Ayushman Bharat health insurance scheme for senior citizens: What is the eligibility criteria? How much will it cost?

The AB PM-JAY is the world's largest publicly funded health assurance scheme

The Centre has approved health coverage to everyone who is 70 and above under the national insurance scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).

Chaired by Prime Minister Narendra Modi, the Union Cabinet issued a statement saying the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) will benefit 4.5 crore families with six crore senior citizens. The free cover is worth Rs 5 lakh and will be on a family basis. The scheme is the world's largest publicly funded health insurance programme.

What are the eligibility criteria ?

According to the scheme, senior citizens aged 70 and above and hailing from families already covered under AB PM-JAY, will get an additional (shared) top-up cover up to Rs 5 lakh per year for themselves.

Those 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 continue their existing scheme or opt for AB PM-JAY.

Those above 70 years and above, who are under private health insurance policies or Employees’ State Insurance Scheme, can also avail these benefits. All eligible senior citizens will be provided with a distinct card to access the scheme's benefits.

Will the scheme cover every senior citizen in the family?

Union Information and Broadcasting Minister Ashwini Vaishnaw said the health coverage in such a scenario will be shared by the eligible beneficiaries of a family. “If there are two senior citizens (70 years+) in a family, then the Rs 5 lakh coverage will be shared between them. This is a big step towards ensuring the social security of senior citizens, especially as India transitions to nuclear families,” he said.

What willAyushman Bharat Pradhan Mantri Jan Arogya Yojana cost the government?

According to Vaishnaw, the initial outlay of the scheme will be Rs 3,437 crore. “This is a demand based scheme; as the demand goes up, the coverage will also be increased,” he said.

According to Indian Express, most states will foot 40 per cent of the bill while 90 per cent of the cost is likely to be borne by the Centre for states in hilly regions and the Northeast. “The nitty-gritty will be worked out later. It will happen at the stage of implementation, once the decision has been taken,” a senior official told IE.

Experts told IE that the cost of expanding the coverage to all persons over 70 years would be higher than that for covering the poorest 40 per cent across all age groups.