More health packages on elderly care likely to be added to AB-PMJAY

New Delhi, Oct 13: The National Health Authority, the implementing agency for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), is assessing the need to add more health packages catering to the elderly as the government is set to roll out the health coverage for all aged 70 years and above.

The expanded scheme, which will benefit an estimated six crore citizens in about 4.5 crore households, is likely to be launched by the end of this month, official sources said.

“The committee which decides on health-benefit packages under the scheme is deliberating on the need for adding more health packages, which exclusively tend to geriatric care, as the number of such beneficiaries will go up with the launch of the scheme,” an official source said.

The scheme presently offers a comprehensive coverage that includes 1,949 medical procedures across 27 medical specialties, such as general medicine, surgery, oncology and cardiology.

Hospital services, including drugs (covering 15 days’ medication post-discharge), diagnostics (up to three days before admission), food and lodging, are provided at no cost to the beneficiaries.

“The admissions necessitated due to certain mental-health conditions, such as Alzheimer’s and dementia, are also covered under the current scheme,” the source said.

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

Till September 1, a total of 29,648 hospitals, including 12,696 private ones, were empanelled under the scheme, which is currently being implemented in 33 states and Union territories, except for Delhi, Odisha and West Bengal.

Anyone aged 70 or above according to the person’s Aadhaar card will be eligible for applying under the scheme, another official source said. It is an application-based scheme and people will need to register on the PMJAY portal or the Ayushman app, the sources said.

“Those already having the Ayushman card will be needed to apply again for a new card and complete their eKYC again,” the source said.

Senior citizens aged 70 years and above and belonging to families already covered under AB-PMJAY will get an additional top-up cover of up to Rs 5 lakh per year for themselves, which they do not have to share with other family members below the age of 70 years.

Senior citizens aged 70 years and above who are under private health insurance policies or the Employees’ State Insurance scheme will also be eligible to avail benefits under the scheme, officials had said earlier.

However, those 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-PMJAY.

The scheme has covered 7.37 crore hospital admissions, including 49 per cent women beneficiaries. The public has benefitted to the extent of over Rs 1 lakh crore under the scheme, the health ministry had said earlier.

The AB-PMJAY scheme has witnessed continuous expansion of the beneficiary base, it had 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.

In January 2022, the Union government 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 and AWHs working across the country and their families for free healthcare benefits.