Manas Dasgupta
NEW DELHI, Oct 29: The Prime Minister Narendra Modi on Tuesday launched health cards under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to provide health coverage to people aged 70 years and above, regardless of their income and economic status and profusely apologised to the elderly in Delhi and West Bengal for not being of any help to them.
The Ayushman Vaya Vandana card marks the beginning of the expanded scheme that is expected to change the face of public healthcare as India’s rapidly growing ageing citizens can now access treatment, which had been out of their reach because of high costs. Everyone of age 70 or more will be entitled to a cover of Rs 5 lakh annually, shared within the family. This means if there are two elderly beneficiaries in the household, the cover will be split among them.
The scheme will cover almost 6 crore individuals from 4.5 crore families. Of them, 1.78 crore are already covered by the scheme. Among the rest, around 80 lakh people are separately covered under various government health schemes — the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme, or cover provided to family members of defence and railway personnel.
Those covered under existing government health schemes will have the option of choosing either Ayushman Bharat or continuing with their existing coverage. People who are covered under the Employees State Insurance Corporation (ESIC), however, will be eligible to have both their existing cover and Ayushman Bharat. This is because premiums for ESIC are paid by the insured and their employer, not the government. People who have their own privately purchased insurance cover will be eligible to have the Ayushman Bharat cover as well.
Mr Modi hit out at Delhi and West Bengal governments for not implementing the Ayushman Bharat health insurance scheme out of “political interests” and said he was pained that the elderly from these two states cannot avail free treatment under the expanded programme.
“But I apologise to the elderly in Delhi and West Bengal for being unable to serve them. I would know that you are in trouble, but I won’t be able to help you. Because the governments in Delhi and West Bengal are not joining this scheme,” he said.
“The tendency to oppress the sick people of your state for political interests does not stand the test of humanity. I can serve the people of the country, but the walls of political interests are preventing me from serving the elderly people of Delhi, and West Bengal,” the Prime Minister said.
Under the Ayushman Bharat scheme, the Centre and state governments shoulder the cost of premiums in a 60-40 ratio. Both Bengal and Delhi governments have health insurance schemes of their own, which they claim are better than the Centre’s plan.
Responding to the PM’s charge, AAP MP Sanjay Singh told the media, “If you have a fridge, you can’t benefit from Ayushman Bharat. If you have a bike, you can’t benefit. If you earn more than ₹ 10,000 per month, you can’t benefit from it. If this scheme is implemented in Delhi, no one will benefit from it.” The Trinamool Congress, too, stressed that its scheme was better in terms of coverage and convenience.
“The elderly people, who always had anxieties about their healthcare because of costs, can now live with swabhimaan (dignity),” said Modi. The scheme will be available everywhere except Delhi and Bengal, since these states have not adopted Ayushman Bharat.
In order to access the health coverage, people need to register on the PM-JAY portal or on the Ayushman app. Those who have an Ayushman card already will also have to apply again on the portal or app and complete their eKYC for a new card.
Making health cover universal over the age of 70 is very significant as India’s population ages. At the time of the 2011 census, only 8.6 per cent of India’s population was over the age of 60 years. This is expected to increase to 19.5 per cent by 2050, according to the government’s Longitudinal Ageing Study in India (LASI). In terms of numbers, Indians over the age of 60 are likely to be 319 million in 2050 — up more than three times from the 103 million in 2011.
While the Ayushman Bharat scheme was geared towards universal health coverage, this would be the first age cohort to receive complete coverage. Members over the age of 70 years in families already covered in accordance with their economic status will get a top-up cover of Rs 5 lakh — to be used only for the elderly. These elderly beneficiaries will have to re-register to receive the top-up cover
The initial outlay from the Centre for the expansion of the scheme will be Rs 3,437 crore. This will cover the costs for the six months in the current financial year and all of next year, officials said. Experts have estimated the cost of expanding the coverage to all persons over 70 years would be higher than that for covering the poorest 40 per cent across all age groups.
“There was a time when people’s houses, lands, jewellery were sold for treatment. The soul of the poor trembled on hearing the cost of treatment for a serious disease. The helplessness of not being able to get treatment due to lack of money would shatter the poor. I could not see my poor brothers and sisters in this helplessness. That is why the ‘Ayushman Bharat’ scheme was born,” Mr Modi said.
The Prime Minister said the government has prepared five highlights of a national health policy. “First is preventive healthcare, second is timely intervention, third is affordable treatment and medicines, fourth is robust facilities and qualified doctors in small cities and the fifth is use of advanced technology. India now looks at healthcare with a holistic viewpoint,” he said.
The Prime Minister launched a string of health projects worth Rs 12,850 crore and also announced the pan-India rollout of the U-WIN portal to digitise routine vaccinations on the occasion of the ninth Ayurveda Day and the birth anniversary of Dhanvantari, the Hindu god of medicine.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is the Modi Government’s flagship health insurance policy which was initially launched in September, 2018, to provide financial security and access to quality healthcare services for economically vulnerable people, with the goal of ensuring that no one falls into poverty due to excessive medical expenses.
All senior citizens of the age 70 and above irrespective of their socio- economic status would be eligible to avail the benefits of the AB PM-JAY. The eligible senior citizens would be issued a new distinct card, colloquially known as the Modi health card, under the AB PM-JAY.
A senior Health Ministry official said 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. “It is an application-based scheme. People will need to register on the portal. The facility of face authentication is available on the portal, which will have a designated link for senior citizens 70+ aged,” he said.
The Steps need to be followed to register a 70+ person to avail the scheme included:
Visit the official website of Ayushman Bharat PM-JAY, Get your Aadhaar or ration card verified at a PMJAY kiosk, Provide family identification proofs and Get your e-card printed with a unique AB-PMJAY ID.
PM-JAY provides cashless cover of up to ₹5,00,000 to each eligible family per annum for listed secondary and tertiary care conditions. The cover under the scheme includes all expenses incurred on the following components of the treatment.
- Medical examination, treatment and consultation
- Pre-hospitalization up to three days
- Medicine and medical consumables
- Non-intensive and intensive care services
- Diagnostic and laboratory investigations
- Medical implantation services (where necessary)
- Accommodation benefits
- Food services
- Complications arising during treatment and
- Post-hospitalization follow-up care up to 15 days.
