Rs 5 lakh health insurance under Ayushman Bharat for senior citizens above 70 years: Who is eligible, benefits, how to apply

The government has approved health insurance coverage for all senior citizens aged 70 and over, regardless of income, under the flagship initiative Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). This was announced via a Press Information Bureau release on September 12, 2024.

AB PM-JAY's advantages would now be available to all senior citizens who are 70 years of age or older, regardless of their socioeconomic status. Under AB PM-JAY, a new, unique card would be given to the senior citizens who qualify.

This announcement was earlier made in April 2024 that the coverage would be extended to senior individuals who are 70 years of age and older.

Find eligible Ayushman Bharat hospital list near you

"It is indeed a step in the right direction to ensure accessible health for the aged population of the country to bring all senior citizens aged 70 years and above into the ambit of the expanded Ayushman Bharat scheme. The move will be highly beneficial in many ways for those who are often left vulnerable due to limited access to health and finances. This will ease the burden on the families as it provides health insurance cover of Rs 5 lakh per year, ensuring that medical emergencies do not become a financial crisis. Finally, it's a good move, benefiting one and all: public health improves, family security improves, and India moves toward more inclusive healthcare solutions," said Pankaj Nawani, CEO of CarePal Secure.

Ayushman Bharat: Who are already covered under the scheme

The senior citizens of the age 70 years and above belonging to families already covered under AB PM-JAY will get an additional top-up cover upto Rs 5 lakh per year for themselves (which they do not have to share with the other members of the family who are below the age of 70 years).

All other senior citizens of the age 70 years and above will get a cover upto Rs 5 lakh per year on a family basis.

Other health insurance

Senior citizens of the age 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 PMJAY.

Private health insurance

It has been clarified that senior citizens of 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.

Ayushman Bharat: Who it will benefit

This aims to benefit approximately 4.5 Crore families with six (6) crore senior citizens with 5 Lakh rupees free health insurance cover on a family basis.

AB PM-JAY scheme details

According to the PIB release, “The AB PM-JAY scheme has witnessed continuous expansion of the beneficiary base. Initially, 10.74 crore poor and vulnerable families comprising the bottom 40% of India’s population were covered under the scheme. Later, the Government of India, in January 2022 revised the beneficiary base under AB PM-JAY from 10.74 crore to 12 crore families considering India’s decadal population growth of 11.7 % over 2011 population. The scheme was further expanded to cover 37 lakh ASHAs/AWWs/AWHs working across the country and their families for free healthcare benefits. Taking the mission ahead, AB PM-JAY would now provide free healthcare coverage of Rs 5 lakh to all citizens of the age-group of 70 years and above across the country.”

How to Apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

Step 1: Visit the official website https://abdm.gov.in/
Step 2: eligible person should get your Aadhaar card or ration card verified at a PMJAY kiosk
Step 3: Submit family identification proofs
Step 4: Get your e-card printed with a unique AB-PMJAY ID
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana coverage

The scheme covers all expenses related to:

• Medical examinations, treatment and consultations.
• Pre-hospitalisation care, up to three days before admission.
• Medicines and medical consumables.
• Non-intensive and intensive care services (ICU care).
• Diagnostic and laboratory investigations.
• Medical implants, if necessary.
• Accommodation and food services during hospitalisation.
• Complications arising during treatment.
• Post-hospitalisation follow-up care, up to 15 days after discharge.