New Delhi: Top officials in the Union health ministry said Thursday that the expansion of the Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) to the 70-plus age group, irrespective of their income status, will be rolled out within a week.
Following the roll-out, the new beneficiaries will be able to register for the scheme with their Aadhaar numbers through the Ayushman Bharat portal or its mobile app.
“Using the Aadhaar for e-KYC in order to enrol for the scheme will be a must,” said a senior health ministry official.
Initially, the official added, there will be a pilot launch to sort out any issues that may arise.
Under the AB-PMJAY, a flagship health scheme of the Narendra Modi government, beneficiaries are entitled to cashless hospitalisation coverage of up to Rs 5 lakh for secondary and tertiary-level healthcare in empanelled hospitals.
So far, the programme, which was first rolled out in 2018, was aimed at 12.3 crore families of low socio-economic status.
The government has estimated that India has a total of nearly 6 crore people who are 70 and above. However, since many of them are already covered on account of being of low-income groups, while others are beneficiaries of government health schemes such as the Central Group Health Scheme (CGHS), an additional 2.72 crore people from 1.96 crore families will now be added to the beneficiary pool.
Another health ministry official said, “As of now many senior citizens, including those who can pay for an insurance premium by private insurers, are denied policies on account of being old and having rising health risks. The expansion of AB-PMJAY will be a boon for them too, along with those who want health protection but cannot afford it.”
Still, the government has also clarified that those in the 70 and above age group, who are covered under private health insurance policies or Employees’ State Insurance scheme (ESIC) will be eligible to avail benefits under the scheme.
“It has been calculated that hospitalisation cost in the case of the 70-plus age group is 7-8 percent more than the lower age groups,” the official added.
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More packages exclusively for geriatric care
The scheme offers 1,947 health benefit packages across 27 specialities; of which 25 are geriatric care packages.
Moving forward, the government plans to constitute a panel with senior doctors to suggest more packages specially designed to cater to the new, older beneficiaries.
The premium paid by the government per family, currently, stands at Rs 1,102 annually, but that may rise now. This will be based on the recommendations of a high-level committee, which was formed earlier this year to suggest reforms in the operationalisation of the AB-PMJAY.
The government officials also said as of now, 49 percent of hospitalisations include women beneficiaries but this may rise with the latest expansion of the scheme.
“That’s because a report by Niti Aayog had suggested that the ratio of women and women in the 70-plus age group is 58:42. Also, a large number of these women are widows,” an official quoted above said.
The government has estimated that the public benefited to the extent of over Rs 1 lakh crore under the scheme while hospitalisations worth Rs 70,000 crore have been offered under the programme, so far.
For the expansion, the government had approved an additional financial outlay of Rs 3,437 crore. Government officials said this amount is likely to be used in the ongoing fiscal as well as the upcoming financial year 2025-26.
The scheme, aimed at aiding 12.3 crore beneficiaries, had been allocated Rs 5,400 crore in the current financial year.
(Edited by Sanya Mathur)
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