Health insurance may cover all over 70
The government has started work on extending its health insurance scheme for the poor, the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), to cover everyone over 70 years of age irrespective of their income level —not just the poor.
The scheme could make it to the full-year budget for FY25 as a poll promise by the Bharatiya Janata Party, two persons informed about discussions in the government said.
The interim budget for FY25 allocated ₹7,500 crore for the scheme, a more than 10% increase over the amount spent in the just-concluded financial year.
The scheme in its current form gives beneficiaries an insurance coverage of ₹5 lakh person per year on a meanstested basis—to qualify, the individual's annual income must not exceed ₹2.4 lakh.
Expanding the coverage of the scheme to include everyone above 70 years of age by removing the income cap could cost the exchequer an additional ₹15,000 crore– ₹20,000 crore a year as per preliminary estimates, said one of the persons quoted above.
While the figure for over-70s was not immediately available, the UN state of world population report of 2023 says 7% of India’s over 1.4 billion people are aged 65 years or above.
Although the BJP has thus far steered clear of announcing populist measures in its manifesto and stuck to the path of fiscal prudence, improving access to quality healthcare, especially for the middle class, is a key element of the party’s welfare agenda.
AB-PMJAY, rolled out in 2018, is the largest health assurance scheme in the world. It seeks to provide a health cover of ₹5 lakh a year for secondary and tertiary care hospitalization to over 120 million poor families—or the 550 million individuals who make up the bottom 40% of the Indian population.
Surgeries such as knee replacements, hip replacements, and congenital heart diseases are in demand under the scheme. The Union health ministry is also planning to expand the scope of the scheme, covering more expensive cancer and transplant-related surgeries and treatments.
An official at the National Health Authority said the agency is preparing to issue health cards to everybody above the age of 70 years. The official declined to comment on the union budget for FY25.
“Since many aged people find it difficult to buy health insurance policies, government seeking to ensure their healthcare coverage is a welcome decision,” said Dr Rajeev Jayadevan, a public health expert.
“Many people in this age group find medical insurance expensive, many people are made to pay extra or denied treatment. Since the public hospitals are always overcrowded, septuagenarians and older people can avail of the facilities in private hospitals,” he said.
gireesh.p@livemint.com
The Union health ministry is also planning to expand the scope of the scheme, covering more expensive care