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PM Modi to Unveil Health Cover Scheme for Senior Citizens; Check Eligibility, Docs and How to Apply

New Delhi: Prime Minister Narendra Modi is set to roll out health coverage for all citizens aged 70 years and above irrespective of their income status under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) on Tuesday. As per sources, the expanded scheme under the Ayushman Bharat health insurance scheme will benefit an estimated six crore citizens in about 4.5 crore households,” the source said.

Be it poor, middle class, upper middle class or rich, every individual who is 70 years and above is eligible for getting Ayushman card and will receive free treatment up to Rs 5 lakh at any of the AB PMJAY empanelled hospitals once the expanded scheme gets launched.

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Features of Health Insurance Scheme for Senior Citizens

  • Senior citizens aged 70 and above belonging to families already covered under AB PM-JAY will get an additional top-up cover up to 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 up to Rs 5 lakh per year on a family basis.
  • The health insurance scheme is being implemented in 33 states and Union territories currently except for Delhi, Odisha , and West Bengal. 
  • Anyone aged 70 or above as per Aadhaar card, will be eligible for applying for the scheme.
  • It is an application-based scheme and people will need to register on the PMJAY portal or on the Ayushman app, official sources said.
  • Those already having the Ayushman card will need to again apply for a new card and complete their eKYC again, sources said.
  • Senior 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 the scheme, officials had said earlier.
  • Those senior citizens already availing benefits of other public health insurance schemes such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS) and Ayushman Central Armed Police Force (CAPF) may either choose their existing scheme or opt for AB PM-JAY.
  • The scheme has covered 7.37 crore hospital admissions, including 49 per cent women beneficiaries. The public has benefited to the extent of over Rs 1 lakh crore under the scheme, the health ministry had said earlier.

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The AB PM-JAY scheme has witnessed continuous expansion of the beneficiary base, it said, adding that initially, 10.74 crore poor and vulnerable families comprising the bottom 40 per cent of India’s population were covered under the scheme. Till September 1, 2024, a total of 29,648 hospitals, including 12,696 private hospitals, have been empanelled under the PMJAY.

In January 2022, the Centre revised the beneficiary base from 10.74 crore to 12 crore families considering India’s decadal population growth of 11.7 per cent over the 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.

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On Tuesday, PM is also scheduled to launch the U-WIN portal developed for maintaining an electronic registry of routine immunisations, which is currently operational on a pilot basis.

The U-Win platform, which is a replication of the COVID-19 vaccine management system Co-WIN, has been developed to keep a permanent digital record of vaccination of pregnant women as well as children from birth up to the age of 17 under the Universal Immunization Programme.

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