All Elderly Above 70 Years to be Covered Under Ayushman Bharat Scheme: Modi 3.0 Fulfils Big Promise

Senior citizens aged 70 and above will now be included in the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the Centre announced on Wednesday. Union Minister Ashwini Vaishnaw confirmed that the expansion will benefit approximately 4.5 crore families, encompassing around 6 crore senior citizens across the country. The AB-PMJAY, the largest publicly funded health insurance scheme in the world, aims to provide health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to 12 crore families.

Hospital Empanelment and Management (HEM) guidelines for empanelment of hospitals under AB-PMJAY mandates the State Health Agencies (SHAs) with the responsibility of empanelling hospitals under the scheme.

Eligible senior citizens will receive a new, distinct card under the AB-PMJAY scheme. Seniors aged 70 and above from families already covered by the scheme will receive an additional top-up cover of up to Rs 5 lakh per year, exclusive to themselves and not shared with younger family members. Other senior citizens will be covered up to Rs 5 lakh per year on a family basis.

It clarified that senior citizens of 70 years and above who are under private health insurance policies or Employees' State Insurance scheme will be eligible to avail benefits under the the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).

However, those already availing benefits of other public health insurance schemes such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS) and Ayushman Central Armed Police Force (CAPF) may either choose their existing scheme or opt for AB PM-JAY, the statement said.

According to the government, AB PM-JAY is the world's largest publicly funded health assurance scheme which provides health cover of Rs 5 lakh per family annually for secondary and tertiary care hospitalization to 55 crore individuals corresponding to 12.34 crore families.

All members of the eligible families irrespective of age are covered under the scheme.

The scheme has covered 7.37 crore hospital admissions, including 49 per cent women beneficiaries. The public has benefited to the extent of over Rs 1 Lakh crore under the scheme, the statement said.

AB PM-JAY scheme has witnessed continuous expansion of the beneficiary base, it said, adding that initially, 10.74 crore poor and vulnerable families comprising the bottom 40 per cent of India's population were covered under the scheme.

In January 2022, the Union government revised the beneficiary base from 10.74 crore to 12 crore families considering India's decadal population growth of 11.7 per cent over the 2011 population.

The scheme was further expanded to cover 37 lakh ASHAs/AWWs/AWHs working across the country and their families for free healthcare benefits.

"Taking the mission ahead, AB PM-JAY would now provide free healthcare coverage of Rs 5 lakh to all citizens of the age group of 70 years and above across the country," the statement said.