Government Health Schemes for Senior Citizens: Benefits, Limits & Key Features

What are Government Health Schemes for Senior Citizens?

Health schemes for senior citizens are dedicated health insurance policies and services for older people. These are government-backed health schemes that provide adequate coverage at affordable premiums. Since these are govt health insurance for senior citizens, there is a sense of trust and reliability for senior citizens.

With health schemes in place, senior citizens no longer have to worry about unreasonably high medical bills, as his policies offered financial support, medical coverage, and access to essential treatments.

Why Senior Citizens Must Have Health Insurance?

Health insurance has become a necessity today, especially amid rising medical costs and increased health risks nationwide. Here are a few reasons why senior citizens must not avoid purchasing health insurance schemes for senior citizens:

Rising Medical Costs

Medical inflation in the country is at an all-time high, making even basic healthcare facilities a financial burden. In such situations, having a health insurance policy becomes a necessity.

High Health Risks

Although medical emergencies can occur at any time, senior citizens are often considered to be at a higher health risk. With growing age, the risk of common diseases such as diabetes, arthritis, and other chronic illnesses increases. Health schemes for senior citizens offer adequate coverage for such diseases.

Limited Source of Income

Typically, most senior citizens depend on their income from life, savings, or pensions, which limits their sources of income. In such situations, a medical emergency can take a huge financial toll. This is why a health insurance policy becomes important.

List of Government Health Schemes for Senior Citizens

At present, there are multiple Indian government health insurance for senior citizens. Some of them include.

Pradhan Mantri Jan Arogya Yojana (PMJAY)

The Pradhan Mantri Jan Arogya Yojana, also known as Ayushmann Bharat Yojana, is one of the most popular government health schemes for senior citizens launched by the Central government. This scheme was introduced to support economically weaker families in the country by providing coverage for secondary and tertiary care hospitalisation. The PMJAY aims to cover over 12 crore viable families in India under this scheme.

Key highlights:

• The sum insured amount is ₹5 lakh for every family.
• There are no restrictions on the family size, age, or gender.
• The scheme covers around 1,929 medical procedures.
• Under the scheme, pre-existing diseases are covered from day one.
• The scheme also covers three days of pre-hospitalisation and 15 days of post-hospitalisation costs.

Central Government Health Scheme

The Central Government Health Scheme is probably one of the first few schemes launched by the Central government. This government medical scheme for senior citizens was introduced in 1954 to offer medical coverage, primarily for central government employees, pensioners, and their dependents.

Key highlights:

• Free consultation with specialists is provided at polyclinics and empanelled hospitals.
• Under the scheme, medical coverage is available at Central government health scheme wellness centres, government hospitals, and empanelled private hospitals.
• Costs incurred on hearing aids and other medical appliances can be reimbursed.
• Medical tests such as X-rays and lab investigations are also covered.

Pradhan Mantri Suraksha Bima Yojana (PMSBY)

The Pradhan Mantri Suraksha Bhima Yojana was launched on 1st June 2015. This health insurance for seniors in India by government was introduced to provide financial protection in case of accidental death, partial or total disability. It works like a personal accident insurance policy.

Key highlights:

• The Pradhan Mantri Suraksha Bhima Yojana is available for people between the ages of 18 and 70 years.
• It is mandatory to have a savings account in a participating bank or post office.
• Coverage upto ₹2 lakh is provided in case of an accidental death or total disability.
• In case of a partial disability, health coverage up to ₹1 lakh is provided.
• This comprehensive health scheme is available at an annual premium of only ₹20.

Employees State Insurance Scheme

The Employees' State Insurance Scheme was introduced to combine the benefits of health insurance and social security programmes. This health insurance scheme for senior citizens by government covers permanent factories or businesses with 10 or more employees.

Key highlights:

• It ensures financial protection for workers and their families in case of a medical emergency.
• The scheme aims at offering sickness benefits, funeral expenses, maternity insurance, and confinement expenses.
• Under the scheme, families can receive a dependent benefit in case of the insured employee's death or injury at work.

Universal Health Insurance Scheme

The universal health insurance scheme was also introduced to offer financial protection in case of a medical emergency or accidental death of the primary breadwinner of the family. This scheme was introduced by the Ministry of Health and Family Welfare.

