On October 29 (Ayurveda Day), Prime Minister Narendra Modi launched Ayushman Vaya Vandana health cards under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to provide health coverage to people aged 70 years and above, regardless of their income and economic status.
AB PM-JAY is the world’s largest public health insurance scheme. It provides free cover up to Rs 5 lakh annually to all members of eligible families — estimated to comprise the bottom 40% of the population economically — irrespective of age.
It is a Centrally Sponsored Scheme and states will have to contribute 40% to the cost of the scheme. Ayushman Bharat has not been implemented by Delhi, West Bengal, and Odisha.
Ayushman Bharat Yojana
1. The Ayushman Bharat Yojana, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a health insurance scheme launched by the Government of India in 2018.
Its primary aim is to provide comprehensive health coverage of up to ₹5 lakh per family per year. It connects the public and private health sectors into a one-nation, one-system.
2. This financial shield applies to serious (secondary) and critical (tertiary) care, including various surgeries and illnesses. Whether it’s a knee replacement, heart bypass, cancer treatment, or even chronic conditions, the Ayushman Bharat Yojana empowers beneficiaries to get the medical attention they need without financial hardship.
The program goes even further by covering pre and post-hospitalization expenses, ensuring a more comprehensive healthcare experience.3. The scheme targets families identified through the Socio-Economic Caste Census (SECC) data. This data categorises families into various income brackets, focusing on those living below the poverty line (BPL) and those categorised as deprived based on specific socio-economic indicators.
4. PMJAY is for inpatient secondary and tertiary care. Outpatient services are not a part of the scheme. The latter component is being addressed through Ayushman Arogya Mandirs (AAMs), earlier called Health and Wellness Centres. With over 1,75,000 AAMs free consultations and many medicines (up to 172) and diagnostics (up to 63) are being provided free.
Points to be noted:
Everyone age 70 or more will be entitled to a cover of Rs 5 lakh annually, shared within the family. This means if there are two elderly beneficiaries in the household, the cover will be split among them.
Elderly members (age 70 and more) of families that are already covered by their economic status will get a top-up cover of Rs 5 lakh — to be used only for the elderly.
The scheme will cover almost 6 crore individuals (from 4.5 crore families), of whom 1.78 crore are already covered by the scheme. “For the additional top-up amount, the financial implication is very little,” a senior official said.
Those who are already covered under other government health schemes like the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme, etc will have the option of choosing either Ayushman Bharat or continuing with their existing coverage.
People who are covered under the Employees State Insurance Corporation (ESIC), however, will be eligible to have both their existing cover and Ayushman Bharat. This is because premiums for ESIC are paid by the insured and their employer, not the government.
Significance of extending AB-PMJAY to senior citizens:
With increasing lifespans and an increasing number of people ageing in the next three decades, a fifth of India is likely to be over the age of 70 by 2050. There is a need for far-reaching changes in welfare policies to tackle this demographic transition.
Older Indians are much more likely to be hospitalised and to stay in hospitals for longer. The rate of admission among the elderly already covered under the scheme has been more than 7% — double the 3-4% admission rate for the younger people covered under the scheme, according to officials.
According to the India Ageing Report 2023, the elderly remain largely uncovered by any health scheme. Just over 20% of India’s population above the age of 60 is currently covered by any government schemes.
Women make up the larger share of the elderly population — a survey by NITI Aayog found that 58% of the elderly are women, and 54% among them are widows.
It is significant for a country where out-of-pocket expenditure (OOPE) on health is often a reason for crushing poverty. Yet, the fact that OOPE constitutes 50 per cent of all health expenses, more than two-and-half times the global average, underlines unfinished tasks.
A Niti Aayog position paper, released in January, recognised that with families becoming increasingly nuclear, ease of access and quality of care will be crucial determinants in the health-seeking behaviour of senior citizens.
