Here’s all you need to know about the new insurance coverage under Ayushman Bharat
About the new scheme
The union cabinet, chaired by Prime Minister Narendra Modi, has given the green light to the new initiative designed to offer extensive health coverage to senior citizens aged 70 and above. This scheme falls under the umbrella of the flagship program Ayushman Bharat.
Coverage
The government’s new initiative is set to support around 4.5 Crore families, which includes six (6) crore senior citizens. Under this program, each family will receive free health insurance coverage of up to 5 Lakh rupees.
The AB PM-JAY extends financial protection to approximately 55 crore people, equivalent to 12.34 crore households, by providing a health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization. Since its inception, it has facilitated 7.37 Crore hospital admissions, with women constituting 49 percent of the beneficiaries. The cumulative financial benefit availed by the public under this scheme has surpassed Rs. 1 Lakh crore.
The key advantage of this top-up is that it is exclusively available to the senior citizen and does not need to be shared with other family members below the age of 70. Also, for senior citizens who are already benefiting from other public health insurance schemes, such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), or Ayushman Central Armed Police Forces (CAPF), there is an option to either continue with their existing scheme or switch to AB PM-JAY, depending on their preference and healthcare needs. Elderly people aged 60 and above who have private health insurance coverage or are beneficiaries of the Employees’ State Insurance program can still avail themselves of the advantages offered by the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
Eligibility
The new insurance coverage aims to provide healthcare benefits to all citizens above the age of 70, regardless of their income level.
The government has announced that senior citizens who meet the eligibility criteria will receive a unique card, distinct from the existing one, as part of the scheme.
About the flagship Pradhan Mantri Jan Arogya Yojana
The Pradhan Mantri Jan Arogya Yojana (PM-JAY) is an initiative by the government to ensure that all citizens, particularly the underprivileged, vulnerable sections of society and now all citizens above 70, have access to quality hospital services without facing financial hardship.
PM-JAY offers a wide range of health services, including expenses related to hospitalization, day care surgeries, follow-up care, and benefits for pre and post-hospitalization expenses. The scheme also covers services for newborn children.
Steps to apply for PMJAY OnlineFirst check eligibility
- Go to the official
PMJAY website at [www.pmjay.gov.in](http://www.pmjay.gov.in). - Click on the “Am I Eligible” tab from the homepage menu.
- Input your mobile number and CAPTCHA code, then click on “
Generate OTP .” - After OTP verification, enter your state of residence along with your name, ration card number, household number, or mobile number.
- If your family is covered under the
Ayushman Bharat Yojana , your name will appear in the results. - Look for your name in the displayed list to confirm eligibility.
Once you’ve confirmed your eligibility, follow these steps to avail the PMJAY scheme:
1. Access to services:
- Beneficiaries can avail services at all public hospitals and empaneled private healthcare facilities.
- Information about empaneled hospitals will be available through- Government websites, Mobile apps, Helpline ( 14555), ASHAs, ANMs, and other local touchpoints.
2. Cashless and paperless access:
Beneficiaries receive free treatment for secondary and tertiary care for specific packages. Services are cashless and paperless at public hospitals and empaneled private hospitals.
3. Empanelment of hospitals:
Hospitals are empaneled by the state government via an online portal.
4. Eligibility:
PM-JAY is entitlement-based, with no enrolment required. Eligible families are identified based on deprivation and occupational criteria using the SECC database in both rural and urban areas.
Documents Required for PMJAY Registration
To register for the PMJAY scheme, ensure you have the following documents ready:
- Age & ID Proof: Aadhaar card or PAN card.
- Contact Details: Mobile number, residential address, and email address.
- Caste Certificate (if applicable).
- Income Certificate: Annual income must be up to Rs 5 lakh.
- Family Proof: Documentation proving current family status (joint or nuclear family
(Please note: These steps are applicable for those eligible under the scheme before the recent announcement. The portal has not been updated for the new changes at the time of publication of this article)
