The Indian government has extended the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to cover all senior citizens above the age of 70, irrespective of their socio-economic status.
This decision, announced by the National Health Authority, marks a pivotal step towards achieving universal health coverage in India.
Why Ayushman Bharat for Senior Citizens above 70?
According to the 2011 Census, the population of senior citizens in India was around 104 million, and this number is expected to rise significantly in the coming years.
As people age, their healthcare needs become more complex and frequent, necessitating a robust healthcare system that can cater to these demands.
AB-PMJAY to all senior citizens above 70 addresses this gap, ensuring that every elderly individual has access to essential healthcare services.
All senior citizens 70 years and above are eligible for this scheme.There is no income restriction under this scheme. Hence, irrespective of your income if you are a senior citizen, then you can opt for this. The eligible senior citizens would be issued a new distinct card under AB PM-JAY.
The senior citizens aged 70 years and above belonging to families already covered under the Ayushman Bharat Scheme (Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY)) 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.
Senior citizens of the age 70 years and above who are already availing benefits of other public health insurance schemes such as Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), Ayushman Central Armed Police Force (CAPF) may either choose their existing scheme or opt for AB PMJAY.
Even the 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.
Key Features of the Scheme
The AB-PMJAY is one of the world’s largest government-funded healthcare programs, providing coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization. With the inclusion of all senior citizens above 70, the scheme now offers:
Comprehensive Coverage: The scheme covers a wide range of medical treatments, including surgeries, hospitalization, and post-hospitalization care. This ensures that senior citizens can receive timely and appropriate medical attention without the burden of high medical costs.
Cashless and Paperless Access: Beneficiaries can avail of cashless and paperless healthcare services at any empaneled hospital across the country. This simplifies the process and reduces the hassle for elderly patients and their families.
Portability: The scheme’s portability feature allows beneficiaries to access healthcare services in any part of the country, ensuring that senior citizens can receive care even if they are away from their home state.
Empaneled Hospitals: A vast network of public and private hospitals is empaneled under the scheme, providing beneficiaries with a wide choice of healthcare providers.
The implementation of this expanded coverage will be overseen by the National Health Authority, which has been instrumental in the successful rollout of AB-PMJAY since its inception.
By removing financial barriers to healthcare, the scheme aims to improve health outcomes, reduce out-of-pocket expenses, and enhance the quality of life for the elderly.
The key services covered under the Ayushman Bharat Senior Citizen Scheme:
Medical Examinations, Treatment, and Consultations:
- Routine check-ups and consultations with doctors.
- Specialist consultations and follow-ups.
Pre-Hospitalization Care: Coverage for medical expenses incurred up to three days before hospitalization.
Hospitalization Services: Both non-intensive and intensive care services, including ICU care. Surgical procedures and treatments.
Accommodation and food services during hospitalization
Post-Hospitalization Care: Follow-up care for up to 15 days after discharge.
Medicines and Medical Consumables: Coverage for prescribed medications and necessary medical supplies.
Diagnostic and Laboratory Investigations: Tests and diagnostics required for treatment.
Medical Implants: Coverage for necessary medical implants and devices.
Complications Arising During Treatment: Management and treatment of any complications that occur during treatment.
This extensive coverage ensures that beneficiaries, including senior citizens, receive the necessary medical attention without the financial burden, promoting better health outcomes and quality of life.
The extension of Ayushman Bharat to all senior citizens above 70 is a landmark decision that underscores the Indian government’s commitment to inclusive healthcare. By providing comprehensive, cashless, and portable healthcare coverage, the scheme promises to significantly improve the health and well-being of the elderly population. As India continues to grapple with the challenges of an aging population, such initiatives are vital in building a resilient and inclusive healthcare system that leaves no one behind.
