Why is this in the news?
The Union Cabinet has approved the expansion of the Ayushman Bharat Pradhan
Mantri Jan Arogya Yojana (AB PM-JAY) to provide comprehensive health coverage to
all senior citizens aged 70 years and above, irrespective of their income levels.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)
Overview:
Launched in September 2018, AB PM-JAY is a flagship scheme aimed at providing
secondary and tertiary care services to vulnerable populations. It is part of the larger
Ayushman Bharat initiative and offers:
- Coverage: Rs 5 lakh per family annually for hospitalizations requiring secondary and
tertiary care. - Target Population: Nearly 40% of India’s population, focused on the poorest and
most vulnerable. - Eligibility: Based on the Socio-Economic Caste Census (SECC) data, covering 10.74 crore poor, deprived rural families, and urban
occupational categories. - Benefits: Cashless access to services, including surgeries, medical treatments, and medicines at hospitals.
- Health Benefit Packages: Cover various medical services, day-care treatments, and diagnostics.
Role of the National Health Authority (NHA):
NHA is responsible for the implementation of the AB PM-JAY, including the design of technological infrastructure and the
execution of the National Digital Health Mission. State Health Agencies (SHAs) assist in implementing the scheme at the state
level.
Ayushman Bharat Health Insurance for Senior Citizens
About the News:
The government has extended AB PM-JAY to provide health coverage to individuals aged 70 years and above, irrespective of
their income levels. Currently, the scheme is based on economic criteria, but the new provisions extend these benefits to a
broader senior population.
Expansion Details:
- Coverage Extension: All citizens aged 70 years and older will receive Rs 5 lakh annual health coverage per family.
- Additional Top-up for Senior Citizens: For families already covered under AB PM-JAY, senior citizens aged 70+ will receive an
additional Rs 5 lakh shared top-up per year for their healthcare needs. - Eligibility Flexibility: Those covered under other public health schemes like CGHS, ECHS, or Ayushman CAPF can choose to
continue with their current plans or opt for AB PM-JAY. - Private Insurance Holders: Senior citizens with private health insurance or those under the Employees’ State Insurance Scheme
can also avail themselves of AB PM-JAY benefits. - Demand-based Scheme: The coverage can increase as demand rises, ensuring flexibility in response to healthcare needs.
Additional Features:
Each eligible senior citizen will be provided a new health card, allowing for easy access to healthcare services.
Impact of the Scheme Expansion
This move is expected to benefit approximately 6 crore elderly individuals from 4.5 crore families, providing much-needed
relief to a demographic facing high disease burdens and financial challenges, especially as India moves towards a nuclear
family structure. The expansion is vital in ensuring that senior citizens have access to healthcare without significant
out-of-pocket expenses.
Although Ayushman Bharat aims for universal health coverage, this marks the first targeted age group to receive
comprehensive health coverage under the scheme.