AYUSHMAN BHARAT FOR SENIOR CITIZENS
Why In News ?
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) has been expanded to cover all Indians aged 70 years and older, regardless of their income.
- This expansion, approved by the Union Cabinet, marks a significant milestone in India’s healthcare policy.
- Registration for the expanded scheme is expected to start within a week, with a formal launch likely by the Prime Minister.
ABOUT THE SCHEME
The Ayushman Bharat programme was launched in 2018 to address health issues at all levels – primary, secondary, and tertiary.
It has two components:
- Pradhan Mantri Jan Arogya Yojana (PM-JAY), earlier known as the National Health Protection Scheme (NHPS)
- Health and Wellness Centres (HWCs)
Ayushman Bharat is an integrated approach comprising health insurance and primary, secondary and tertiary healthcare.
Targeted Beneficiaries: 12 Crore Households.
ABOUT AB-JAY
Introduction:
- Launch Date: September 2018
- Objective: Provide secondary and tertiary healthcare services to vulnerable populations.
Features:
- Coverage: Up to ₹5 lakh per family per year for hospitalization.
- Target Audience: Poor and vulnerable families, covering around 40% of the population.
- Eligibility: Includes 10.74 crore families based on Socio-Economic Caste Census (SECC) data.
Benefits:
- Cashless Services: Beneficiaries get cashless access to healthcare services.
- Health Benefit Packages: Includes surgeries, medical treatments, day care treatments, medicines, and diagnostics.
Implementation:
- National Health Authority (NHA): Responsible for strategy, technological infrastructure, and National Digital Health Mission.
- State Health Agencies (SHAs): Implement the scheme at the state level.
ABOUT HEALTH & WELLNESS CENTRES (HWCs)
HWCs are being created by converting the existing primary health centres and sub centres.
They provide comprehensive primary health care (CPHC) including a child and maternal health services, non-communicable diseases, and also diagnostic services, and free essential drugs.
HWCs are important because they offer CPHC that is critical to enhancing health outcomes. Primary healthcare plays a vital role in preventing many disease conditions. Providing CPHC decreases morbidity and mortality at a lower cost and greatly reduces the requirement for secondary and tertiary care.
THE CURRENT EXPANSION
Registration Process
- Eligibility: Individuals who have turned 70 as per their Aadhaar can register for the new health cover.
- Registration Methods:
- Through the Ayushman Bharat App
- At the Ayushman Bharat counter at any government health facility
- Features:
- No exclusions or waiting period for pre-existing conditions.
- Registration will include eKYC, with face-authorisation to assist elderly individuals whose fingerprints may be difficult to read.
Coverage Details :
- Annual Cover: ₹5 lakh per elderly individual, shared within the family.
- Example: If 2 elderly members are in a household, the ₹5 lakh cover is split between them.
- Top-Up Cover: Elderly members of already covered families will receive an additional ₹5 lakh top-up, exclusive to elderly care. They will need to re-register to access this top-up.
Beneficiary Statistics :
- Total Coverage: The scheme will cover approximately 6 crore individuals from 4.5 crore families.
- Out of these, 1.78 crore are already covered.
Existing Health Schemes :
- Coverage Options:
- Integration with Other Schemes: Beneficiaries with other public health insurance (e.g., CGHS, ECHS) can either continue their existing schemes or opt for the expanded AB-PMJAY coverage.
- New Health Cards: Senior citizens will receive new health cards for streamlined access to benefits.
- Private Insurance: Individuals with private insurance can also avail of the Ayushman Bharat cover.
Financial Implications
- Government Cost: The initial cost for expanding the scheme is ₹3,437 crore, covering six months of the current financial year and the entire next year. States will contribute 40% to the scheme’s cost.
SIGNIFICANCE OF THIS EXPANSION
- Demographic Shift:
- As of the 2011 census, 8.6% of India’s population was over 60.
- By 2050, this is expected to rise to 19.5%, with 319 million people over 60.
- The elderly are more likely to require hospitalization, with a higher admission rate compared to younger populations.
- Current Coverage:
- Only about 20% of the elderly population is covered by any health scheme.
- Women constitute a larger share of the elderly population, with 58% being women and 54% of them widows. The scheme is expected to provide significant support, especially for widowed women.
Note: Connect with Vajirao & Reddy Institute to keep yourself updated with latest UPSC Current Affairs in English.
Note: We upload Current Affairs Except Sunday.
