PM Modi to expand AB-PMJAY: Check benefits and eligibility

New Delhi: Prime Minister Narendra Modi is set to expand the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) by launching a health coverage initiative specifically for senior citizens aged 70 and above, regardless of their income.

This significant expansion aims to provide health insurance to an estimated six crore citizens across approximately 4.5 crore households, according to reports.

“The PM is likely to launch the expanded scheme under the Ayushman Bharat health insurance scheme for those aged 70 years and above. It will benefit an estimated six crore citizens in about 4.5 crore households,” reported news agency PTI quoting a source.

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As one of the largest healthcare schemes globally, Ayushman Bharat was initiated in September 2018 to provide comprehensive health coverage to over 50 crore Indians, focusing primarily on the economically weaker sections of society.

Under this initiative, eligible individuals can receive a maximum insurance coverage of Rs 5 lakh per family for medical treatments. The scheme covers a wide range of healthcare costs, including hospitalisation, medicines, diagnostics, and pre-hospitalisation expenses. Beneficiaries can access cashless treatment at any of the 29,648 empanelled hospitals under PMJA, including 12,696 private facilities, by presenting their PMJAY e-card.

The inclusion of senior citizens is particularly noteworthy, as many in this age group struggle to find affordable health insurance due to rising costs associated with age-related health issues. The expansion of AB-PMJAY to cover those over 70 aims to address this gap, providing a family health cover of up to ₹5 lakh. Furthermore, individuals already enrolled in other government schemes will have the option to transition to AB-PMJAY.

Eligibility Criteria

• For Rural Beneficiaries: To qualify for the PMJAY scheme, households must fall under at least one of the following six deprivation categories:
• Households living in a single-room home with Kucha walls and roof.
• No adult members aged 16 to 59 years.
• No adult male members in the same age group.
• Households with a disabled member and no able-bodied individuals.
• Scheduled Castes (SC) and Scheduled Tribes (ST).
• Landless households primarily dependent on manual casual labor.

For Urban Beneficiaries: Urban households are categorised based on their occupation. Eligible occupations include:

• Beggars
• Domestic workers
• Ragpickers
• Street vendors
• Construction workers
• Sanitation workers
• Artisan and handicraft workers
• Drivers and transport workers
• Shop workers and small establishment employees
• Repair workers and mechanics
• Chowkidar/Washer-man