On October 29, the union government extended the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to provide free health insurance to all citizens aged 70 and above, irrespective of their income.
To enroll in the scheme, senior citizens need to generate an Ayushman Vaya Vandana (AVV) card. Although the government has specified the process, a large number of them are unable to implement it.
Take the case of Dilip Madapur, 70, from Mumbai. He did his e-KYC only to see a pop-up stating that the state where he lives does not offer the scheme or the model code of conduct is in effect due to elections. Same was the case with Abhishek Agnihotri, 71, from Kanpur. He was told that he could only apply for the scheme after the Model Code of Conduct was lifted. This code is intended to ensure that political parties do not launch public plans or provide financial support to tilt votes in their favor in the run-up to elections.
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To find out where all these are currently in force, we called the Ayushman Bharat helpline number ‘14555’. According to PMJAY’s customer service representative, the model code is in force in Maharashtra, Jharkhand and some districts of Assam and Bihar, Chhattisgarh, Gujarat, Kerala, Madhya Pradesh, Meghalaya, Punjab, Rajasthan, Sikkim, Uttar Pradesh and Uttarakhand. It is not known how long the measure will be in effect in these states, but you can call the helpline to inquire about your specific district.
In particular, residents of Delhi and West Bengal cannot apply for the scheme at all. Since health is a state subject, the governments of these two regions have not allowed the central government to offer PMJAY.
Those who are eligible can apply for it and download the AVV card through the process below.
How to apply
Although the process is not difficult, some may find it too complicated. Kamal Kapoor from Lucknow, who applied on behalf of his father-in-law, said, “Elderly people may find it complicated as multiple OTPs have to be entered and they do not come at the same time. This increases the confusion. my father-in-law, a retired judge, couldn’t do it, you can imagine how less educated or tech-savvy people would do it themselves,” he said.
Here is the step by step process:
- Visit https://beneficiary.nha.gov.in/
- Find the login widget on the left
- Log in as beneficiary. Enter the captcha and your mobile number
- Click ‘verify’. You will receive an OTP on your phone.
- Enter it to be redirected to the next page
- The top widget shows schedule, state, sub-schedule and district. Ignore these options
- Go to the ad-like widget about PMJAY for seniors
- Click on “click here to register”
- Enter your Aadhar number, family ID (if available) and captcha
- Click on ‘new registration’ to complete the e-KYC
- The next page will show your Aadhar number. Click ‘verify’
- Enter the Aadhar OTP (from UIDAI) and the mobile OTP (from NHA).
- Your e-KYC is successful
- On the next page you will be asked about your existing health insurance policies
- Choose if you have one or continue with ‘none of the above’
- Your Aadhar details are shown with the image
- You’ll need to take a photo, so have your camera ready
- After verification, you can add additional information
- Feel free to add more mobile numbers
- Provide details of family members along with their Aadhar numbers
- Click ‘send’
- After 15 minutes, download the AVV card by entering your Aadhar number and captcha
Apply offline
To apply offline, you can visit the nearest Health and Wellness Center (HWC), Common Service Center (CSC) or hospital affiliated with PMJAY. The ‘Aarogya Mitra’ will help you generate the AVV card. Carry your Aadhar card with you.
Advantages of the scheme: The scheme offers ₹5 lakh annual cover for inpatient hospitalization at the family level. If a family has two members who are over 70 years old, they both share the policy cover ₹5 lakhs. If a family already has younger Ayushman Bharat beneficiaries, an additional supplement will be provided for senior citizens above 70 years. The best thing about the policy is that there is no waiting period. Many private health insurance policies typically impose a waiting period of up to three years for pre-existing conditions.
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Disadvantages: Costs for outpatient departments, dental treatments and vaccinations and immunizations are not covered by AB-PMJAY. In addition, the treatment is only reimbursed in the general department of a hospital. If you choose a private or semi-private room, you may have to pay a large part of the bill yourself. Most importantly, the treatment under PMJAY is cashless only so you cannot get admitted to a non-empanelled hospital and claim reimbursement. The network of hospitals in your area is therefore crucial. Check it out here: https://hospitals.pmjay.gov.in/Search/
Although National Health Authority data shows that around 30,000 hospitals are affiliated with AB-PMJAY, not all of them are active. “Active hospitals are hospitals where at least one discharge has occurred in the past 45 days. Under PMJAY, it is less than 3,000,” said Ankur Gigras, co-founder and CEO of HexaHealth.
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Still, something is better than nothing. At a time when health insurance premiums for seniors are skyrocketing, you may consider signing up for this as plan B. Make sure you have plan A ready in the form of private health insurance or a health fund.
