Ayushman Bharat PM-JAY: Senior Citizens Get Free Health Insurance Coverage, but Limitations Persist
The Union government's health insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), has now been expanded to cover all senior citizens aged 70 and above. The 4.5 crore families expected to benefit from the scheme will enjoy annual free health insurance coverage of up to Rs 50 lakh for secondary and tertiary hospital treatments.
While Ayushman Bharat provides a significant safety net for vulnerable populations, particularly those no longer actively employed and depend on external support for their well-being, critics argue that it may not be a complete solution for all healthcare needs. The flagship scheme's limitations include:
Limited coverage: A family floater of Rs 5 lakh is shared among family members, which may not be sufficient for chronic care, specialized treatments, and high hospital bills. Limited network: Ayushman Bharat primarily covers government and certain private hospitals, leaving senior citizens with limited choices. No private rooms: The scheme focuses on general ward admissions, whereas private health insurance often offers the flexibility of private rooms. Exclusions: Treatment for organ transplants, cosmetic surgeries, and certain types of cancer treatment are excluded from coverage.
Experts emphasize that while Ayushman Bharat can be a valuable backup, comprehensive health insurance with adequate sum assured and coverage for outpatient services remains essential. Senior citizens require flexibility, faster access, and continuous care.
"Comprehensive health insurance offers added peace of mind," said Narendra Bharindwal, Vice President at the Insurance Brokers Association of India (IBAI).
The government's decision to expand Ayushman Bharat to senior citizens aged 70 and above is expected to benefit millions. However, critics remind that healthcare needs continue to evolve, and a tailored approach to support seniors' unique requirements is crucial.
The Indian government's push for affordable healthcare remains a significant emphasis, but experts caution that relying solely on the Ayushman Bharat scheme for all healthcare needs may not be sufficient for this demographic segment.