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Ayushman Bharat Yojana Above 70 Years Age: Rs 5 lakh free health cover would benefit senior citizens of around 4.5 crore families.
The expansion to include senior citizens aged 70 and above was announced by Prime Minister Modi in April 2024. (Representative image/Getty)
Prime Minister Narendra Modi on Tuesday extended the government’s flagship health insurance scheme Ayushman Bharat to all senior citizens aged 70 years and above.
The major push in the health sector was unveiled on the occasion of the ninth Ayurveda Day and the birth anniversary of Dhanvantari, the Hindu god of medicine.
Background
In a landmark decision, the Union Cabinet approved an expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) on September 11, 2024, offering comprehensive health insurance to senior citizens aged 70 and above. This move will provide free health coverage of up to Rs 5 lakh per family, regardless of income, benefiting around 6 crore senior citizens across 4.5 crore families.
Ayushman Bharat: Key Numbers Of The Health Scheme
According to government sources, the Ayushman Bharat scheme has benefited nearly 7 crore people, reducing out-of-pocket expenditure by around Rs 1 lakh crore.
- The recent expansion will include approximately 2 crore additional families and 3 crore individuals.
- Of the new beneficiaries, 58% are women, with 54% of these being widows.
- Funding split: Centre contributes 60%, states bear 40%.
- Delhi and West Bengal have declined to implement the scheme since 2019, citing the 40% cost share and a preference for renaming it after the Chief Minister.
- Odisha initially refused to join under BJD, but the stance changed under the newly-formed BJP government.
- Delhi and West Bengal operate independent health schemes.
- Among the top-performing states in Ayushman Bharat are Tamil Nadu, Karnataka, Rajasthan, and Kerala, three of which are opposition-ruled, excelling in hospital admissions.
Ayushman Health Insurance For All Senior Citizens Aged 70 Years and Above
- 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 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.
Breakdown Of Scheme Expansion Details
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 hospitalisation 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% 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 the continuous expansion of the beneficiary base, it said, adding that initially, 10.74 crore poor and vulnerable families comprising the bottom 40% 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% 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.
