Ayushman Bharat PM-JAY: Comprehensive Health Coverage for Senior Citizens Aged 70 and Above

In a significant move to enhance healthcare accessibility and affordability for the elderly, the Union Cabinet, chaired by Prime Minister Narendra Modi, has approved the expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to include all senior citizens aged 70 and above, irrespective of their socio-economic status.

Expanded Coverage and Benefits

Under this new initiative, approximately 4.5 crore families, comprising around 6 crore senior citizens, will be eligible for a free health insurance cover of up to ₹5 lakh per year on a family basis. Senior citizens who are already part of families covered under AB PM-JAY will receive an additional top-up cover of ₹5 lakh per year, exclusively for their use and not to be shared with other family members below the age of 70.

Eligibility and Existing Schemes

Senior citizens aged 70 and above who are currently benefiting from other public health insurance schemes, such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), or Ayushman Central Armed Police Force (CAPF), have the option to either continue with their existing scheme or opt for AB PM-JAY. Additionally, those covered under private health insurance policies or the Employees’ State Insurance scheme are also eligible to avail the benefits of AB PM-JAY.

New Distinct Cards and Access

Eligible senior citizens will be issued new, distinct cards under AB PM-JAY to access the scheme's benefits. This move is part of the government's commitment to ensuring affordable and top-quality healthcare for every Indian, as emphasized by Prime Minister Narendra Modi.

Impact and Achievements of AB PM-JAY

The Ayushman Bharat PM-JAY scheme has been instrumental in transforming healthcare access and affordability in India. Since its inception, the scheme has covered 7.37 crore hospital admissions, with 49% of the beneficiaries being women. The public has benefited to the extent of over ₹1 lakh crore under the scheme. As of September 9, 2024, over 35.4 crore Ayushman cards have been issued, and the scheme is operational in 33 states and union territories, except for NCT Delhi, West Bengal, and Odisha.

Continuous Expansion and Benefits

The AB PM-JAY scheme has witnessed continuous expansion of its beneficiary base. Initially, it covered 10.74 crore poor and vulnerable families, which was later revised to 12 crore families in January 2022 to account for India's decadal population growth. The scheme was further expanded to cover 37 lakh ASHAs/AWWs/AWHs and their families for free healthcare benefits. This latest expansion to include senior citizens aged 70 and above is a significant step in the government's mission to provide comprehensive healthcare coverage to all citizens.

The expansion of AB PM-JAY to senior citizens is expected to alleviate significant financial burdens associated with healthcare. Without this scheme, the total cost of treatment would have been 1.5 to 2 times higher, leading to savings of over ₹1.25 lakh crore in out-of-pocket expenses. Additionally, district hospitals have experienced substantial financial gains, with an annual net benefit projected to increase further.

Choices for Senior Citizens

Senior citizens now face a choice between retaining their costly health policies or opting for the AB PM-JAY coverage. This decision is crucial as it involves weighing the benefits and costs of each option, highlighting the complexity of healthcare choices for the elderly.

Preparing for India's Aging Population

This initiative aligns with the broader strategy of preparing to reap India’s "silver dividend" by ensuring that the aging population has access to quality healthcare. As India's population ages, such comprehensive health coverage schemes are essential for maintaining the health and well-being of senior citizens.

In conclusion, the expansion of Ayushman Bharat PM-JAY to include all senior citizens aged 70 and above is a landmark decision that underscores the government's commitment to equitable and affordable healthcare for all Indians, particularly the most vulnerable populations. This move is set to transform the healthcare landscape in India, ensuring that elderly citizens have access to necessary medical care without financial hardship.