New Delhi: Prime Minister Narendra Modi this week formally launched the expansion of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), paving the way for all citizens above 70 years of age to join the government’s flagship health insurance scheme.
Now, people in the said age group, who are more prone to hospitalisation than others, can register for the scheme on the Ayushman Bharat portal or its mobile app with their Aadhaar details, irrespective of their income.
Officials in the Union Ministry of Health and Family Welfare told ThePrint that it is mandatory for all eligible senior citizens to provide Aadhaar details during eKYC to enrol into the scheme.
Once registered, they will be issued a new card called Ayushman Vaya Vandana.
Under the AB-PMJAY, first launched in 2018, beneficiaries are entitled to cashless hospitalisation coverage of up to Rs 5 lakh for secondary- and tertiary-level healthcare in empanelled hospitals.
Around 12.3 crore families of poor socio-economic status have been covered under the programme so far.
According to government data, India has a total of nearly six crore people who are aged 70 or above. But since many of them are already covered on account of being part of low-income groups or as beneficiaries of government health schemes such as the Central Government Health Scheme (CGHS), an additional 2.72 crore people from 1.96 crore families will now be added to the beneficiary pool.
Government officials ThePrint spoke to said there is a plan on the anvil to launch a mega awareness campaign on all social media platforms and through field-level workers and community participation. “Also, there is no waiting period or cooling off period to join the scheme. Once eKYC is done, the card will immediately be operational,” a senior government official said.
New Delhi-based NatHealth, a major association of private healthcare providers, welcomed the move, saying the initiative marks a pivotal step in elderly care. This is because it extends support to a segment with high disease burden, presses the need for enhanced healthcare access and reinforces the nation’s position as “a leader in inclusive healthcare”.
Abhay Soi, president, NatHealth, and chairman and managing director, Max Healthcare told ThePrint they are happy that the government has tailored the scheme to address the specific needs of senior citizens, “ensuring a comprehensive continuum of care”.
A position paper on senior care released in February by apex public policy think tank NITI Aayog—Senior Care Reforms in India: Reimagining the Senior Care Paradigm—said 75 per cent of the elderly have one or more chronic diseases. In terms of social protection, only 18 per cent reported being covered by any health insurance, the paper said.
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Choice between AB-PMJAY & other govt schemes
According to government officials, citizens aged 70 and above belonging to families already covered under AB PM-JAY will get an additional top-up amount of up to Rs 5 lakh per year for themselves.
People in the above age group already availing benefits of other public health insurance schemes such as CGHS, ex-servicemen contributory health scheme (ECHS), Ayushman Central Armed Police Forces (CAPF) initiative may either choose their existing scheme or opt for AB PM-JAY. In addition, those under private health insurance policies or Employees’ State Insurance Scheme (ESIC) will be eligible to avail benefits under AB-PMJAY.
As of now, the scheme offers 1,947 health benefit packages across 27 specialities, of which 25 are geriatric care packages. Officials maintain that a panel of senior doctors has been formed to suggest more packages specially designed to cater to the new beneficiaries.
Currently, the annual premium for AB-PMJAY stands at Rs 1,102 per beneficiary, but the amount may rise now. This will be based on the recommendations of a high-level committee, which was formed earlier this year to suggest reforms in AB-PMJAY’s operation.
Government statistics show that more than six crore people have already availed the scheme so far, which has reduced their out-of-pocket expenditure on healthcare by nearly Rs 1 lakh crore.
(Edited by Radifah Kabir)
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