Lok Sabha Question No. 2012 (UNSTARRED), answered on 2024-12-06
Subject: Beneficiaries above 70 years of Age under AB-PMJAY
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Adv Dean Kuriakose

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2012 TO BE ANSWERED ON 06 TH DECEMBER, 2024

## BENEFICIARIESABOVE70YEARSOFAGEUNDERAB-PMJAY

## 2012. ADVDEAN KURIAKOSE:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

- (a) the total number of beneficiaries above the age of 70 years eligible for the PMJAY programme in the country, State-wise;
- (b) the total amount of additional premium that is calculated for the additional beneficiaries of above 70 years of age;
- (c) whether this premium is different for each State considering the morbidity and demographic profile of the State, if so, the details thereof, State-wise; and
- (d) the details of financial estimation of additional resources that is required for all States implementing the said programme indicating the ratio of Central/State share, State-wise?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI PRATAPRAO JADHAV)

(a): The estimated number of beneficiary families aged 70 years and above is 4.5 crore, which corresponds to the 6 crore individuals under Ayushman Bharat -Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). State/UT-wise details of estimated number of eligible beneficiaries (70 years and above) under the scheme are at Annexure .

(b) to (d): Expenditure of an amount of Rs. 3,437 crore is estimated, out of which Rs. 2,165 crore is the central share expenditure which is likely to be incurred during Financial Year 2024-25 and 2025-26, for the said scheme.

The additional cost for inclusion of senior citizens shall be shared between Central and State Governments in the ratio as per the extant directives issued by the Ministry of Finance in this regard. The ratio of Central share to State share for all States, except North-Eastern States and 3 Himalayan States/UTs, is 60:40. For North-Eastern States and 3 Himalayan States/UTs (viz. Jammu and Kashmir, Himachal Pradesh and Uttarakhand), the ratio of Central share to State share is 90:10. In the case of Union Territories, the Central contribution of premium is 100% for UTs without legislature, while it is 60:40 for those with legislature.

In States/UTs, where the scheme is implemented through insurance mode, the central share of premium is paid based on market determined rate in such States/UTs. In States/UTs, where the scheme is implemented in Trust / Society mode, the central share of funds is provided based on actual expenditure. In both the cases, it is subject to a ceiling rate decided by the government from time to time.

Central Government ' s share of Grant-in-Aid is based on the above sharing pattern for the actual cost of treatment of AB-PMJAY beneficiary families (which include existing AB-PMJAY beneficiary families + new families of senior citizens aged 70 years and above) or maximum ceiling amount decided by Government of India, whichever is less. The premium ceiling decided by the Government of India presently is Rs. 1052. As new beneficiary families are added over the course of time, the release of the central share of funds would be done as per the latest available beneficiary family base and utilisation data of the State/UT, subject to the maximum ceiling amount as stated above.

## Annexure

## State/UT-wise details of estimated number of eligible beneficiaries (70 years and above) under the scheme

| State/UT                    | Estimated number of senior citizens of 70 years and above   | Estimated number of senior citizens of 70 years and above   |
|-----------------------------|-------------------------------------------------------------|-------------------------------------------------------------|
|                             | Families                                                    | Individuals                                                 |
| Andaman And Nicobar Islands | 9,984                                                       | 13,329                                                      |
| Andhra Pradesh              | 19,43,486                                                   | 25,94,554                                                   |
| Arunachal Pradesh           | 26,281                                                      | 35,085                                                      |
| Assam                       | 9,04,507                                                    | 12,07,517                                                   |
| Bihar                       | 29,53,168                                                   | 39,42,479                                                   |
| Chandigarh                  | 28,790                                                      | 38,434                                                      |
| Chhattisgarh                | 8,22,062                                                    | 10,97,453                                                   |
| DNH&DD                      | 9,784                                                       | 13,062                                                      |
| Goa                         | 69,458                                                      | 92,727                                                      |
| Gujarat                     | 21,37,596                                                   | 28,53,690                                                   |
| Haryana                     | 9,56,300                                                    | 12,76,661                                                   |
| Himachal Pradesh            | 3,54,275                                                    | 4,72,957                                                    |
| Jammu And Kashmir           | 4,37,276                                                    | 5,83,763                                                    |
| Jharkhand                   | 8,64,437                                                    | 11,54,024                                                   |
| Karnataka                   | 25,02,165                                                   | 33,40,390                                                   |
| Kerala                      | 20,10,672                                                   | 26,84,247                                                   |
| Ladakh                      | 10,861                                                      | 14,500                                                      |
| Lakshadweep                 | 2,063                                                       | 2,754                                                       |
| Madhya Pradesh              | 260,1,742                                                   | 34,73,325                                                   |
| Maharashtra                 | 49,64,017                                                   | 66,26,963                                                   |
| Manipur                     | 92,210                                                      | 1,23,101                                                    |
| Meghalaya                   | 59,327                                                      | 79,201                                                      |
| Mizoram                     | 31,664                                                      | 42,272                                                      |
| Nagaland                    | 47,493                                                      | 63,403                                                      |
| Puducherry                  | 55,032                                                      | 73,468                                                      |
| Punjab                      | 13,01,116                                                   | 17,36,990                                                   |
| Rajasthan                   | 23,55,898                                                   | 31,45,124                                                   |
| Sikkim                      | 18,922                                                      | 25,261                                                      |
| Telangana                   | 13,50,558                                                   | 18,02,995                                                   |
| Tripura                     |                                                             |                                                             |
|                             | 1,38,001                                                    | 1,84,232                                                    |
| Uttar Pradesh               | 66,71,437                                                   | 89,06,369                                                   |
| Uttarakhand                 | 3,99,505                                                    | 5,33,339                                                    |