Ayushman Bharat Scheme, AB PM-JAY: How Much FREE Health Insurance Cover Is Offered To Senior Citizens?

The Prime Minister Narendra Modi-led Union Cabinet has announced good news for senior citizens in the age category of 70 years and above. The cabinet approved health coverage for all elderlies in the said age group under the flagship scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).

The scheme aims to offer Rs 5 lakh free health insurance cover on a family basis. About 4.5 Crore families with six (6) crore senior citizens will benefit from the latest development in the scheme.

It said, "Taking the mission ahead, AB PM-JAY would now provide free healthcare coverage of Rs 5 lakh to all citizens of the age group of 70 years and above across the country."

As per the Prime Minister's website, with this approval, all senior citizens aged 70 years and above irrespective of their socio-economic status would be eligible to avail the benefits of AB PM-JAY. The eligible senior citizens would be issued a new distinct card under AB PM-JAY.

According to the statement, the senior citizens aged 70 years and above belonging to families already covered under AB PM-JAY will get an additional top-up cover of up to ₹5 lakh per year for themselves (which they do not have to share with the other members of the family who are below the age of 70 years).

All other senior citizens of the age 70 years and above will get a cover up to ₹5 lakh per year on a family basis.

Notably, senior citizens aged 70 years and above who are already availing benefits of other public health insurance schemes such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), Ayushman Central Armed Police Force (CAPF) may either choose their existing scheme or opt for AB PMJAY.

The government further clarified that senior citizens of 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.

To date, Ayushman Bharat scheme, the world's largest publicly funded health assurance scheme has offered health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to 55 crore individuals corresponding to 12.34 crore families.

Also, all members of the eligible families irrespective of age are covered under the scheme.

Data from the government showed that the scheme has covered 7.37 Crore hospital admissions including 49 per cent of women beneficiaries. The public has benefited to the extent of over Rs. 1 Lakh crore under the scheme.

Furthermore, the data revealed that the scheme has witnessed continuous expansion of the beneficiary base. Initially, 10.74 crore poor and vulnerable families comprising the bottom 40% of India's population were covered under the scheme. Later, the Government of India, in January 2022 revised the beneficiary base under AB PM-JAY from 10.74 crore to 12 crore families considering India's decadal population growth of 11.7 % over the 2011 population.

Additionally, the expanded to cover 37 lakh ASHAs/AWWs/AWHs working across the country and their families for free healthcare benefits.

Expansion of cover to senior citizens of the age of 70 years and above was earlier announced in April 2024 by PM Modi and his cabinet.