Senior Citizen Health Insurance Scheme by Government of India: ₹5 Lakh Health Cover for People Aged 70+

Senior Citizen Health Insurance Scheme By Government Of India Turns Important Healthcare Support For Older Indians

Senior citizens in India will find increased government health coverage through the expansion of Ayushman Bharat – PM Jan Arogya Yojana or AB PM-JAY. All citizens aged 70 years and older will be eligible for health cover up to ₹5 lakh annually, without an income cap or socio-economic criteria.

Hospitalisation expenses are a key concern for many after retirement, which is why this programme is significant for Indians 70+. Here is what you should know if you, or an elderly family member, are eligible.

What Is the Government Health Insurance Scheme for Senior Citizens?

As of October 29, 2024, the government of India updated the AB PM-JAY to extend coverage to all Indian seniors aged 70 and above, without regard for their economic status.

Benefiting eligible senior citizens will receive an Ayushman Vay Vandana Card, which they can use for covered treatment at empanelled public and private hospitals under AB PM-JAY. Government estimates around 4.5 crore families and 6 crore senior citizens can benefit.

Senior Citizen Health Insurance Scheme Eligibility

Let’s take a look at the eligibility for this government scheme expansion for senior citizens. There are few conditions:

• Candidate must be a citizen of India.
• Age should be 70 years or older.
• There is no income cap for senior citizen expansion under AB PM-JAY.
• Having a private health insurance plan is not a disqualification. An eligible senior can still receive benefits under AB PM-JAY.

If enrolled under government run health schemes like CGHS, ECHS or Ayushman CAPF, senior citizens do have a choice. They can choose to instead receive benefits under AB PM-JAY, but current government rules mandate seniors choose between the current government health scheme or AB PM-JAY. They cannot receive benefits under both schemes at the same time.

Key Benefits of Ayushman Vay Vandana Card

Senior citizen health cover from AB PM-JAY can cover a significant portion of expensive hospital treatment.

Important benefits include:

• Health cover of up to ₹5 lakh every year
• Ability to seek cashless treatment from empanelled hospitals
• Covers approved secondary and tertiary hospitalisation
• Pre-existing diseases will be covered from day-1
• Includes pre-hospitalisation expenses upto 3 days and post-hospitalisation for 15 days
• Can be used at any of the empanelled hospitals nationwide
• Hospitalisation treatment package includes medicines, diagnostics, room rent, ICU stay and other eligible expenses.

If enrolled under AB PM-JAY as part of a family plan, senior citizens 70+ can get additional top-up cover of ₹5 lakh every year which is separate from the rest of the family.

How to Apply for Senior Citizen Health Insurance

Seniors who are eligible can apply and create their own Ayushman Vay Vandana Card from the official AB PM-JAY beneficiary portal or authorised outlets.

The application process includes the following steps:

1. Aadhaar-link verified through e-KYC process.
2. Verify eligibility and beneficiary status.
3. Complete verification process.
4. Generate Ayushman Vay Vandana Card.
5. Present card at empanelled hospital and get eligible treatment.

Government has launched the Ayushman App. This mobile-first solution allows applicants to self-verify their credentials and apply for a card using a smartphone, including face-authentication technology.

An Important Point Before Applying

When you see ₹5 lakh do not expect ₹5 lakhs handed to you as cash. This is a health insurance coverage for eligible hospitalisation and treatment under the rules of AB PM-JAY.

As covered above, the card is only applicable for a select range of hospital procedures covered under the scheme. It works with a list of packaged rates for each hospitalization procedure and only at empanelled hospitals. The distinction is important for seniors to know – AB PM-JAY insurance card is most useful when used at the hospital for an eligible procedure, rather than thinking of it as a traditional cash benefit.

Final Takeaway

Expanded coverage under AB PM-JAY is a major step for government funded healthcare for Indians 70 years of age or older. By removing income restrictions for senior citizens, the Ayushman Vay Vandana Card offers up to ₹5 lakh per year in health coverage. It can help seniors and their families cope with the financial burden of serious hospitalization.

Before proceeding with hospital treatment, we recommend seniors and their families first verify card status, ensure the hospital is empanelled under AB PM-JAY and the required treatment is covered by the scheme.