Health Coverage for All senior citizens aged 70
Kartavya Desk Staff
Syllabus: Schemes for the Vulnerable sections
Source: TH
Context: The Union Cabinet has approved health coverage for all senior citizens aged 70 and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)
More about Health Cover for Senior Citizens under AB PM-JAY:
| Description
Eligibility Criteria | All senior citizens aged 70 and above, regardless of income.
Beneficiaries | Approximately 6 crore senior citizens.
Benefits Offered | Family-based cover of Rs 5 lakh annually.
An additional top-up of Rs 5 lakh annually for those already covered by AB PM-JAY.
Ease of Access | Eligible seniors will receive a distinct AB PM-JAY card.
Option to choose between existing public health schemes or AB PM-JAY.
Other Eligible Groups | Senior citizens under private health insurance or Employees’ State Insurance schemes.
About AB PM-JAY Scheme
Ministry | Ministry of Health & Family Welfare
Type | Centrally Sponsored Scheme under Ayushman Bharat Mission
Target | 12 crore families (approximately 55 crore beneficiaries)
Purpose | To achieve Universal Health Coverage (UHC)
Benefits | Health cover of Rs 5 lakh/family/year for secondary and tertiary care
Covers up to 3 days pre-hospitalization and 15 days post-hospitalization expenses.
Significance | World’s largest publicly funded health assurance scheme
Other Schemes for Senior Citizens
Atal Vayo Abhyuday Yojana | To improve the quality of life of senior citizens.
SAGE Initiative | To promote and incentivize senior care products and services.
SACRED Portal | To connect senior citizens with job providers in the private sector.
Health Care Concerns for Senior Citizens:
• Rise in Chronic Illness: 1 in 5 elderly persons has mental health issues, with 75% suffering from chronic diseases (LASI, 2021).
• Need for Geriatric Care: Increased expenses for treating non-communicable diseases and conditions like cataracts and hearing loss create financial challenges.
• Low AB PM-JAY Penetration: Limited reach in smaller cities and towns hampers universal health coverage.
• Lack of Outpatient Care: No coverage for outpatient services and medicines, despite high elderly spending on chronic diseases.
• Limited to Hospitalization: Focus on secondary and tertiary care; inadequate primary health care for seniors.
• Functional Issues: Misinformation, overburdened staff, and limited role of Arogyamitras affect AB PM-JAY’s effectiveness.
• Insurance Model Limitations: Over-reliance on insurance schemes, unlike models focusing on primary care, can lead to higher costs.
Measures to Rejuvenate India’s Insurance Sector:
• Parametric Insurance: Use data analytics and IoT for quick payouts based on triggers like rainfall for crop insurance.
• Employer-Driven Group Insurance: Promote group insurance for informal sectors, inspired by Germany’s Bismarck Model.
• Public-Private Partnerships (PPPs): Collaborate with government agencies for affordable, need-based insurance in underserved areas.
• Awareness Campaigns: Large-scale efforts to improve insurance literacy and dispel myths.
• Improve AB PM-JAY: Empower Arogya mitras for better claim support.
• Expand Healthcare Infrastructure: Increase health centers to reduce doctor-patient imbalance.
• Strengthen Primary Care: Enhance primary and secondary care to reduce tertiary hospital loads.
Other Suggested measures for Elderly:
Measures | Description
Ensure comprehensive Social Security Systems | E.g., Kalaignar Magalir Urimai Thittam is a women’s rights grant scheme just rolled out in Tamil Nadu aimed at providing financial support to eligible women recognized as heads of families
Karnataka Gruha Lakshmi Scheme supports women heads of families by providing eligible women will receive financial assistance of ₹2000 per month.
Intergenerational programs: Programs that promote intergenerational bonding, such as mentorship programs and community service projects
Access to Healthcare | Improve access to healthcare services, including geriatric care, preventive screenings, and mental health support, to address the specific health needs of older women.
Social Inclusion | Promote social inclusion and active participation of older women through community-based programs, intergenerational activities, and support networks.
Civil Society Engagement | Community-based initiatives and CSO engagement through Senior citizen clubs and programs, can provide social support and help prevent social isolation among the elderly
E.g. Asha Deep Foundation provides Day Care Centre for the elderly members of our community who are either neglected, have no children or are abandoned by their families.
Demographic Stability | Focus on policies and programs that address population ageing and the needs of older women, such as promoting family planning, women’s empowerment, and intergenerational solidarity.
Community-based care system for elders | ASHA program could be used for building a community-based workforce to support the diverse health and social care needs of elders
Age-friendly cities | Cities can be designed to be age-friendly, with infrastructure and public spaces that are accessible to all, including elderly citizens.
Government Scheme for Old Age:
Scheme | About
National Social Assistance Programme (NSAP) | Offers non-contributory pensions for the elderly, widowed women, and disabled individuals. Administered by the Ministry of Rural Development.
Pradhan Mantri Vaya Vandana Yojana (PMVVY) | Exclusive pension scheme for senior citizens aged 60 and above. Extended up to 2023 for three more years beyond 2020.
Integrated Program for Older Persons (IPOP) | Aims to enhance the quality of life for senior citizens by providing basic amenities such as food, shelter, medical care, and entertainment opportunities.
Rashtriya Vayoshree Yojana | Central sector scheme funded by the Senior Citizens’ Welfare Fund. Provides aids and assistive living devices to elderly BPL individuals with age-related disabilities.
SAMPANN Project | Launched in 2018, an online pension processing system for Department of Telecommunications pensioners. Direct credit of pension into bank accounts of pensioners.
SACRED Portal for Elderly | Developed by the Ministry of Social Justice and Empowerment. Citizens above 60 can register to find jobs and work opportunities, and access information and guidance on various issues.
Elder Line: Toll-Free Number for Elderly | Provides information, guidance, emotional support, and immediate assistance for elderly citizens, particularly on pension, medical, and legal matters.
SAGE (Seniorcare Ageing Growth Engine) Initiative | A platform offering access to elderly care products and services by credible start-ups, supporting entrepreneurship in the field of elderly care.
Conclusion:
By recognizing the specific needs of older persons and providing targeted support, we can create a society that values and empowers them, ensuring their well-being and active participation in all spheres of life.
Insta Links:
• Assessing India’s Social Security Programs
Prelims Links:
Who among the following can join the National Pension System (NPS)? (UPSC 2017)
(a) Resident Indian citizens only
(b) Persons of age from 21 to 55 only
(c) All State Government employees joining the services after the date of notification by the respective State Governments
(d) All Central Government employees including those of Armed Forces joining the services on or after 1st April, 2004
Ans: (c)
• Regarding ‘Atal Pension Yojana’, which of the following statements is/are correct? (UPSC 2016)
• It is a minimum guaranteed pension scheme mainly targeted at unorganized sector workers.
• Only one member of a family can join the scheme.
• Same amount of pension is guaranteed for the spouse for life after the subscriber’s death.
Select the correct answer using the code given below:
(a) 1 only (b) 2 and 3 only (c) 1 and 3 only (d) 1, 2 and 3
Ans: (c)