The Union Cabinet on Wednesday approved health coverage to all persons aged 70 years and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana irrespective of their income, benefiting around six crore senior citizens.
The Rs 5 lakh free health insurance cover would benefit senior citizens of around 4.5 crore families. Eligible beneficiaries would be issued a new distinct card under the scheme.
“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 Rs 5 lakh per year for themselves (which they do not have to share with the other members of the family who are below the age of 70 years).
“All other senior citizens of the age 70 years and above will get a cover up to Rs 5 lakh per year on a family basis,” an official statement said.
Ayushman Health Insurance For All Senior Citizens Aged 70 Years and Above
- The Union Cabinet approved health coverage for all senior citizens aged 70 years and above, regardless of income, under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
- Around 4.5 crore families, including 6 crore senior citizens, will benefit from Rs 5 lakh health insurance coverage per family.
- Senior citizens aged 70 years and above, regardless of socio-economic status, will be eligible for AB PM-JAY benefits.
- Eligible senior citizens will receive a distinct card under AB PM-JAY.
- Senior citizens aged 70 and above, already covered under AB PM-JAY, will receive an additional top-up of Rs 5 lakh per year exclusively for themselves.
- All other senior citizens aged 70 and above will receive coverage of Rs 5 lakh per year on a family basis.
- Senior citizens aged 70 and above under public health insurance schemes (CGHS, ECHS, CAPF) can choose between their current scheme or AB PM-JAY.
- Those under private insurance or Employees’ State Insurance will also be eligible for AB PM-JAY benefits.
- AB PM-JAY is the world’s largest publicly funded health assurance scheme, offering Rs 5 lakh per family annually for secondary and tertiary care hospitalizations, covering 12.34 crore families (55 crore individuals).
- Since its inception, the scheme has covered 7.37 crore hospital admissions, with 49% being women beneficiaries.
- More than Rs 1 lakh crore worth of benefits have been provided under the scheme.
- The expansion to include senior citizens aged 70 and above was announced by Prime Minister Modi in April 2024.
- AB PM-JAY initially covered 10.74 crore families from the bottom 40% of India’s population. This was expanded to 12 crore families in 2022 due to population growth.
- The scheme also covers 37 lakh ASHAs/AWWs/AWHs and their families for free healthcare.
- The latest expansion ensures free healthcare coverage of Rs 5 lakh to all senior citizens aged 70 years and above across the country.
Scheme Details
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 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.
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