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Last September, Prime Minister Narendra Modi announced a significant health insurance policy for all senior citizens aged 70 and above, expanding the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PM-JAY). This initiative will provide free health insurance coverage of up to ₹5 lakh per family annually to approximately 4.5 crore families, including six crore senior citizens. The scheme is inclusive, allowing participation regardless of income or socioeconomic status. The AB-PM-JAY has already extended financial protection to around 55 crore individuals, equivalent to 12.34 crore households, making it the largest social security scheme in the world. This is a timely decision, especially as the proportion of senior citizens in India is on the rise; by 2040, it’s estimated that they will comprise 20% of the population.

Many have praised the policy. Anil Matai, Director General of the Organization of Pharmaceutical Producers of India (OPPI), called it a significant milestone in providing essential health care services to the elderly, highlighting that private and government insu-rers previously did not cover very senior citizens. He noted that this policy would address the needs of the ‘missing middle’ of older citizens. Similarly, Harsh Mahajan, Chair of FICCI’s Health Services, emphasized that as the elderly population grows, so does the need for specialized geriatric care, and this expansion will help families access essential services without overwhelming medical expenses.

However, the reality for senior citizens is more complex, as several studies indicate.

Social and Structural Changes : Rapid economic changes have dramatically transformed Indian society. Factors such as industrialization, urbanization, technological advancements, and globalization have weakened traditional intergenerational family ties. In the past, older individuals were primarily cared for by family members, particularly women. The shift from joint families to nuclear households has made it increasingly difficult for families to support their elderly members.

Feelings of Loneliness and Neglect : Many elderly people feel disconnected, as their children and other family members no longer seek their advice or engage with them as they once did. This loss of status can lead to feelings of loneliness and frustration, potentially resulting in psychological issues such as depression and dementia.

Impact of COVID-19 : The COVID-19 pandemic has exacerbated these challenges. As job opportunities declined, many women have left the workforce to manage household responsibilities, including caring for elderly family members. This shift has strained family incomes, making it more difficult to care for both older adults and children simultaneously. While some women have taken up part-time work in family businesses, this can further complicate the situation for older family members.

Increasing Physical Disabilities: With age comes an increase in physical and mental disabilities, necessitating personal care that is often only feasible for some families.

Beyond Insurance Coverage : The discussion highlights that the challenges faced by the elderly extend beyond medications and hospitalizations. While free insurance may cover hospita-lization costs, many day-to-day needs are just as critical for maintaining the physical, mental, and psychological well-being of seniors. Addressing these needs requires a different approach than what is offered by health insurance policies alone.

The role of Government and Society : Several existing policies, such as the National Old Age Pension Policy and the Maintenance and Welfare of Parents and Senior Citizens Act of 2007, aim to benefit the elderly. Additionally, various state governments have implemented programs to support senior citizens.

There is a pressing need for more old age homes, and NGOs, local governments, and state authorities should initiate efforts to establish these facilities. This could also create employment opportunities for both men and women. Furthermore, local governments can develop organizations specifically focused on caring for elderly residents, thereby generating local employment and providing essential services.

Conclusion : While the introduction of ₹5 lakh health insurance for senior citizens is a commendable step, it is crucial to recognize that it addresses only a portion of the multifaceted challenges faced by the elderly population. A more comprehensive approach is necessary to ensure their overall well-being.