Industry reacts to the health coverage announcement for senior citizens under AB-PMJAY

Dr Harsh Mahajan, Chair, FICCI Health Services Committee and Founder, Mahajan Imaging & Lab

“The inclusion of senior citizens under the Ayushman Bharat scheme marks a significant enhancement of our national healthcare infrastructure. The scheme offers ₹5 lakh in coverage per family annually, which, although shared among multiple elderly members within the same family, still offers considerable financial relief. As our elderly population grows, so does the need for specialised geriatric care, and this expansion will enable more families to access essential services without the burden of overwhelming medical expenses.

However, expanding the beneficiary base by such a significant margin presents real-life challenges, particularly regarding the viability of the scheme for smaller and medium-sized hospitals. These institutions often operate on tight margins, and the added pressure of accommodating a larger patient base, especially with senior citizens requiring more intensive care, could strain their resources. The sustainability of the scheme hinges on ensuring that reimbursement rates are not just adequate but also reflective of the actual costs incurred by healthcare providers. Additionally, timely payments are critical; delays can disrupt cash flow and hinder the ability of these hospitals to maintain the quality of care. Without addressing these implementation challenges, there is a risk that the expansion could overwhelm the system, making it difficult for smaller providers to continue participating, ultimately affecting the availability and quality of healthcare services for the elderly.

Dr Santy Sajan, Group Chief Operating Officer, Paras Health

“As India’s senior population grows, the demand for geriatric care is increasing, and this initiative is a timely response to that need. By providing comprehensive health coverage to our senior citizens, the scheme not only alleviates the financial burden on families but also reinforces the importance of accessible healthcare for all age groups. However, to make this expansion truly effective and sustainable, it is crucial that reimbursement rates under the scheme remain fair and that payments are made in a timely manner. This will help ensure that healthcare providers, especially smaller hospitals and clinics, can continue to participate actively and deliver the high-quality care that our elderly citizens deserve.”

Abhay Soi, President, NATHEALTH and Chairman & Managing Director, Max Healthcare Institute

“We are witnessing a historic shift in how the country approaches elder care, a segment with a high disease burden and in urgent need of social protection. As an organisation dedicated to the advancement of healthcare in India, NATHEALTH fully supports this initiative. We believe this initiative will bring much-needed relief to millions of families and strengthen India’s position as a leader in inclusive healthcare. The benefit package needs to be tailored to the population segment so that it encompasses the entire continuum of care, and NATHEALTH is ready to support the government with the rollout.”

Anil Matai, Director General, OPPI

“The Union Cabinet’s visionary decision, chaired by the Hon’ble Prime Minister Shri Narendra Modi, to extend health coverage to all senior citizens aged 70 years and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), is a significant milestone in providing essential healthcare services to the elderly. It is undoubtedly a crucial step towards fostering a more inclusive healthcare ecosystem and OPPI welcomes the move.

While this initiative marks a major advancement in healthcare accessibility, OPPI takes this opportunity to emphasise the importance of including the ‘Missing Middle’, those who are currently excluded from both government and private health insurance schemes, as part of AB PM-JAY and as recommended by the NITI Aayog in its 2021 Report titled ‘Health Insurance for India’s Missing Middle’. These individuals represent a segment that must be brought into the fold of financial protection.

OPPI remains committed to supporting such transformative policies, with the aim of advancing equitable healthcare access for all citizens.”

Pavan Choudary, Chairman,  MTaI

“Today, the utility of elders has diminished, as the repository of knowledge they carried is only a google-click away and industrialisation has catalysed the mobility of the young away from family professions and towards nuclearisation of families. Therefore, the increasing healthcare and caregiving costs may make elders seem like an expensive burden. Many caregivers fall in the ‘sandwich generation’, with parents to care for on one side and their own children to care for on the other.”

Therefore, the government’s decision to extend health coverage to all senior citizens aged 70 and above -irrespective of income – under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) –  is commendable. MTaI, having consistently advocated for this inclusion, recognises this move as a landmark step toward equitable healthcare for India’s ageing population.” 

Ravi Hirwani, Senior Vice President, Bhailal Amin General Hospital, Vadodara 

“We welcome and revere this move to provide family health cover for individuals above 70 is a coveted move to promote health security and well-being for senior citizens. As per reports, the elderly population of India is expected to reach 19.4 million by 2031. Along with this, a major share of the population in India is deprived of healthcare treatments owing to financial problems and lack of health insurance coverage.

As the country makes major strides towards emerging as Viksit Bharat, developments like this are vital to ensure the health and well-being of the citizens. This initiative not only promotes the overall health of our population but also provides financial liberty, ensuring that high-quality healthcare is available and affordable, regardless of social or economic background. It’s a critical step toward building a healthier, more inclusive India.”