Centre Expands Ayushman Bharat Health Insurance to All Above 70: What You Need to Know

The Union Cabinet has taken a significant step to bolster healthcare for India’s elderly by expanding the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). In a major policy shift, the scheme will now provide free health insurance coverage to all citizens aged 70 and above, regardless of their income or background. This decision is expected to benefit six crore people across 4.5 crore families by offering a health cover of ₹5 lakh per eligible individual.

For many aging Indians, concerns about managing health conditions and the escalating costs of healthcare have been a persistent worry. However, following the government’s announcement on Wednesday (September 11), “these concerns may finally be alleviated.” The Union Cabinet has approved the expansion of the AB-PMJAY, extending its coverage to “all senior citizens aged 70 years and above irrespective of their income.”

Union Minister Ashwini Vaishnaw, who announced this development, stated that the rollout of the new provision will happen “soon.” Prime Minister Narendra Modi also lauded the scheme, stating on X (formerly Twitter), “We are committed to ensuring accessible, affordable and top-quality healthcare for every Indian. This scheme will ensure dignity, care, and security to six crore citizens!”

What Does This Mean for Senior Citizens?

The extension of this scheme marks a significant shift in the landscape of public healthcare in India, providing a safety net for those above 70 years old when it comes to managing their health.

But how exactly will this expanded scheme operate, and who qualifies? Here is everything you need to know:

Who Is Eligible for the Scheme?

According to the recent government announcement, all senior citizens aged 70 and above are eligible under the AB-PMJAY scheme. Each eligible senior citizen will receive a health cover of ₹5 lakh on a family basis. For those already covered under the existing AB-PMJAY scheme, a top-up of ₹5 lakh per year will be provided for individuals aged 70 and above, which will not have to be shared with other family members.

Launched in 2018, the AB-PMJAY is currently the world’s largest government-funded health insurance scheme, covering 12 crore families. It is primarily aimed at families in the poorest 40% of India’s population, providing them with access to quality healthcare. Additionally, it also covers 37 lakh ASHA workers and their families for free healthcare benefits.

Senior citizens aged 70 and above who are covered under other public health insurance schemes like the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), and Ayushman Central Armed Police Force (CAPF) may continue with their existing schemes or choose to opt for AB-PMJAY. Furthermore, those with private health insurance or covered by the Employees’ State Insurance Scheme (ESIS) will also be eligible to avail of the new benefits.

Union Minister Vaishnaw clarified that in cases where there are two senior citizens within a family, the ₹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.

How Many Will Benefit from the Expansion?

The government estimates that extending the scheme to include all citizens aged 70 and above will benefit around six crore people across 4.5 crore families. Eligible beneficiaries will be issued a new, distinct card under the scheme, ensuring seamless access to benefits.

What Will the Costs Be?

The initial outlay for expanding the AB-PMJAY scheme to cover all citizens aged 70 and above is set at ₹3,437 crore. As per Minister Vaishnaw, state governments will bear 40% of the expenses, while the Centre will cover the remaining 60%. However, in hilly and northeastern states, the Centre will assume 90% of the costs.

Why Is This Development Significant?

Including all citizens aged 70 and above in the Ayushman Bharat health scheme is momentous for several reasons. It marks the first time that the government has extended coverage to an entire age group, irrespective of their financial status or any other criteria.

Additionally, this move is seen as a fulfillment of a key promise made by the Narendra Modi government. In April, while releasing the BJP’s poll manifesto, the Prime Minister announced that senior citizens over 70 and the transgender community would be covered under the Ayushman Bharat Yojana. In June, President Droupadi Murmu reiterated this commitment, stating that “all elderly above 70 years will get the benefit of free treatment under the Ayushman Bharat scheme.”

Expanding the scheme to cover more people, especially the elderly who are most in need, is a timely decision. The Longitudinal Ageing Study in India (LASI) projects that the percentage of India’s population over the age of 60 will increase from 8.6% in 2011 to 19.5% by 2050. According to the United Nations Population Fund (UNFPA), the elderly population of 153 million (aged 60 and above) is expected to reach 347 million by 2050. Given this demographic shift, the need for extensive health coverage is more critical than ever.

A Step Towards Inclusive Healthcare

While the expansion of the Ayushman Bharat health scheme has been widely lauded, some critics note that it only applies when a patient is hospitalized, excluding outpatient department (OPD) services that account for a significant portion of healthcare needs. Studies suggest that nearly 40-80% of health expenditure in India is on OPD services, necessitating further policy intervention to address this gap.

This initiative is a vital step towards ensuring that India’s senior citizens receive adequate healthcare support. However, more needs to be done to create a comprehensive and inclusive healthcare system.

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