Even as the union health ministry claimed that over 34.7 crore Ayushman cards have been created under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme across the country, the NDA’s poll-promise of free health insurance for all senior citizens over 70 remains unfulfilled, and now uncertain!
Prime Minister Modi, while releasing the BJP’s Lok Sabha poll manifesto in April 2024, had announced that senior citizens above 70 years of age and the transgender community will be brought under the ambit of the Centre’s health scheme Ayushman Bharat Yojana.
Extending the Ayushman Bharat coverage to everyone aged above 70 years and the pan-India roll out of the U-WIN portal to digitise routine vaccinations were also among the highlights of Narendra Modi’s new government’s 100-day agenda for the Union health ministry, according to media reports.
Extending the Ayushman Bharat coverage to everyone aged above 70 years and the pan-India roll out of the U-WIN portal to digitise routine vaccinations were also among the highlights of Narendra Modi’s new government’s 100-day agenda for the Union health ministry, according to media reports.
Though expectations were high that the announcement would be made in the first Budget of Modi 3.0, the proposed inclusion of senior citizens in PM-JAY wasn’t announced and a recent update from health ministry has clarified that there is currently no proposal for expansion of beneficiary database.
A press release from the ministry of health and family welfare on July 26, claimed that there was “currently no proposal to open the scheme beyond the existing beneficiary base on the contribution of premium.” The release went on to add that AB-PMJAY scheme was currently available to 55 crore individuals corresponding to 12.34 crore families, mostly from the economically backward and vulnerable communities.
As of now, only about 20 per cent of people over 60 are covered by health schemes such as the Central Government Health Scheme, Employees State Insurance Scheme, Rashtriya Swasthya Bima Yojna, cooperative health insurance, employer medical reimbursement, or private insurance. This data coming from the India Ageing Report 2023, according to an India Today report, clearly indicates that a large population of senior citizens are without any form of health insurance as most private players in the insurance sector do no entertain senior citizens as policyholders.
The Ageing Report shows that elderly men have slightly higher coverage (19.7%) compared to elderly women (16.9%). It also indicates that there is minimal difference in coverage between rural and urban areas.
The Ageing Report shows that elderly men have slightly higher coverage (19.7%) compared to elderly women (16.9%). It also indicates that there is minimal difference in coverage between rural and urban areas.
Originally, 10.74 crore beneficiary families under AB PM-JAY were identified based on the Socio-economic Caste Census (SECC) of 2011 using select deprivation and occupational criteria separately for rural and urban areas.
In January 2022, the beneficiary base was expanded to 12.34 crore families and States/UTs have been given the flexibility to use other digitized databases of similar socio-economic conditions for identification of beneficiaries under the scheme. Accordingly, States/UTs have provided Aadhaar-seeded databases of poor and vulnerable families for verification under the scheme. Beneficiaries can now access cashless treatment at any empanelled public or private hospital nationwide. Treatment is provided free of charge based on the hospital’s diagnosis. After discharge, the hospital submits the claim for reimbursement.
Eligible beneficiaries can avail of cashless and paperless healthcare services related to hospitalization across more than 29,000 empanelled hospitals in the country. In the latest national master of the Health Benefit Package (HBP), the scheme provides cashless healthcare services related to 1949 procedures across 27 medical specialties including General Medicine, Surgery, Cardiology, Oncology, etc.