Ahead of Union Finance Minister Nirmala Sitharaman’s Budget presentation for FY2024-25 on July 23, some people wonder whether she will introduce the changes in the Ayushman Bharat Yojana (APY) as promised in the ruling party’s election manifesto. Given the rising healthcare cost, the insurance coverage of senior citizens aged 70 and above under the Ayushman Bharat scheme will provide them huge relief. This insurance coverage is especially critical for this age group as their income is limited, and they require financial assistance for adequate healthcare protection.

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Many senior citizens could remain excluded from health insurance coverage without government aid, leading to social and economic inequalities.

What Was Promised In The Manifesto?

The government pledged to expand insurance coverage to all senior citizens above 70 under the Ayushman Bharat Pradhan Mantri Yojana to provide them with free and quality healthcare.

In her recent address to parliament, Indian President Draupadi Murmu also reiterated the government’s promise: “Every elderly person above 70 will be covered and benefit from free treatment under Ayushman Bharat Yojana.” Expectations are also rife that the government could increase the coverage under Ayushman Bharat from Rs 5 lakh to Rs 10 lakh.

Salient Features Of Ayushman Bharat Yojana

The ABY has two components: Pradhan Mantri Jan Arogya Yojana (PMJAY)) and Ayushman Arogya Mandirs or health and wellness centres.

PMJAY offers free annual health insurance coverage up to Rs 5 lakh per eligible family. Currently, around 34 crore citizens are covered under this scheme.

On the other hand, the Arogya Mandirs provide primary health care to people, including maternal and child healthcare and free medicine and diagnostics services.

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How The Extended Coverage Will Benefit Senior Citizens?

Parthanil Ghosh, director and chief business officer, HDFC ERGO general insurance, says, “As one ages, the chances of falling sick also increase. Senior citizens often face higher medical costs due to increasing age-related health issues. It is especially challenging for the economically weaker section, as the senior citizens from this segment face limited means.

“However, with schemes like Ayushman Bharat Yojana, where senior citizens from economically weaker areas will also get free healthcare, one can avail of quality treatment without worrying about medical bills, alleviating financial stress and out-of-pocket expenses. The assurance of free healthcare curtails stress and anxiety related to medical bills, thus ensuring peace of mind for senior citizens and their families.”

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How Will Ayushman Bharat Yojana’s Expansion Impact Insurance Landscape?

It will ease the healthcare cost burden for many seniors. However, the scheme is primarily for people from financially vulnerable backgrounds, selected based on the deprivation and occupational criteria of the Economic Caste Census 2011 or those covered under Rashtriya Swasthya Bima Yojana (RSBY).

Ghosh asserts, “The expansion of the benefits of the Ayushman Bharat Yojana is poised to usher in a wave of positive changes in the insurance sector. It will significantly enhance awareness among the beneficiaries”.

Moreover, “The move will spur the insurers to innovate and develop customised products and services to complement the government scheme, which could include top-ups, riders, tailored to senior citizens, etc. Private insurers can focus more on preventive care and wellness measures. Launching wellness products and services can promote overall well-being, which can help curtail healthcare costs. Similarly, insurers can offer home healthcare services such as nursing, telemedicine consultation, etc., particularly useful for people with mobility issues.”

This enhanced coverage will help seniors in the economically weaker sections address their health issues timely and live a life of dignity without depending on anyone. Further, private sector insurers must innovate products and services to expand their reach.