Cabinet approves free health insurance for 70 plus senior citizens under Ayushman Bharat

Union Minister Ashwini Vaishnaw during the Cabinet briefing on September 11.

In a major move aimed at providing health security to senior citizens, the Union Cabinet on Wednesday approved free health insurance coverage of up to Rs 5 lakh per year for all citizens aged 70 years and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). This decision will benefit approximately 4.5 crore families, covering an estimated 6 crore senior citizens across the country.

The newly-introduced provision will be implemented in a demand-based manner, with an initial outlay of Rs 3,437 crore. However, this amount is subject to increase depending on the uptake of the scheme, Information and Broadcasting Minister Ashwini Vaishnaw said during the Cabinet briefing. He also mentioned that the Health Ministry would soon announce the rollout details for the program.

The new policy extends the health cover to senior citizens irrespective of their income or socio-economic status. "All senior citizens of the age 70 years and above, irrespective of their socio-economic status, would be eligible to avail the benefits of AB PM-JAY," Vaishnaw said. This move aims to provide much-needed support to senior citizens by addressing their healthcare needs through the world’s largest publicly funded health assurance scheme.

The scheme, already covering 55 crore individuals across 12.34 crore families, will now include an additional layer of protection for senior citizens. Those who are already part of families covered under AB PM-JAY will receive an extra top-up cover of Rs 5 lakh, which will be exclusively for senior members. "The senior citizens of the age 70 years and above belonging to families already covered under AB PM-JAY will get an additional top-up cover of Rs 5 lakh per year for themselves," the Union Cabinet said in a statement.

For those currently enrolled in other health schemes, such as the Central Government Health Scheme (CGHS) or the Employees' State Insurance scheme (ESI), they will have the option to switch to AB PM-JAY or retain their existing coverage. "Senior citizens of the age 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," Vaishnaw clarified.

Hospitals already enrolled under Ayushman Bharat will automatically be a part of this initiative. Currently, every state in India - except for West Bengal and Delhi - is part of the Ayushman Bharat scheme.

The expansion of the beneficiary base comes after Prime Minister Narendra Modi first announced the initiative in April 2024. The government had earlier expanded the AB PM-JAY scheme in January 2022 to include 12 crore families, taking into account India's population growth. "The AB PM-JAY scheme has witnessed continuous expansion of the beneficiary base," the statement said.

With over 7.37 crore hospital admissions since its inception, AB PM-JAY has provided healthcare coverage worth over Rs 1 lakh crore to the public, with women making up 49 percent of the beneficiaries.

This latest move to cover senior citizens ensures that one of the most vulnerable sections of the population receives adequate healthcare, contributing to the government's mission of ensuring healthcare for all.