NEW DELHI: With the Union Cabinet approving health insurance coverage to those aged 70 years and above irrespective of income, the Centre’s flagship Ayushman Bharat scheme has now become much bigger as it will now cover six crore senior citizens and around 4.5 crore families.Union Health Secretary Apurva Chandra on Thursday said Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), which provides Rs. 5 lakh per family per year for secondary and tertiary care hospitalisation to 55 crore individuals corresponding to 12.34 crore families, can now be availed by anyone aged 70 years or above as per Aadhar card.He said the probability of people over 70 years visiting the hospital is higher than the rest. “Private insurance is difficult to obtain for old-age people. Their hospital admission rate tends to go up 8 to 9 per cent compared to 3 to 4 per cent of a younger person,” he said.Considering this, the Centre is also working towards adding more packages that exclusively tend to handle old age-related ailments. Currently, there are 25 such packages under the scheme.The biggest beneficiary of the expanded scheme will be elderly women.“This scheme is also expected to help women further as 58% of those 70 plus years of age are women, of which 54% are widows,” he added.On Wednesday, the union cabinet brought senior citizens aged 70 and above under the Ayushman Bharat scheme, which is touted to be the world’s largest health insurance scheme.“Eligible senior citizens will be issued a new distinct card under AB PM-JAY, and the registration process or enrollment through a portal will be opened in a week. Senior citizens of 70 years and above belonging to families already covered under AB PM-JAY will get an additional top-up cover up to Rs 5 lakh per year for themselves,” he added.“Initially, a pilot launch will sort out any issues. It’s an application-based scheme, and people will need to register on the portal,” Chandra said, adding that there is no waiting or cooling-off period.“Once KYC is done, a card will be operational immediately,” he added.Those already having the Ayushman card must apply for a new card and complete their eKYC again.Face authentication will be available on the portal, which will have a designated link for senior citizens 70 years and above.The Centre will also launch an awareness campaign on all media platforms through Information, Education, and Communication (IEC), field-level workers, and other community-level participation.The Centre will continue to fund its share of the scheme, which is 60%.“If states expand the scheme or modify it to include other age groups, it is up to them. Some states have expanded the beneficiary base beyond SECC (Socio Economic and Caste Census). They provide the premium for these beneficiaries,” the health secretary said. Only Delhi and West Bengal are not part of the scheme. Odisha will soon be joining the scheme.He also hinted that the premium being paid by the centre to states is being revised based on a NITI Aayog committee headed by Dr V K Paul, Member (Health), Niti Aayog.More than six crore people have already availed of the benefits of this scheme, which has reduced their out-of-pocket expenditure by around 1 lakh crore.Prime Minister Narendra Modi announced the expansion of insurance coverage to senior citizens aged 70 years and above in April 2024.The health secretary also said that those with private insurance and ESIC beneficiaries can apply for the scheme.Senior citizens aged 70 years and above who are 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 choose their existing scheme or opt for AB PM-JAY.Those covered by private health insurance policies or employees’ state insurance schemes will be eligible to avail themselves of benefits under AB-PMJAY.The scheme since its launch in 2018 has covered 7.37 crore hospital admissions, including 49 per cent of women beneficiaries. The public has benefited from over Rs. 1 Lakh crore under the scheme.Initially, 10.74 crore poor and vulnerable families comprising the bottom 40% of India’s population were covered under the scheme. Later, the government, in January 2022, revised the beneficiary base under the scheme from 10.74 crore to 12 crore families, considering India’s decadal population growth of 11.7 % over the 2011 population.The scheme was later expanded to cover 37 lakh ASHAs/Aganwadi workers working across the country and their families for free healthcare benefits.
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