Health Insurance Scheme
The Union government has approved health coverage to everyone who is 70 and above under the national insurance scheme Ayushman Bharat.
The Union Cabinet, chaired by Prime Minister Narendra Modi, in a statement said the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) will benefit 4.5 crore families with six crore senior citizens. The free cover is worth ₹ 5 lakh and will be on a family basis.
“With this approval, all senior citizens of the age 70 years and above irrespective of their socio- economic status would be eligible to avail the benefits of AB PM-JAY. The eligible senior citizens would be issued a new distinct card under AB PM-JAY,” the government said in the statement.
Senior citizens of the age 70 years and above belonging to families already covered under AB PM-JAY will get an additional top-up cover up to ₹ 5 lakh per year for themselves (which they do not have to share with other members of the family who are below the age of 70 years), the government said.
Senior citizens above 70 who are already getting benefits of other public health insurance schemes such as 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 PMJAY.
“We are committed to ensuring accessible, affordable and top quality healthcare for every Indian,” Prime Minister Narendra Modi posted on X.
It has been 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 AB PM-JAY.
The AB PM-JAY is the world’s largest publicly funded health assurance scheme which provides health cover of ₹ 5 lakh per family per year for secondary and tertiary care hospitalisation to 55 crore people, corresponding to 12.34 crore families.
All members of 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 ₹ 1 lakh crore under the scheme, the government said.
The expansion of cover to senior citizens of 70 and above was announced by PM Modi in April.
The government said the AB PM-JAY scheme has seen continuous expansion of the beneficiary base. Initially, 10.74 crore poor and vulnerable families comprising the bottom 40 per cent of India’s population were covered under the scheme.
Later, the government in January 2022 revised the beneficiary base under AB PM-JAY from 10.74 crore to 12 crore families considering India’s decadal population growth of 11.7 per cent over 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 ₹ 5 lakh to all citizens of the age-group of 70 years and above across the country.
Everyone Over 70 to be Covered Under Health Insurance Scheme
In a major policy shift aimed at safeguarding the elderly population, the government has announced that individuals aged 70 and above will now be covered under a comprehensive health insurance scheme. This landmark initiative is designed to address the growing health challenges faced by the elderly and provide them with financial protection against rising medical costs.
Key Features of the Scheme:
1.Eligibility: Every citizen aged 70 and above is eligible for coverage under the scheme, regardless of their socio-economic status.
2. Coverage: The insurance plan will cover a wide range of medical treatments, including hospitalizations, surgeries, and chronic illness management.
3. Premium: The scheme will either be government-funded or highly subsidized, ensuring that senior citizens, particularly those from economically weaker sections, are not burdened with heavy premiums.
4. Cashless Treatment: Beneficiaries will have access to a network of hospitals where they can avail of cashless treatment, reducing the immediate financial strain on families.
5. Preventive Health Checkups: To encourage proactive healthcare, the plan will include free annual health checkups for all policyholders.
Rationale Behind the Initiative:
With an increasing elderly population, India is witnessing a rise in age-related diseases such as cardiovascular issues, diabetes, and respiratory disorders. The government recognizes the importance of providing affordable healthcare to this vulnerable section of society. This initiative is a part of a broader strategy to enhance the quality of life for the elderly, reduce out-of-pocket expenses on healthcare, and promote dignity and independence in old age.
Impact:
This policy is expected to benefit millions of senior citizens across the country. Many families, especially in rural areas, often face financial hardship due to the high cost of medical treatments for elderly members. By offering an insurance cover, the scheme will alleviate these concerns and contribute to the overall well-being of the elderly.
The scheme reflects the government’s commitment to inclusivity in healthcare and aligns with its broader goal of achieving universal health coverage. The announcement has been widely welcomed by senior citizen groups and healthcare professionals, who view it as a significant step forward in addressing the healthcare needs of India’s aging population.
