Know how the new Ayushman Bharat health insurance scheme will benefit senior citizens
The central government is set to implement an expansion of the Ayushman Bharat programme, which will focus on citizens above 70 years of age. The benefits of the new Ayushman Bharat Pradhan Mantri Jan Arogya Yojana The health insurance scheme will offer health insurance of up to Rs 500,000 per year. Union Minister Ashwini Vaishnaw said on Wednesday that this scheme will benefit 450 million families and will include 600 million senior citizens.
The plan also says that families already covered under the scheme will get an additional top-up of Rs 500,000 per year, specifically for senior citizens. People covered by ESIC and a private health insurance policy would also be eligible.
Vaishnaw said, “Prime Minister Narendra Modi has committed that all citizens above the age of 70 years will be covered under the Ayushman Bharat PM Jan Arogya Yojana. There are many families who are already covered and have senior citizens. In such families, the additional cover, the top-up cover will be Rs 5 lakh…”
According to an official release, “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) and Central Armed Police Force Ayushman Scheme (CAPF) can choose their existing scheme or opt for AB PMJAY. It has been clarified that citizens aged 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.”
People aged 70 years and above will be provided with a specific card under AB PM-JAY for healthcare coverage.
According to the Pradhan Mantri Jan Arogya Yojana (PM-JAY), the following benefits are provided:
- Medical examination, treatment and consultation.
- Prehospitalization
- Medicines and medical supplies
- Intensive and non-intensive care services
- Diagnostic and laboratory investigations
- Medical implantation services (when necessary)
- Benefits of accommodation
- Food services
- Complications that arise during treatment
- Post-hospitalization follow-up care for up to 15 days.
Other features of PM-JAY
- PM-JAY is the world’s largest fully government-funded health insurance and guarantee system.
- It provides a coverage of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization in public and private hospitals in India.
- More than 12 million poor and vulnerable families (approximately 55 million beneficiaries) are eligible to receive these benefits.
- PM-JAY provides cashless access to healthcare services to the beneficiary at the point of service i.e. the hospital.
- PM-JAY is intended to help mitigate the catastrophic spending on medical treatments that pushes nearly 60 million Indians into poverty every year.
- Covers up to 3 days of pre-hospitalization and 15 days of post-hospitalization expenses such as diagnoses and medications.
- There are no restrictions on family size, age or gender.
- All pre-existing conditions are covered from day one.
- The benefits of the scheme are transferable across the country, i.e. a beneficiary can visit any certified public or private hospital in India for cashless treatment.
- Services include approximately 1,929 procedures covering all treatment-related costs including but not limited to medications, supplies, diagnostic services, physician fees, room charges, surgeon charges, occupational therapy and ICU charges, etc.
- Public hospitals receive reimbursement for health care services equivalent to that of private hospitals.
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