Senior citizens are set to receive a new health insurance coverage under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). The Union Cabinet announced on Wednesday the expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to include individuals aged 70 years and above, regardless of their income level, in public healthcare. This initiative is anticipated to bring significant transformation to the insurance sector.
Initially structured on an income-based criteria, the current AB PM-JAY offers Rs 5 lakh annual coverage to all members of eligible families, encompassing the bottom 40% economically disadvantaged population, without considering their age.
Following the Cabinet's approval of the scheme extension on September 11, all citizens aged 70 years and older will now receive Rs 5 lakh annual coverage per family. It is estimated that an additional 6 crore individuals within this age bracket, belonging to 4.5 crore families, will benefit from this development, as per a government statement. The eligible recipients will be issued a new card under PM-JAY.
Eligibility
This time, the Centre has extended the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana for all senior citizens aged 70 years and above. Even for those who are part of families already enrolled in the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
All seniors are eligible to receive an added top-up coverage of up to Rs 5 lakh annually for themselves under the expanded plan. This additional coverage is exclusive to seniors in this age group and does not require them to share it with younger family members below the age of 70 years.
Furthermore, senior citizens aged 70 years and above, who are not part of families covered under AB PM-JAY, will receive coverage of up to Rs 5 lakh per year on a family basis.
Individuals who are currently enrolled in public health insurance programs like the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), or Ayushman Central Armed Police Force (CAPF) have the option to either retain their current scheme or select the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
Moreover, senior citizens aged 70 and above who are covered by private health insurance policies or are participants in the Employees' State Insurance Scheme are also eligible to access the benefits provided under AB PM-JAY.
If there are two senior citizens, each aged 70 years or above, within a single family, then the coverage of Rs 5 lakh will be divided equally between them.
How to apply
Step 1: To begin the process, kindly proceed to the official website of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana by visiting https://abdm.gov.in/
Step 2: If you are deemed eligible, it is imperative for you to authenticate your identity by verifying your Aadhaar card or ration card at a PMJAY kiosk.
Step 3: Following the verification step, provide the necessary family identification documents as stipulated in the program's requirements.
Step 4: Once the verification process is completed, you will be issued an e-card bearing a unique AB-PMJAY ID, which should be retained for future reference and access to healthcare benefits under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana coverage.
How would affect the insurance segment
“In line with the government’s commitment to ensuring the well-being of all citizens, particularly senior citizens, this scheme extends comprehensive protection to individuals aged 70 years and above. Importantly, this inclusion is irrespective of socio-economic background, ensuring equitable access to healthcare for all. As an additional benefit, senior citizens who belong to families already enrolled under the AB PM-JAY scheme will receive a top-up of ₹5 lakh on their health insurance. This additional coverage is exclusively for senior citizens, offering further protection and peace of mind. By expanding the scope of health insurance, the AB PM-JAY will significantly enhance insurance penetration in India, benefitting one of the world’s largest demographics. It will enable citizens to easily access essential secondary and tertiary care,” said Rakesh Jain, CEO, Reliance General Insurance.
“The extension of the Ayushman Bharat PM-JAY scheme to provide free healthcare coverage for citizens aged 70 and above represents a welcome move for the public. For the insurance sector, this move highlights the government's commitment to expanding universal healthcare access, potentially reshaping the market dynamics for senior citizen health plans. For citizens, it eases a considerable financial burden, as families will no longer have to shoulder the cost of costly medical treatments for their elderly parents. This initiative not only enhances social welfare but also strengthens India's position as it progresses towards becoming a developed economy, a healthier and more inclusive society,” said G Srinivasan, MD & CEO, Galaxy Health Insurance Co Ltd.