Last year, the government expanded the scope of its flagship health insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), to include senior citizens aged 70 and above. Under this scheme, every eligible family receives free health insurance coverage of up to ₹5 lakh annually.
Regarding the ₹10 lakh cover, it’s important to understand the conditions.
With the inclusion of senior citizens, families with members aged 70 or older can now receive a total health cover of up to ₹10 lakh. However, it’s crucial to understand a key point here.
This additional ₹5 lakh cover is reserved exclusively for the treatment of senior citizens. This means that if the family’s general ₹5 lakh cover is exhausted for the treatment of the spouse or children, they cannot utilize the additional ₹5 lakh reserved for their elderly parents. In simple terms, the cover is divided into two parts:
₹5 lakh: For the spouse and children
₹5 lakh: For senior citizens aged 70 or older
The good news is that there is no limit on the number of family members under the Ayushman Bharat scheme. Therefore, this scheme can be quite beneficial for joint families where elderly members also reside.
Ayushman Card for Senior Citizens: Important Points
Who is eligible and are there any income criteria?
The only eligibility criterion for this scheme is that the individual must be 70 years of age or older. There are no income, employment, or economic status requirements. If you are over 70, you are eligible.
Which documents are required for enrollment, and is Aadhaar mandatory?
An Aadhaar card is mandatory for the enrollment of senior citizens. E-KYC is done through Aadhaar, and the Ayushman card is issued. No other documents are required.
If only the year of birth is mentioned in the Aadhaar card, how will the age be determined?
In such cases, the government has clarified that January 1st of the year following the year of birth mentioned in the Aadhaar card will be considered the official date of birth. If there is more than one member in the family above 70 years of age, will separate registrations be required?
No. After the registration of the first 70+ member of the family, the remaining eligible senior citizens can be added to the same family through the ‘Add Member’ option.
Will senior citizens receive a separate Ayushman card?
Yes, all eligible senior citizens aged 70 years or older will be issued a separate Ayushman card under the scheme.
When will online application and treatment be available?
The application for the Ayushman card for senior citizens can be done online—through the Ayushman Bharat portal or the Ayushman app. Treatment facilities are available from the very first day of registration. There is no waiting period for any illness or treatment.
There is no income limit set for this scheme. Whether it’s pension or business income, every Indian citizen above 70 years of age can be included.
If both grandparents (paternal and maternal) in the family are 70+, how will the coverage be provided?
The ₹5 lakh health cover is provided on a family basis. This means that all senior citizens will be covered within that ₹5 lakh limit; they will not receive separate ₹5 lakh coverage each.
Overall, including senior citizens in the Ayushman Bharat scheme is a significant relief, but it is crucial to understand this specific condition of the coverage to fully grasp its benefits.