As a health insurance advisor, I witness firsthand the anxieties families face regarding their senior citizens’ healthcare needs. The rising cost of medical care can be a significant burden, and the prospect of a sudden health crisis can be overwhelming.

The launch of Ayushman Bharat, particularly the Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), has been a welcome development. It provides a much-needed safety net for families by offering free health insurance coverage. However, in my experience, it’s crucial to view Ayushman Bharat as a stepping stone rather than the final solution, especially for senior citizens.

Before discussing it further let us first understand who can apply and how

Who Can Apply ? 

Anyone aged 70 or above with a valid Aadhaar number would be eligible for applying under the scheme and that initially there would be a pilot launch to sort out any issues that might arise

How to Apply ? 

1.Visit the official website of Ayushman Bharat  ( https://pmjay.gov.in/)

2.Get your Aadhaar or ration card verified at a PMJAY kiosk

3.Provide family identification proofs

4.Get your e-card printed with a unique AB-PMJAY ID.

𝗘𝗻𝗿𝗼𝗹𝗹𝗺𝗲𝗻𝘁 𝗮𝗻𝗱 𝗖𝗼𝘃𝗲𝗿𝗮𝗴𝗲

• The scheme is expected to be extended to all senior citizens above 70 years old.
• A pilot program is likely to start this week in select locations before a nationwide rollout. (The scheme offers free health insurance coverage of up to Rs 5 lakh per family.
• Senior citizens can choose to continue with their existing public health insurance schemes or opt for Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

Understanding Ayushman Bharat’s Benefits and Limitations

Let’s break down Ayushman Bharat:

Strengths:

This scheme offers cashless hospitalization services and covers a wide range of medical procedures, reducing out-of-pocket expenses. It also ensures access to quality healthcare at empanelled hospitals. 

Weakness :

The coverage amount of Rs. 5 lakh per year may not be sufficient for senior citizens with chronic conditions requiring long-term care or expensive treatments. Additionally, the availability of quality healthcare facilities within the network, especially in remote areas, can be a concern. 

Why Senior Citizens Might Still Need Separate Health Insurance

Here’s where separate health insurance for senior citizens comes into play:

Enhanced Coverage:

Separate plans can provide additional financial protection beyond the Rs. 5 lakh limit offered by Ayushman Bharat. This ensures comprehensive coverage for potentially expensive procedures.

Specificity:

Senior-specific health insurance plans are often designed to address the unique needs of older adults, including pre-existing conditions and age-related illnesses.

Wider Network Options:

These plans may offer access to a wider network of hospitals, including private institutions, which might provide specialized care or better amenities.

Addressing Existing Concerns

While Ayushman Bharat addresses a critical need, there are existing concerns that need to be acknowledged, as pointed out in Deccan Herald. Improving the quality of care within the network and ensuring smoother claim settlements are crucial for the scheme’s long-term success.

The Bottom Line: A Tailored Approach

Ayushman Bharat is a positive step towards a healthcare-secure future for senior citizens in India. However, for comprehensive protection, especially considering potential limitations and individual needs, exploring separate health insurance is highly recommended.

As your health insurance advisor, I encourage you to schedule a consultation to discuss your specific situation and explore the best options for your senior loved ones. Together, we can create a healthcare plan that provides peace of mind and ensures they receive the care they deserve.

Click here  to book a free consultation