Ayushman Bharat Scheme For Senior Citizens Above 70: Is It Enough?

Senior citizens are the wise and experienced people of our society. The Indian government is taking significant steps to take care of their financial needs. The Ayushman Bharat scheme is one of those steps towards their betterment. Let us learn more about the Ayushman Bharat scheme below.

What is the Ayushman Bharat Scheme: PMJAY?

The Pradhan Mantri Jan Arogya Yojana (PM-JAY) is also known as the Ayushman Bharat Yojana. It is a flagship programme launched by the Government of India in 2018, for the bottom 40% of the Indian population. Know more about Ayushman Bharat-PMJAY here. It gives coverage of Rs 5 Lakh, which is quite good but not enough in the case of senior citizens.

First things first, AB-PMJAY for senior citizens?

Yes, recently the central government has announced that Ayushman Bharat PM-JAY has extended to all senior citizens who are 70 years and above, irrespective of their income levels. This is indeed a good step but for some, it might not be very useful. Some senior citizens feel that they might need extra care and coverage as per their health requirements.

Why do senior citizens need separate health insurance despite PMJAY?

While the Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a commendable initiative to provide health insurance coverage to a large section of the Indian population, senior citizens often require additional health insurance coverage.

Here’s why:

1. Cost Capping

   The government of India has capped the charges that a hospital can put for any procedure. For example:

   • A caesarian has been capped at Rs 9,000.
   • For knee replacements, it is Rs 9,000 per leg.
   • Bypass surgery is capped at Rs 1.5 lakh.

   However, these services are just double or more when you go to any private hospital. Though the experts are trying to lower the rates of medical services, it is not possible on the ground level.

2. Increased healthcare needs

   Senior citizens are more prone to chronic diseases like heart ailments, diabetes, arthritis and much more that require ongoing medical care and medications. So, due to their age and health conditions, senior citizens are more likely to require frequent hospitalisations, which can be expensive.

3. Limited coverage

   PM-JAY provides a substantial sum insured, but it might not be sufficient to cover all the healthcare expenses required by senior citizens, especially in the case of prolonged hospitalisation or expensive treatments. Sometimes, the treatment or conditions might have a waiting period which could delay the coverage for senior citizens who need immediate coverage.

4. Additional benefits

   You will see that many private health insurance plans offer coverage beyond hospitalisation. They offer cashless treatment, pre-hospitalisation, post-hospitalisation, and home healthcare treatment (a basic need for people above 60) which are not included in the PMJAY scheme.

5. Rising medical cost

   Healthcare costs are increasing, especially in India with a medical inflation of 14%. In such a scenario, only a senior citizen health insurance plan can offer the best features and benefits for senior citizens and their families.

6. Financial security

   Senior citizen health insurance plans from private or standalone health insurers are specifically curated to cover every need of old-age ailments and related costs. The Ayushman Bharat Scheme with such a low sum insured of only 5 Lakhs is just not enough for our beloved senior citizens. Though the premiums are higher in the case of private health plans, the cost of healthcare in a medical emergency is well covered saving them out-of-pocket expenses.

7. Tax Benefits

   In private senior citizens plans, you might have to pay higher premiums. But you can get tax benefits for upto Rs 50,000 under section 80D of the Income Tax Act which is quite higher in the case of private health insurance for senior citizens.

   POV- While PM-JAY is a valuable asset for many, senior citizens should consider supplementing their coverage with a separate health insurance plan to address their specific healthcare needs and financial concerns.

Current scenario for Ayushman Bharat PMJAY

The Ayushman Bharat scheme provides a good backup for your healthcare needs but it cannot be considered a substitute for your own health coverage.

In short, you need separate health insurance coverage for senior citizens:

• To get a higher sum insured.
• Larger cashless network of hospitals.
• Option to select a high-end private room.
• To reduce the waiting time for the admission procedure to the hospital.

Top private health insurance policy for senior citizens

You can read more here about the senior citizen’s health insurance plans.

Do not ignore the benefits of separate health insurance policies for senior citizens

While the Ayushman Bharat-PMJAY scheme offers significant benefits to a large segment of the Indian population, senior citizens often require additional health insurance coverage to meet their unique healthcare needs. The scheme’s limitations in terms of sum insured, waiting periods, and coverage for certain treatments can leave you vulnerable to substantial out-of-pocket expenses. By considering a separate health insurance plan, senior citizens can ensure financial security, peace of mind, and access to comprehensive healthcare services, ultimately enhancing their quality of life.

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