Cabinet Approves ₹5 Lakh Health Coverage Plan for Senior Citizens Aged 70 and Above
Image Source: Hindustan Times
On Wednesday, the Cabinet approved the extension of financial benefits under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana to all citizens aged 70 and above.
On Wednesday, the Cabinet, chaired by Prime Minister Narendra Modi, approved the extension of financial benefits under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to all citizens aged 70 and above, as announced by Union Minister Ashwini Vaishnaw during a briefing on several key decisions. The coverage will be provided regardless of the beneficiaries’ financial status. Originally, the Ayushman Bharat health insurance scheme offered coverage to citizens from poor and vulnerable families, determined by the deprivation and occupational criteria outlined in the 2011 Socio-Economic Caste Census (SECC). This scheme provides up to ₹5 lakh per family per year for cashless secondary and tertiary care hospitalization.
Vaishnaw highlighted that this new decision extends universal health coverage to senior citizens under the Ayushman Bharat scheme, fulfilling a commitment made by the Prime Minister. According to government estimates, around 4.5 crore families (equivalent to 6 crore senior citizens) will benefit from this decision, expanding the current beneficiary base of 12.3 crore families. For families already covered under the scheme with senior citizens, an additional shared top-up cover of up to ₹5 lakh per year will be provided. Middle or upper-middle-class families, who are currently not covered under the scheme due to their socioeconomic status, will receive a shared cover of ₹5 lakh per year if they have senior citizens. “The additional top-up coverage of up to ₹5 lakh will be specifically allocated to senior citizens within already covered families. The term’shared cover’ means it will be shared among the senior citizens,” explained Vaishnaw.
Prime Minister Modi reiterated the government’s commitment to providing accessible, affordable, and high-quality healthcare for every Indian. “In this context, the Cabinet has decided to further expand the scope of the Ayushman Bharat PM-JAY to provide health coverage for all citizens above 70 years,” he posted on X, adding that the scheme would ensure dignity, care, and security for 60 million citizens. Vaishnaw also emphasized that this decision is vital, especially considering the current trend of families transitioning from joint to nuclear structures. “In such circumstances, today’s decision is highly relevant as it will provide health coverage and social security to our senior citizens,” he added. The new provisions will be rolled out soon, and senior citizens will need to apply to receive the benefits.
However, those who are already covered by other health insurance schemes, such as the Central Government Health Scheme (CGHS) or defense schemes, will be given the choice of continuing with their existing coverage or switching to the Ayushman Bharat scheme. Even those with private insurance will be eligible to opt in. Eligible beneficiaries will receive a new, distinct card under the scheme. The initial funding for this expansion is set at ₹3,437 crore, with provisions to extend coverage in the future based on demand. Professor K. Srinath Reddy, a senior public health expert and former president of the Public Health Foundation of India, welcomed the decision, noting that it acknowledges the many healthcare needs of the elderly, who often require long-term medical attention and treatment. He pointed out that elderly people are more susceptible to chronic diseases like heart disease, diabetes, cancer, and arthritis, which often worsen with age, and that many retirees lack personal finances for long-term care or hospitalization. Thus, the expanded coverage under PMJAY will allow the elderly to access necessary healthcare without facing financial hardship.
However, Reddy also cautioned that the relief might be limited if PMJAY does not cover outpatient care in addition to hospital care, as much of the healthcare expenditure for the elderly involves managing chronic conditions requiring ongoing outpatient care and regular diagnostic tests. He questioned whether the central government would allocate additional funds to the PMJAY scheme beyond what was announced in the March 2024 budget and if states would contribute their share for the additional financing. He concluded that, while clarifications are awaited, the expanded coverage would bring comfort to many elderly individuals who want to remain healthy and active rather than becoming frail or denying themselves necessary healthcare.
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