Nearly every fourth person admitted to hospital in the country under the Ayushman Bharat scheme so far was a senior citizen. This explains why the Modi government’s move to extend the free health insurance scheme to everyone above 70 years of age is a major move. The Cabinet approved the move on Wednesday.
Prime Minister Narendra Modi had announced this promise in April while unveiling the BJP’s manifesto for Lok Sabha Elections 2024. Details with News18 show that out of the total hospital admissions under the scheme since its inception over five years ago, nearly 24 per cent were those of senior citizens showing they needed the scheme the most.
Over one crore senior citizens have been admitted in hospitals under the scheme so far, the data shows. The latest decision of the Cabinet means that 4.5 crore families with as many as six crore citizens who are 70 years and above will benefit now with the Rs 5 Lakh free health insurance cover on a family basis.
Why This is Important
The BJP went by widespread public feedback to include this point in the manifesto, a promise that has now been fulfilled. There have been cases of senior citizens above 70 years of age being abandoned by their families if they fall ill or turn infirm, or these seniors having no means to finance their medical treatment. Most medical insurance companies don’t offer medical insurance to those above 70 years of age, as they anticipate a high number of claims from this age group. The few insurers who do offer medical insurance to those above 70 years of age have extremely high annual premiums that many middle-class families can’t afford.
There are also pre-ailment clauses that don’t cover existing ailments for two-three years. The existing data under Ayushman Bharat shows that those above 70 are the ones that need medical insurance the most as they are prone to falling sick or are already suffering from serious ailments like heart disease, kidney ailments and lung or brain diseases. The procedure with maximum claims under Ayushman Bharat is Dialysis, which many seniors ail from.
The situation is even more precarious post the Covid-19 pandemic as immunity of those above 70 years of age is more vulnerable after the pandemic. Many 70+ age people suffering from serious ailments require costly medical treatment but the middle class has no option but to pay for it from their pocket or cough up heavy premiums that upset their budget.
Now, all senior citizens of age 70 years and above, irrespective of their socio-economic status, would be eligible to avail the benefits of Ayushman Bharat. The senior citizens of age 70 years and above belonging to families already covered under Ayushman Bharat will get an additional top-up cover up to Rs 5 lakh per year for themselves (which they do not have to share with the other members of the family who are below the age of 70 years). All other senior citizens of the age 70 years and above will get a cover up to Rs 5 lakh per year on a family basis.
Senior citizens of the age 70 years and above who are already availing benefits of other public health insurance schemes such as Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), Ayushman Central Armed Police Force (CAPF) may either choose their existing scheme or opt for Ayushman Bharat. It has been clarified that senior citizens of 70 years and above who are under private health insurance policies or Employees’ State Insurance scheme will be eligible to avail benefits under Ayushman Bharat.
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