbreaking decision to provide health coverage to all senior citizens aged 70 and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), regardless of income.

Ayushman Bharat

The Union Cabinet has taken a monumental step to provide health coverage for all senior citizens aged 70 and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). This decision, which transcends income-based restrictions, is set to benefit over six crore senior citizens across the country. With the promise of ₹5 lakh free health insurance coverage, the initiative ensures that senior citizens receive adequate medical support, especially during critical hospitalizations for secondary and tertiary care.

This expanded coverage will cater to around 4.5 crore families, bringing substantial relief to the elderly and their caregivers, as well as mitigating the financial burden associated with healthcare.

Key Details of the Expansion

The latest Union Cabinet decision highlights significant features that will impact the healthcare landscape for senior citizens in India:

  • ₹5 Lakh Health Insurance Coverage: Every senior citizen aged 70 and above will be entitled to free health coverage up to ₹5 lakh per year, a benefit designed to assist in hospitalization and treatment costs.

  • Eligibility Without Income Barriers: Unlike previous criteria, senior citizens over the age of 70 will be covered irrespective of their socio-economic background. This ensures that millions of elderly individuals across diverse economic classes can access medical care without financial strain.

  • Distinct AB PM-JAY Cards: Eligible beneficiaries will be issued a special AB PM-JAY card under this scheme, which will distinguish their status as senior citizens entitled to exclusive health benefits.

Additional Coverage for Existing AB PM-JAY Families

The expanded coverage has specific provisions for families already enrolled in the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. For senior citizens aged 70 and above within these families, there will be an additional top-up cover of ₹5 lakh per year, reserved solely for their healthcare needs. This top-up ensures that elderly members of the family do not have to share the allocated coverage with younger family members.

For all other senior citizens who fall outside the previously covered population but are aged 70 and above, the ₹5 lakh coverage will apply to them and their families on a yearly basis.

Choices for Those Under Other Health Schemes

In an important move, the Union Cabinet clarified that senior citizens who are already enrolled under public health insurance schemes—such as the Central Government Health Scheme (CGHS), the Ex-Servicemen Contributory Health Scheme (ECHS), and the Ayushman Central Armed Police Force (CAPF)—can either continue with their current coverage or choose to avail the benefits of AB PM-JAY.

Additionally, those who are covered under private insurance plans or Employees’ State Insurance will also be eligible to enroll in Ayushman Bharat. This brings flexibility for seniors who may want to explore different health coverage options, ensuring that they can access the best possible care.

Ayushman Bharat: The World’s Largest Public Health Scheme

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is regarded as the world’s largest publicly funded health assurance scheme. Since its inception, the program has provided ₹5 lakh of health coverage annually for secondary and tertiary care hospitalizations to over 12.34 crore families. This translates to approximately 55 crore individuals, forming nearly 40% of India’s population.

Since it was introduced, AB PM-JAY has facilitated 7.37 crore hospital admissions, with 49% of the beneficiaries being women. Furthermore, the total value of benefits provided under this scheme has surpassed a whopping ₹1 lakh crore, underscoring its significance in India’s healthcare landscape.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

Steady Expansion of the Scheme

When Ayushman Bharat was initially rolled out, it targeted 10.74 crore poor and vulnerable families from the lower 40% of India’s population. Recognizing the country’s growing healthcare needs and expanding population, the government revised the scheme’s scope in January 2022, covering 12 crore families.

The scope of AB PM-JAY was also widened to provide healthcare benefits to 37 lakh ASHAs (Accredited Social Health Activists), Anganwadi Workers (AWWs), and Anganwadi Helpers (AWHs) along with their families. These community health workers, who play a pivotal role in grassroots healthcare delivery, were granted free healthcare coverage, acknowledging their contributions to the nation.

Prime Minister Modi’s Commitment to Expanding Healthcare

This recent expansion to cover senior citizens aged 70 and above reflects Prime Minister Narendra Modi’s commitment to strengthening healthcare for vulnerable groups. In April 2024, he announced this initiative, underscoring the government’s dedication to ensuring that elderly citizens across the country receive access to free healthcare without the financial stress that comes with medical treatments.

By focusing on senior citizens, this expansion acknowledges the growing healthcare challenges faced by India’s aging population. With the rise in chronic illnesses and the need for long-term medical care, AB PM-JAY offers a comprehensive safety net for the elderly.

Challenges and the Road Ahead

While the expansion of Ayushman Bharat to senior citizens aged 70 and above is a welcome move, its successful implementation will require effective coordination between the central and state governments, as well as healthcare providers. Ensuring that eligible citizens receive their distinct AB PM-JAY cards and are informed about the benefits they can access will be crucial to its success.

Moreover, there must be continuous monitoring to guarantee that healthcare facilities are equipped to manage the increased number of senior citizens seeking care, especially in rural and underdeveloped regions.

In a Nutshell

The Union Cabinet’s decision to provide ₹5 lakh health insurance coverage to all senior citizens aged 70 and above is a transformative step in India’s healthcare sector. It not only broadens the scope of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana but also solidifies India’s commitment to improving healthcare access for its elderly population. With over six crore senior citizens set to benefit, this expansion marks a significant stride toward ensuring dignified and accessible healthcare for all.

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