AB PM-JAY benefits extended to senior citizens of 70 years and above

The central government has extended the benefits of the world’s largest government-funded health insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY), to all senior citizens 70 years of age or above in the country. This was decided at a meeting of the Union Cabinet chaired by Prime Minister Narendra Modi.

Prime Minister Narendra Modi launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) on September 23, 2018, in Ranchi, Jharkhand. 

According to the government, as of 9 September 2024, over 35.4 crore Ayushman cards have been issued under the AB-PMJAY across the country. 

The scheme is operational in 33 States and Union Territories except Delhi, West Bengal, and Odisha.

Key features of the Decision

• The inclusion of 70 years and above senior citizens in the scheme is expected to benefit  
• 6 crore senior citizens.
• They will get Rs 5 lakh health insurance annually, irrespective of their socio-economic status. 
• If a senior citizen aged 70 or above belongs to a family covered under the scheme, then the family health insurance coverage will be increased to Rs 10 lakh. The extra Rs 5 lakh benefit will be exclusively for the senior citizen. 
• Those already enrolled under various public health insurance schemes can continue with their existing health scheme or opt for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
• Senior citizens 70 years of age or older enrolled under the private health insurance scheme or the Employees’ State Insurance scheme will be eligible to receive benefits under AB PM-JAY.
• They will be issued separate Ayushman cards.

Benefits Under the AB PM-JAY 

• AB PM-JAY is a family floater health insurance scheme in which eligible families get Rs 5 lakh per year insurance for secondary and tertiary care hospitalisation.
• A family floater plan means that a family member or all the members combined can get health insurance benefits of Rs 5 lakh per year in eligible public or private sector hospitals.
• The central government and the state government share the insurance premium. 
• The AB PMJAY is a cashless health insurance facility. The government reimburses hospitals after the beneficiaries under the scheme are treated.

Eligibility under AB PM-JAY 

Initially, the scheme was for the identified poor and vulnerable families (approximately 55 crore beneficiaries), based on the deprivation and occupational criteria of the Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas, respectively.

• Later, the scheme was extended to include 37 lakh Accredited Social Health Activists (ASHAs), Anganwadi Workers, and Anganwadi Helpers and their families, 
• No restriction on family size.
• The scheme is being implemented by the National Health Authority under the Union Ministry of Health and Family Welfare.

Ayushman Bharat Health&Wellness Centres, renamed Ayushman Arogya Mandir