Healthcare access for senior citizens in India is set to improve significantly with the expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). In a landmark decision, the Union Cabinet has extended the scheme to provide health coverage of up to Rs 5 lakh per year to all citizens aged 70 and above, regardless of their income level. This move will greatly benefit Kerala, where the ageing population is growing rapidly, and healthcare costs are a concern for many elderly individuals.

How the Scheme Works

The Ayushman Bharat scheme already provides health coverage to the economically weaker sections of society, covering the bottom 40% of the population. Under the current model, families eligible under the scheme receive Rs 5 lakh of shared annual coverage. However, with the new changes, families with senior citizens aged 70 and above will receive an additional Rs 5 lakh of coverage for these individuals alone.

An estimated 6 crore people, from 4.5 crore families, will benefit from this expanded scheme. Eligible individuals will receive a new PM-JAY card, ensuring that they can access the healthcare benefits with ease.

Who Can Benefit?

If you’re a senior citizen aged 70 or above and are already part of a family covered under AB PM-JAY, you will be eligible for this top-up cover of Rs 5 lakh per year. The scheme is also extended to individuals who are part of other public health insurance programs such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), and Ayushman CAPF (Central Armed Police Force). You can choose to continue with these schemes or opt into AB PM-JAY.

Senior citizens who are enrolled in private health insurance or the Employees’ State Insurance Scheme will also be eligible to switch to this government-backed plan.

How Coverage Works for Families

In cases where there are multiple senior citizens aged 70 and above in the same family, the Rs 5 lakh coverage will be shared among them. This shared coverage will significantly ease the burden on families, particularly in a state like Kerala, where nuclear families are becoming more common, leaving elderly members more vulnerable to financial and healthcare stress.

Why is this Important?

The expansion of the Ayushman Bharat scheme marks a major step toward universal health coverage in India. Previously, the scheme focused on providing coverage to the economically disadvantaged across all age groups. Now, for the first time, an entire age group – those 70 and above – will receive complete healthcare coverage, addressing the specific needs of an ageing population.

What is the Cost to the Government?

Rolling out this extended healthcare coverage is expected to cost the government Rs 3,437 crore in the initial phase. The scheme is demand-based, meaning the government is prepared to increase coverage as needed. For most states, the cost will be split, with the central government covering 60% and states covering 40%. However, for states in hilly regions and the Northeast, the central government will cover 90% of the costs.

The Growing Importance of Health Coverage for Seniors

India’s population of people aged 60 and above is expected to nearly triple by 2050, growing from 103 million in 2011 to 319 million. As per the India Ageing Report 2023, only 20% of this population currently has health coverage. Kerala, with its high life expectancy and ageing demographic, stands to benefit greatly from the expanded health coverage, helping reduce the disease burden and providing a stronger safety net for its elderly citizens.

This move is a crucial step toward ensuring that senior citizens, who are among the most vulnerable members of society, can access affordable healthcare without the fear of financial hardship.

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