No Panel Formed to Extend Ayushman Bharat Benefits to Seniors: MoS Prataprao Jadhav

Jadhav also stated that there is no proposal to expand the scheme beyond the current beneficiaries based on premium contributions.

No expert committee has been set up to extend health benefits to citizens aged 70 and above under the Ayushman Bharat Scheme, Union Minister of State for Health, Prataprao Jadhav informed Lok Sabha on Friday. The revelation arrived in a question hour session in the parliament.

Without much explaining, he also stated that there is no proposal to expand the scheme beyond the current beneficiaries based on premium contributions.

Jadhav was responding to a question on whether the government proposed to cover citizens aged 70 and above by expanding Ayushman Bharat through the launch of a National Health Claims Exchange (NHCX) and if an expert panel had been set up to strengthen the format of the scheme for the planned expansion.

"No expert committee has been set up for extending the health benefits to cover senior citizens aged 70 and above," he stated.

It is here to be noted that, as per the 100-day health agenda, PM Narendra Modi announced the extension of the Ayushman Bharat health insurance scheme to cover all citizens aged 70 years and above.

Further, in his written reply, Jadhav emphasized that all members of eligible families, regardless of age, are covered under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana.

The scheme provides health insurance coverage of INR 5 Lakh per family per year for secondary and tertiary care hospitalization to 55 Cr individuals, corresponding to 12.34 Cr families.

Ambiguity Surrounds Senior Citizen Coverage Despite Promises

This statement fuels speculation on the extent of the expansion to cover senior citizens, a topic notably absent from the Union Budget.

Earlier, President Droupadi Murmu announced during her address to the joint sitting of Parliament that all citizens aged 70 or above would receive free treatment under Ayushman Bharat.

In June, the Narendra Modi-led government unveiled an ambitious 100-day Agenda for the Union Health Ministry. A key highlight of the agenda is the extension of the Ayushman Bharat health insurance scheme to cover all citizens aged 70 years and above.

Expansion of Ayushman Bharat

Initially, 10.74 Cr beneficiary families were identified based on the 2011 socio-economic caste census, using specific deprivation and occupational criteria for rural and urban areas.

In January 2022, the beneficiary base was expanded to 12.34 Cr families. States and Union Territories were given the flexibility to use other digitized databases of similar socio-economic conditions for identifying beneficiaries under the scheme.

The scheme is implemented in 33 states and Union Territories, excluding the NCT of Delhi, West Bengal, and Odisha.

About NHCX

Responding to another question, Jadhav stated that 34 insurers and third-party administrators are operational, and approximately 300 hospitals are ramping up to start sending their claims on the NHCX as of July 21.

The NHCX, built under the Ayushman Bharat Digital Mission, aims to streamline and standardize health insurance claim processing, enhancing efficiency and improving patient experience.

The NHCX serves as a gateway for exchanging health claim information among insurers, third-party auditors, healthcare providers, beneficiaries, and other relevant entities, ensuring interoperability, machine-readability, auditability, and verifiability, making the information exchange accurate and trustworthy.