Key highlights:

• The scheme is available for both families below the poverty line and above the poverty line.
• The scheme offers coverage for several hospitalisation expenses without any waiting period.
• The scheme offers health coverage up to ₹30,000 for medical expenses.
• The scheme offers disability compensation of ₹50 every day for 15 days.
• In case of an accidental death of the head of the family or spouse, coverage of ₹25,000 is provided.

Rashtriya Swasthya Bima Yojana

The Rashtriya Swasthya Bima Yojana was introduced in 2008. This policy scheme was specifically launched to protect the families below the poverty line in case of medical emergencies.

Key highlights:

• It offers coverage for treatments for all pre-existing diseases.
• The scheme requires only ₹30 for registration or renewal annually.
• There is no restriction on the age or number of family members.

Yeshasvini Health Insurance Scheme

The Yeshasvini Health Insurance Scheme was introduced by the government of Karnataka to offer healthcare services at minimal cost.

Key highlights:

• The scheme is available for cooperative societies, self-help groups, and farmers.
• The sum insured is ₹5 lakh.
• The scheme offers coverage for several medical procedures, such as orthopaedics and heart disease.

Mukhyamantri Amrutum (MA) Yojana

The Mukhyamantri Amrutum (MA) Yojana was introduced by the state government of Gujarat to offer quality medical services to families below the poverty line and lower-income families.

Key highlights:

• The scheme ensures cashless healthcare and surgical treatment for several illnesses, including cardiovascular and neurological diseases.
• The scheme is free of cost as the premium is fully paid by the government.
• The sum insured is ₹5 lakh.
• ₹300 is provided per hospital visit for any treatment.

Karuna Arogya Suraksha Padhathi (KASP)

The Karuna Arogya Suraksha Padhathi (KASP) was introduced by the state government of Kerala. This scheme was introduced to merge several different government health schemes and offer enhanced healthcare access to economically vulnerable families.

Key highlights:

• The sum insured is ₹5 lakh.
• There is no restriction on the size of the family or the number of beneficiaries named.
• There is no waiting period, and the scheme offers coverage for pre-existing diseases from day one.

Bhamasha Swasthya Bima Yojana

The Bhamasha Swasthya Bima Yojana is a state-level health scheme introduced by the Rajasthan State government. The scheme was renamed as the Ayushmann Bharat Mahatma Gandhi Rajasthan Swastha Bhima Yojana in 2021. The scheme was introduced to offer cashless insurance coverage to economically weaker families.

Key highlights:

• The sum insured is ₹5 lakh.
• The scheme offers coverage for both inpatient and day care treatments.
• There are no restrictions on the age or number of family members.

West Bengal Health Scheme

The West Bengal Health Scheme was introduced for employees, pensioners, and dependents of the state government.

Key highlights:

• The scheme offers reimbursement for indoor treatment in both network and non-network hospitals.
• It offers cashless health insurance facilities for ₹2 crore per indoor treatment.
• The scheme provides coverage for OPD treatment for up to 18 specified diseases.

Telangana State Government Employees and Journalist Health Scheme

This health insurance for senior citizens by government was introduced specifically to offer cashless treatment to journalists, employees, pensioners, and their dependent family members.

Key highlights:

• There is no coverage limit for the procedures that are listed under the scheme.
• The scheme offers inpatient treatment for listed therapies for identified diseases.
• One-year coverage for follow-up services is offered for specialised treatments.

Which is Better: Government Vs Private Health Plan for Senior Citizens?

Both government and private health policies for senior citizens are designed to offer adequate coverage at affordable premiums. However, there are a few differences that you must know to make an informed choice. Take a quick look at this comparison table for a better understanding:

Final Words

Dedicated government medical insurance for senior citizens is a great initiative taken by the government of India to make healthcare facilities accessible and affordable for the elderly. Whether you choose a government or a private health scheme for senior citizens, make sure to carefully check eligibility, sum insured, coverage, and exclusions.

If you’re looking to purchase a reliable health insurance policy for senior citizens, you can trust Jio Insurance Broking to bring the best plans and the same platform for you to explore, compare, and purchase.

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