Explained | Everything about AB-PMJAY's Rs 5 lakh coverage scheme for senior citizens above 70 years

Who is eligible, what is covered, and what if you already have insurance? Here's everything you need to know.

The Cabinet, on Wednesday, approved health coverage of Rs 5 lakh to all senior citizens aged 70 years and above irrespective of their income under the flagship scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), in a meeting chaired by PM Modi.

According to a press release, the scheme aims to benefit approximately four and a half crore families, with six crore senior citizens getting Rs 5 lakh free health insurance cover on a family basis.

Here's everything you need to know about it:

Who is eligible?

All senior citizens aged 70 years and above irrespective of their socio- economic status are eligible to avail the benefits of AB PM-JAY. Eligible senior citizens will be issued a new distinct card under AB PM-JAY.

What if they already have insurance coverage?

Already covered under PM-JAY:

Senior citizens whose families are covered under the scheme already will get an additional top-up cover upto Rs 5 lakh per year for themselves, which they need not share with other family members below the age of 70 years.

Covered under another government scheme:

If they are covered under any other government scheme, such as the Central Government Health Scheme (CGHS), the Ex-Servicemen Contributory Health Scheme (ECHS), and the Ayushman Central Armed Police Force (CAPF), they may choose to continue with the same, or switch to AB PM-JAY.

Covered under private health insurance:

Furthermore, those under private health insurance policies or Employees’ State Insurance scheme will still be eligible to avail benefits under AB PM-JAY.

What is covered under AB-PMJAY?

The cover under the scheme includes all expenses incurred on the following components of the treatment:

• Medical examination, treatment and consultation

• Pre-hospitalization

• 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

• Post-hospitalization follow-up care up to 15 days

How to apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

Step 1: Visit the official website of AB-PMJAY

Step 2: Click on the ‘Am I Eligible’ tab on the right-hand side of the page.

Step 3: Submit your mobile number, CAPTCHA code, and the OTP

Step 4: Enter your state and your name, ration card number, household number, or mobile number

If your family is covered under Ayushman Bharat Yojana, then your name will be displayed in the results