Government Pensioners Eligible for Ayushman Bharat; Choice Between Schemes Required

The Indian government has successfully issued over 42 crore Ayushman cards, extending free healthcare coverage to approximately 12 crore vulnerable families under the Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana (AB-PMJAY). The scheme's eligibility guidelines have been progressively refined to encompass more citizens. Initially based on the 2011 Socio-Economic Caste Census, it was expanded to 12 crore families in January 2022. Further relaxations included ASHAs, Anganwadi Workers, and Helpers last year. A significant expansion occurred on October 29, 2024, offering up to Rs 5 lakh annual treatment benefits to over 6 crore senior citizens aged 70 and above, regardless of their economic status.

Crucially, the scheme now clarifies that government retirees holding cards from schemes like the Central Government Health Scheme (CGHS) or Ex-Servicemen Contributory Health Scheme (ECHS) are eligible for AB-PMJAY. However, a key condition is that beneficiaries must choose between their existing government health scheme or AB-PMJAY; benefits from both cannot be availed concurrently. This is a one-time decision with no provision to switch back. Coverage is up to Rs 5 lakh per family, increasing to Rs 10 lakh for families with parents above 70 years old.

Impact This news is significant for the Indian healthcare and insurance sectors. Increased eligibility for government pensioners under AB-PMJAY could lead to a rise in demand for services from empanelled hospitals and potentially impact the business of private health insurance providers. It signals a growing reach for government welfare schemes, potentially affecting market sentiment towards companies involved in healthcare delivery and financing. Rating: 7/10.

Difficult Terms: Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana (AB-PMJAY): A government flagship scheme providing health insurance coverage. Accredited Social Health Activists (ASHA), Anganwadi Workers (AWW), Anganwadi Helpers (AWH): Community healthcare volunteers. Socio-Economic Caste Census (SECC) 2011: A survey to identify poor households for welfare schemes. Central Government Health Scheme (CGHS): A healthcare scheme for central government employees and pensioners. Ex-Servicemen Contributory Health Scheme (ECHS): A healthcare scheme for retired armed forces personnel. Family floater basis: Health insurance coverage that covers the entire family under a single sum insured. Pre-existing conditions: Health issues that a person has before the policy start date.