Ayushman Bharat Scheme for Senior Citizens

The  Ayushman Bharat scheme is an important program that strives to offer a broader scope of medical facilities to the poorest section of people in India. One of the salient features of the program is the provision of the Ayushman Card, which aims at providing security against medical costs for elderly people aged 70 years and above.

The scheme provides financial support for hospitalisation and treatment in registered hospitals. Senior citizens can apply for an Ayushman Bharat card to access benefits. Let’s explore the article to comprehend its benefits and the process to apply for it.

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) provides free health coverage of up to ₹5 lakh per year to all senior citizens aged 70 and above. In a significant move, the Union Cabinet approved a major expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) on September 11, 2024. 

Individuals of 70 years and above can avail of the treatments for the exhaustive list of survivable diseases with no age limit and no premium. To avail of the benefits, the eligible people have to apply for the Ayushman Bharat Card and go to the listed hospitals against the scheme. The scheme aims to benefit 6 crore individuals by providing free health insurance coverage.

The 2011 Socio-Economic Caste Census and Rashtriya Swasthya Bima Yojana (RSBY) recipients have been used to determine the beneficiaries up to this point. However, everyone is now covered under the plan:

• The Ayushman Bharat initiative is open to seniors who have insurance from private insurers or who can afford it. Therefore, seniors 70 years of age and older are no longer limited in their ability to receive the PM-JAY benefit based on their income.

• Retired government workers can also access it. However, they are limited to using either the Ayushman Yojana or their current plan. For instance, central government workers who receive benefits from the Central Armed Police Force (CAPF), Ex-Servicemen Contributory Health Scheme (ECHS), or Central Government Health Scheme (CGHS) now have the choice to receive their medical treatment through Ayushman Yojana or one of the current programs. 

• In addition to the family coverage, seniors from lower-income families who were previously insured under the program can now receive an extra Rs 5 lakh. The entire coverage amount will reach Rs 10 lakh (Rs 5 lakh for the family plus Rs 5 lakh for the family's elderly person).

Checking eligibility for Ayushman Bharat Health Insurance (PM-JAY) is simple and can be done online. Follow these steps to verify your eligibility:

• Step 1: Go to the official Ayushman Bharat website at https://pmjay.gov.in.
• Step 2: Click the ‘Am I Eligible’ button on the homepage to start the eligibility check.

• Step 3: Enter a valid mobile number and CAPTCHA code to generate an OTP (One-Time Password).
• Step 4: Input the OTP received on your mobile phone to proceed to the next step.

• Step 5: Choose your state and search by either Name, Mobile Number, or Ration Card Number.

• Step 6: The system will display your eligibility status based on your household's inclusion in the Socio-Economic Caste Census (SECC) database.

If eligible, you can apply for the Ayushman Bharat Health Insurance and receive the benefits accordingly.

Specific documents are required to apply for the Ayushman Card. These documents ensure seamless registration under the Ayushman Card Insurance for Senior Citizen scheme.

• Aadhaar Card for Biometric Verification: Biometric authentication uses the Aadhaar card as the principal document.
• *Family Documents (Ration Cards/PM Letters/CM Letters): Ration cards and letters from the Prime Minister or Chief Minister are considered valid family documents.
• *Parivar Pehchan Patra (PPP ID) for Family Verification: The Parivar Pehchan Patra (PPP ID) is the family identification for the identification management for entitlement programs.
• DNO Recommendation Letter: A DNO (District Nodal Officer) recommendation letter is necessary for a beneficiary who wishes to make any correction of information relating to him/her or the family on SocioEconomic.
• *Verification Letter from Sarpanch/Municipal Councilor: It is a verification letter from the Sarpanch or Municipal Councilor that supports the recommendation by the DNO on the general income of the community.

Note:  *Mandatory documents are marked as asterisk

Applying for an Ayushman Bharat for senior citizens is straightforward, allowing them to access healthcare benefits easily. Here are the steps to apply for the scheme:

• Step 1: Go to the Ayushman Bharat PM-JAY website or the PMJAY portal 
• Step 2: Select the ‘Create ABHA (Ayushman Bharat Health Account) Number’ option on the homepage.

• Step 3: Create the ABHA number using your Aadhaar number or Driving License for identification.
• Step 4: Enter the required personal details such as name, date of birth, and address. Use your Aadhaar-linked mobile number to receive an OTP for verification.

• Step 5: After OTP verification, your ABHA Number will be generated. You can use it to link your health records with participating healthcare providers.
• Step 6: Download and save the ABHA Card, allowing senior citizens to digitally access and share their medical records across various health services.

