The Union Cabinet has recently approved an expansion of the Ayushman Bharat PM-JAY scheme, extending its health coverage to citizens aged 70 and above, irrespective of their income level. This substantial enhancement of the Ayushman Bharat PM-JAY scheme is set to revolutionize public healthcare and address the needs of India’s rapidly growing elderly population, who often struggle with the high costs of medical treatments, medications, and therapies without adequate social security.
Expansion of the Ayushman Bharat PM-JAY Scheme
Historically, the Ayushman Bharat PM-JAY scheme was income-based, providing ₹5 lakh in shared annual coverage to families falling within the bottom 40% of the economic spectrum, regardless of age. Under the new extension, all individuals aged 70 and above will now receive ₹5 lakh in annual coverage per person. This change is expected to benefit approximately 6 crore senior citizens from 4.5 crore families, as per government estimates. To access these benefits, eligible individuals will be issued a new PM-JAY card specifically for this purpose.
Eligibility and Coverage Details
Seniors aged 70 and above who are part of families already covered under the Ayushman Bharat PM-JAY scheme will be eligible for an additional ₹5 lakh top-up cover annually. Those currently receiving benefits from other public health insurance schemes, such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), or Ayushman Central Armed Police Force (CAPF), have the option to continue with their current coverage or switch to the AB PM-JAY scheme.
Furthermore, senior citizens with private health insurance policies or those under the Employees’ State Insurance Scheme (ESI) will also be able to access the benefits of the Ayushman Bharat PM-JAY scheme. According to Union Information and Broadcasting Minister Ashwini Vaishnaw, the ₹5 lakh coverage will be shared among eligible senior citizens within a family. For instance, if a family includes two seniors aged 70 or older, the ₹5 lakh coverage will be divided between them. This method aims to bolster the social security of elderly individuals, especially as India increasingly transitions towards nuclear families.
Significance and Financial Implications of the Scheme
The expansion of the Ayushman Bharat PM-JAY scheme marks a significant milestone in providing complete health coverage to a specific age group, representing a major step forward in the pursuit of universal health coverage. The initial cost to roll out this health coverage scheme is projected to be ₹3,437 crore. “The scheme is demand-based, and the coverage will be adjusted according to the needs,” noted Vaishnaw.
Financially, most states are expected to cover 40% of the costs, while the central government will shoulder up to 90% of the expenses for states in hilly regions and the Northeast. The specifics of this financial arrangement will be determined during the implementation phase. Experts have estimated that extending coverage to all individuals aged 70 and above will incur higher costs than providing coverage to the poorest 40% across all age groups.
Impact on Disease Burden
India’s elderly population is projected to rise significantly, with the proportion of those aged 60 and above expected to grow from 8.6% in 2011 to 19.5% by 2050, according to the Longitudinal Ageing Study in India (LASI). This demographic shift will see the elderly population increase from 103 million in 2011 to 319 million by 2050. Currently, only about 20% of this age group has access to health coverage, as reported by the India Ageing Report 2023. The expansion of the Ayushman Bharat PM-JAY scheme is anticipated to substantially alleviate the disease burden on India’s elderly population by offering comprehensive health coverage tailored to their needs.
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