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AB PM-JAY: Is it possible for CGHS cardholders to avail of the benefits offered by Ayushman Bharat PM-JAY?

The Central government, under the leadership of Prime Minister Narendra Modi, has extended the coverage of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) to include senior citizens above the age of 70. These beneficiaries will now receive an additional Rs 5 lakh in health insurance coverage. The government has also made PM-JAY available as an alternative option for those enrolled in the Central Government Health Scheme (CGHS) and the Ex-Servicemen Contributory Health Scheme (ECHS).

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A common question that arises is whether current CGHS cardholders are eligible for the extra benefits provided by Ayushman Bharat PM-JAY. The answer is yes, CGHS cardholders can avail themselves of the benefits offered by PM-JAY. It is important to note, however, that individuals who are already covered under any other government health scheme cannot be enrolled in both the existing scheme and the new PM-JAY.

The recent announcement regarding PM-JAY clarified that seniors currently receiving healthcare benefits from public insurance schemes like CGHS and ECHS will need to make a choice between their current coverage and the additional benefits offered by PM-JAY. Seniors who have private health insurance or are covered under the Employees’ State Insurance Scheme (ESIS) will qualify for the benefits of the AB PM-JAY scheme.

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Switching from CGHS to AB PM-JAY

Former government employees aged 70 and above who choose to participate in the AB PM-JAY scheme and voluntarily give up their current CGHS card or government health insurance will not have the ability to return to their previous coverage. It is important to note that this choice is permanent and can only be made once.

Who all are eligible

Eligible retired government employees over 70 years old choosing to enroll in the AB PM-JAY scheme and relinquish their current CGHS card or government health insurance will not be permitted to revert back to their original coverage. This choice is final and irreversible.

The use of Aadhaar-based e-KYC is compulsory for the enrollment and issuance of Ayushman cards to eligible senior citizens. Aadhaar serves as the only necessary document for this process, streamlining access to the scheme. In situations where the Aadhaar only includes the birth year, January 1st of the subsequent year will be assumed as the individual’s date of birth for determining eligibility.

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How to apply

To apply for the AB PMJAY Senior Citizen Scheme, individuals can submit their applications online through the beneficiary portal at www.beneficiary.nha.gov.in or by using the Ayushman app, found on the Google Play Store. This initiative aims to improve access to quality healthcare for the elderly and provides financial assistance to families facing medical expenses. To view the complete list of hospitals participating in the scheme, please visit the National Health Authority’s official website. The only required document for enrollment in the scheme is the Aadhaar card (AadC).

An exclusive Ayushman card will be provided to all qualifying senior citizens who are 70 years old and older. Additional family members aged 70 or above can be added to the scheme after enrolling the first family member of the same age group, without the need for separate enrollments. Simply utilize the “Add Member” feature on the enrollment portal to include additional eligible family members.

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