Ayushman Bharat Health Insurance Scheme Will Now Cover Senior Citizens Above 70

The Government of India has launched various health insurance schemes. The one that consistently tops the chart is Ayushman Bharat Yojana, the world’s largest health insurance scheme. Why the world’s largest? Because it covers more than 12 crore poor and underprivileged families. 

The PMJAY will provide medical insurance coverage of up to ₹5 lakh per year and cover both the tertiary and secondary hospitalisation expenses.

The scheme provides cashless hospitalisation coverage at both public hospitals and private hospitals and covers the cost of hospitalisation, pre-hospitalisation, medication, and post-hospitalisation charges.

“On 11 Sep 2024, the Union Cabinet announced that the Ayushman Bharat Yojana will now cover senior citizens aged 70 years and above, no matter what their income and socio-economic status is!”

With this decision, almost 4.5 crore families and six crore senior citizens will get the benefit of free medical treatment up to ₹5 lakh. 

Many of you might be wondering:  

If a family is already covered under the PMJAY, will they get this benefit? 

Absolutely! If a family is already covered under the PMJAY, senior citizens in that family who are 70 years old and above will receive additional benefits. They will get a new distinct Ayushman Bharat card with an extra top-up cover of up to ₹5 lakh per year for themselves. This amount is exclusive to them and does not need to be shared with other family members below 70 years of age. 

What is An Ayushman Bharat Card?

To avail of the benefits of the PM-JAY scheme, an Ayushman Bharat Card is mandatory. 

So, what is an Ayushman Bharat Card? 

AB-NHPM, or Ayushman Bharat-National Health Protection Mission, provides every beneficiary household with an Ayushman card. You will receive this card after the successful enrollment in  PMJAY. 

This card contains a unique 14-digit identification number called ABHA ID that works as proof to get healthcare benefits under the PMJAY scheme. It is issued after verifying the beneficiary’s identity at a PMJAY kiosk. 

Eligible people under the PMJAY scheme can apply for an Ayushman Bharat e-card as well. 

Features of Ayushman Bharat Yojana

The key features of the Ayushman Bharat Yojana scheme are:

• Nearly six crore Indians are pushed into poverty each year. Why?
  Due to their health expenditure expenses, they are not able to pay for other essential things like food, housing, and education. This is why the Ayushman Bharat Yojana was launched for the underprivileged to help them cover their medical expenses. 
• One family can enjoy coverage of Rs.5 lakh per year under this scheme, irrespective of family size, gender and the member's age.
• The treatment facility (secondary and tertiary care) is available in both public and private hospitals. Plus, one doesn’t have to worry if they have any pre-existing disease because all pre-existing conditions are covered from the day the policy is bought.
• More than 55 crore beneficiaries are eligible to enjoy the benefits of Ayushman Bharat Yojana. 
• The provided services under PM-JAY are cashless! This means the policyholders don’t have to pay any cash out of their pocket. 
• It includes coverage for up to 3 days of expenses before hospitalisation along with 15 days of expenses after hospitalisation. 
• The services can be availed at any of the country's empanelled public and private hospitals.
• Policyholders will be reimbursed for 1,929 medical procedures. Below, we have named a few. 
  • Costs related to treatment
  • Room charges, 
  • OT, 
  • Diagnostic services, 
  • Surgeon charges. 
  • Physician's fees, 
  • ICU charges, etc.

• Public hospitals are also reimbursed at par with private hospitals for healthcare services.

Conclusion

Initially, PM-JAY scheme coverage started with 10.74 crore poor and vulnerable families; then, in 2022, the number went to 12 crore. Along with this, 37 lakh ASHAs/AWWs/AWHs workers and their families were also ensured financial protection in case of medical emergencies. 

Now, senior citizens above 70 will also be covered. This shows the Indian Government's commitment to reducing the financial burden of healthcare expenses on underprivileged families.