Why the decision to expand health insurance for Indians aged over 70 years is a game changer

The Union Cabinet Wednesday decided to include the elderly in PMJAY which provides a health cover of Rs 5 lakh per annum

The decision of the Union cabinet to extend the benefits of the Pradhan Mantri Jan Arogya Yojana (PMJAY) to 6 crore Indians who are aged over 70 years can be a game changer.

PMJAY is the tertiary care arm of Ayushman Bharat the flagship health programme of the NDA government. Eligible families (12.54 crore) are entitled under the scheme to an annual health insurance cover of Rs 5 lakh. For citizens above the new age criteria, there will be no bar on eligibility based on socioeconomic status, This will also be an individual and not a family health cover. 

The eligible senior citizens would be issued a new distinct card under AB PM-JAY. The senior citizens of the age 70 years and above belonging to families already covered under AB PM-JAY will get an additional top-up cover upto ₹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 upto ₹5 lakh per year on a family basis. 

Dr. Harsh Mahajan, President FICCI ( Health Services) & M.D Mahajan Imaging & Lab, said: “The inclusion of senior citizens under the Ayushman Bharat scheme marks a significant enhancement of our national healthcare infrastructure. This expansion brings an additional 6 crore individuals from over 4.5 crore families into the scheme’s coverage, providing crucial health support to millions. Each senior citizen will receive a health card, making it easier for them to access the scheme’s services. The scheme offers ₹5 lakh in coverage per family annually, which, although shared among multiple elderly members within the same family, still offers considerable financial relief. As our elderly population grows, so does the need for specialized geriatric care, and this expansion will enable more families to access essential services without the burden of overwhelming medical expenses.”

With life expectancy on the rise and nuclear families or migration of children outside the city of the country forcing many seniors to live alone, this programme will help them feel a lot more secure in terms of their health needs.

Senior citizens of the age 70 years and above who are already availing benefits of other public health insurance schemes such as Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), Ayushman Central Armed Police Force (CAPF)  may either choose their existing scheme or opt for AB PMJAY.  It has been clarified that senior citizens of 70 years and above who are under private health insurance policies or  Employees’ State Insurance scheme will be eligible to avail benefits under AB PM-JAY.