As healthcare expenses continue to rise, it is critical to ensure adequate healthcare coverage, especially for seniors. As age increases, the likelihood of health problems increases, making health insurance a necessity. Senior citizens can take advantage of both private insurance and the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to create a more comprehensive health safety net. By combining the two, you can improve your coverage and avoid financial strain during medical emergencies. This is how you can use both effectively.
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Understanding Ayushman Bharat Scheme
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), a flagship health insurance scheme of the Government of India, has recently expanded its eligibility criteria to include Older adults over 70 years of age..
The government has clarified that all senior citizens aged 70 years and above, belonging to families already covered under AB PM-JAY, will be eligible for an additional supplementary cover of Rs 5 lakh per annum. This means that families can share this coverage among their older members.
“While the annual floating health cover of Rs 5 lakh per family can help manage a wide range of secondary and tertiary medical expenses, it may not be enough to cover certain high-cost treatments for age-related diseases,” Siddharth said. Singhal, Head – Health Insurance, Policybazaar.
Many seniors also have their own private health insurance, which they have maintained over the years. The good news is that there is no restriction on combining Ayushman Bharat with private health insurance.
This integration means seniors can use their private insurance as primary coverage and treat Ayushman Bharat as a backup for additional expenses. Basically, government-provided coverage supplements your private insurance, offering a broader safety net. This approach ensures they have access to multiple sources of funds when faced with medical bills, creating a more comprehensive healthcare plan.
“Those who can comfortably afford personal health cover should definitely opt for it in addition to Ayushman Bharat cover. Stand-alone policies usually also offer broader benefits such as OPD services, wellness programs and critical illness coverage, which are vital for seniors who require more frequent and specialized medical care. A personal health cover also ensures continuity of care, especially for those with pre-existing conditions, and ensures access to fast and seamless care,” said Siddharth.
Points to keep in mind when building a comprehensive coverage strategy
Assess your needs: Start by evaluating your health status, family medical history, and potential future requirements. This evaluation will help you choose the right combination of coverage.
Understand Ayushman Bharat Eligibility: Check if you are eligible for Ayushman Bharat. If so, it can serve as base coverage for major hospitalizations.
Choose the right private insurance: Look for policies that cover areas not included in Ayushman Bharat.
Consider recharge plans: These plans offer additional coverage over your base policy at a relatively lower premium. They can significantly improve your overall coverage.
Find coverage for critical illnesses: These specialist policies provide a lump sum upon diagnosis of specific critical illnesses, helping to manage the financial impact of serious health conditions.
First published: October 3, 2024 | 18:44 IS
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