Ayushman Bharat covers a comprehensive list of diseases and medical conditions. List of diseases and Illnesses covered under the Ayushman Bharat Yojana (PMJAY) Scheme:

Double Valve Replacement: A surgical procedure to replace two faulty heart valves, improving blood flow and heart function, is often necessary in cases of severe valve disease.

Carotid Angioplasty: A minimally invasive procedure to open narrowed carotid arteries, improving blood flow to the brain and reducing the risk of stroke.

Prostate Cancer: A common cancer in men that affects the prostate gland and may require surgery, radiation, or hormone therapy for treatment depending on the stage and severity.

Skull Base Surgery: A complex surgical procedure to remove tumours or lesions located at the base of the skull, often involving delicate techniques to preserve surrounding tissues.

Anterior Spine Surgery: A surgical approach to the spine from the front and is often used to correct deformities or relieve pressure on spinal nerves through techniques like discectomy or fusion.

Heart Valve Replacement: A surgical procedure to replace damaged heart valves with artificial ones, improving heart function and alleviating symptoms of heart valve disease.

Pacemaker Implantation: A procedure to implant a pacemaker device in the heart to regulate abnormal heart rhythms and maintain an adequate heart rate.

Renal Transplantation: A surgical procedure to replace a diseased kidney with a healthy one from a donor, restoring kidney function and improving quality of life for patients with renal failure.

Corneal Transplantation: A surgical procedure to replace a damaged or diseased cornea with a healthy donor cornea, improving vision and relieving pain or discomfort.

Paediatric Cancer: Refers to various types of cancer affecting children, often requiring specialised treatments like chemotherapy, radiation, and surgery tailored for young patients.

Neurosurgery: A specialised branch of surgery, focusing on the treatment of brain, spine, and nervous system disorders, including trauma, tumours, and congenital malformations.

Burns: Medical treatment for burns of various degrees, involving pain management, wound care, and potential skin grafts for severe cases to promote healing.

Congenital Heart Defects: A group of heart defects present at birth that may require surgical intervention to repair structural problems and improve heart function.

Maternal Surgeries: Surgical procedures, often performed on pregnant women to address complications or conditions affecting pregnancy.

Hip Replacement: A surgical procedure to replace a damaged hip joint with an artificial joint, relieving pain and restoring mobility in individuals with hip arthritis or injury.

One of the essential elements of the Ayushman Bharat scheme is the network of empanelled hospitals and healthcare providers across the country. To check the Ayushman card hospital list online, follow these simple steps:

Step 1: Go to the official PMJAY website.

• Step 2: Click 'Find Hospital' on the homepage's menu bar.
• Step 3: You will find a list of states and Union Territories. Click on the state and district where you wish to search for empanelled hospitals.
• Step 4: The hospitals are categorised into public and private. Select the category that suits your preference.
• Step 5: You can now search for hospitals by district, speciality, and name. Enter your criteria to get a list of empanelled hospitals matching your preferences.
• Step 6: Once you find a hospital that suits your needs, it is advisable to contact them directly for further information and appointment scheduling.

The Ayushman Bharat Scheme offers extensive healthcare support for senior citizens, ensuring they receive the necessary medical attention. Here are the key benefits specifically designed for senior citizens:

Free Health Coverage

Senior citizens aged 70 and above receive free health coverage of up to ₹5 lakh per family, regardless of their income level. This ensures that financial constraints do not hinder access to essential healthcare.

Separate Card

Senior citizens are given a distinct card to access the scheme's benefits. This card simplifies the process of availing healthcare services and ensures easy identification as beneficiaries.

Top-up Cover

Senior citizens already covered by the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) receive an additional top-up cover of ₹5 lakh per year, enhancing their healthcare protection.

Cashless Treatment

Eligible beneficiaries can avail themselves of cashless treatment at empanelled hospitals. This feature minimises the financial burden during medical emergencies, ensuring prompt care without upfront payments.

Covers a Range of Services

The scheme encompasses various services, including hospital stays, diagnostic tests, lab investigations, implants, meals, complications, and follow-up care, ensuring comprehensive healthcare support for senior citizens.

Option to Continue Existing Scheme

Senior citizens already covered by other public health insurance schemes can continue with their existing scheme or opt for the Ayushman Bharat PM-JAY, providing flexibility in choosing their healthcare.

The Ayushman Bharat scheme for senior citizens is a vital initiative designed to provide essential healthcare services for senior citizens aged 70 and above. The expansion of this scheme underscores the government's commitment to ensuring that senior citizens receive the medical attention they deserve. Seniors can benefit from comprehensive healthcare services by applying for the Ayushman Bharat Card, enabling them to lead healthier lives.