Senior citizens above 70 years should combine Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) with a private health insurance plan for a comprehensive cover. They can use the government cover for primary hospitalisation. And for expensive treatments that go beyond Rs 5 lakh or prolonged hospitalisation, make use of a private cover.
The AB-PMJAY provides a base floater cover of Rs 5 lakh for all senior citizens above 70 years, which is beneficial to cover primary and tertiary expenses. To supplement the cover, senior citizens should consider private plans of at least Rs 5 lakh to cover additional expenses such as outpatient treatments, specific diseases, or higher room categories as health expenses tend to increase with age. This combination will ensure comprehensive coverage and address both essential and advanced healthcare needs.
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Moreover, they can look at a top-up which is a cost-effective strategy to expand coverage for expensive treatments. This can help them avoid high premiums for comprehensive coverage, while ensuring they are covered for substantial expenses if need be.
Siddharth Singhal, head, Health Insurance, Policybazaar.com, senior citizens are vulnerable to high-risk illnesses, treatments for which can be very expensive and may go beyond Rs 5 lakh. “To ensure more comprehensive coverage, seniors can combine it with a private health insurance policy that covers additional healthcare expenses, including any specialised services for expensive treatments,” he says.
Added advantages
Unlike private insurance, there is no waiting period for any pre-existing conditions in AB-PMJAY and the coverage starts immediately after enrolment. Aadhaar is the only document needed for enrolment in the scheme. If there are two members above 70 years in a family, then the Rs 5 lakh coverage will be shared between them.
Senior citizens will have to generate an Ayushman Vaya Vandana card to enroll. Separate enrolments are not needed for people above 70 years in a family. After enrolling the first family member aged 70 years or above, the names of other family members above 70 years can be added under the scheme using the ‘add member’ feature.
Senior citizens already covered under public health insurance schemes like the Central Government Health Scheme will have the option to either continue with their existing scheme or opt for AB-PMJAY.
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