The government last year expanded its flagship health insurance programme — Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) — to include senior citizens aged 70 years and above. Under this scheme, every eligible family receives free health insurance coverage of up to Rs 5 lakh annually.
Now, with the inclusion of senior citizens, families that have members aged 70 and above can avail a total coverage of Rs 10 lakh under the Ayushman Bharat scheme. But there’s an important catch — the additional Rs 5 lakh coverage is reserved only for the senior citizen members of the family.
This means that if a family uses up its Rs 5 lakh limit for the treatment of the husband, wife, or children, they cannot utilise the additional Rs 5 lakh meant for their elderly parents. The coverage is effectively divided — Rs 5 lakh for the family unit (husband, wife, and children) and Rs 5 lakh for the senior citizen members aged 70 or above.
Importantly, there is no cap on family size under Ayushman Bharat PM-JAY. This makes the scheme especially beneficial for multi-generational households where elderly members are also covered.
FAQs on Ayushman Card benefits for senior citizens
Here is a set of FAQs that answer common questions senior citizens and their families may have about the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) and its new health insurance benefit.
Q1. What are the eligibility criteria for senior citizens under this scheme?
Answer: The only eligibility criterion is that the individual must be aged 70 years or above, as verified through their Aadhaar card, regardless of income or economic status.
Q2. Is Aadhaar mandatory for enrolment in the scheme?
Answer: Yes, Aadhaar-based e-KYC is mandatory for enrolment and for the issuance of Ayushman Bharat health cards to eligible senior citizens.
Q3. What documents are required to enrol in the AB PM-JAY Senior Citizen Scheme?
Answer: Aadhaar is the only document required for enrolment under the AB PM-JAY Senior Citizen Scheme.
Q4. If only the birth year is mentioned in Aadhaar, how is the date of birth determined?
Answer: If only the birth year is recorded in Aadhaar, January 1st of the year following the recorded birth year will be considered as the official date of birth.
Q5. Both my parents are over 70 years old. Do I need to enrol each of them separately under the AB PM-JAY Senior Citizen Scheme?
Answer: No, separate enrolments are not required. Once the first family member aged 70 or above is enrolled, other eligible members aged 70 or above can be added using the “Add Member” feature on the Ayushman Bharat enrolment portal.
Q6. Will senior citizens receive a separate Ayushman card?
Answer: Yes, all eligible senior citizens aged 70 years and above will receive a distinct Ayushman card under the scheme.
Q7. Can we apply for an Ayushman card online for our parents aged 70 or older?
Answer: Yes, applications can be made online through the Ayushman Bharat portal http://www.beneficiary.nha.gov.in or via the Ayushman App (available on the Google Play Store).
Q8. Can I receive treatment immediately after enrolling in the AB PM-JAY Senior Citizen Scheme?
Answer: Yes, beneficiaries can start availing treatment from the first day of enrolment. There is no waiting period for any illness or procedure, and coverage begins immediately.
Q9. My father is over 70 years old and earns more than ₹50,000 per month from his business. Is he eligible for this scheme?
Answer: Yes, there is no income limit for eligibility under this scheme. Any Indian citizen aged 70 or above can enrol, irrespective of income level.
Q10. Both my paternal and maternal grandparents are over 70 years old. Will they each receive Rs 5 lakh coverage under PM-JAY?
Answer: No, the Rs 5 lakh health cover is provided on a family basis. Both grandparents will be covered under the scheme, but the Rs 5 lakh annual limit is shared among them as part of the same family.
Q11. My family is already a beneficiary of Ayushman Bharat. Will my father, who is over 70 years old, receive the additional top-up benefit?
Answer: Yes, your father will be eligible for the additional ₹5 lakh top-up cover under the senior citizen category, but he must complete Aadhaar e-KYC again to activate it.
Q12. My family is an Ayushman Bharat beneficiary. Will we all now get a cover of Rs 10 lakh under this scheme?
Answer: No, the additional Rs 5 lakh coverage is available only for family members aged 70 years and above. The rest of the family continues to receive the existing Rs 5 lakh family cover.
Q13. My father is over 70 years old and already has private health insurance. Will he still be eligible under PM-JAY?
Answer: Yes, your father can still avail benefits under Ayushman Bharat PM-JAY even if he holds private health insurance.
Q14. My parents are over 70 years old and covered under ESIC. Will they still be beneficiaries under PM-JAY?
Answer: Yes, your parents remain eligible for PM-JAY coverage even if they are already covered under ESIC.
Q15. I am a retired government employee above 70 years old and have a CGHS card. Can I also enrol under this scheme?
Answer: Yes, you are eligible. However, as per government rules, those availing other government health schemes (such as CGHS) must choose between their existing benefits and those under Ayushman Bharat PM-JAY. Dual benefits cannot be claimed simultaneously.
Q16. If my parents opt for AB PM-JAY and surrender their current government health scheme, can they switch back later?
Answer: No, once your parents opt for Ayushman Bharat PM-JAY and surrender their existing government health coverage, they cannot revert to the previous scheme. It is a one-time, non-reversible choice.