On a recent morning in Madipakkam Chennai, a group of five octogenarians showed off their blue and white government health cards, their faces bright with hope, as they discussed the list of empanelled hospitals in their localities, where, when necessary, they hoped to use their cards. But will their cards work at a private hospital for what they are expecting — cashless treatment? Not if they have the incorrect cards.
Increasingly, a number of residents are mistakenly applying for the Ayushman Bharat Health Account (ABHA) card, when what they intend to apply for is the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana card.
So what are these two cards, how are they different, and how do you apply for the right one?
What is AB-PMJAY?
On September 23, 2018, the Central Government launched its flagship health insurance scheme, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, or AB PM-JAY. The scheme (earlier called the National Health Protection Scheme), rolled out by PM Modi, is touted as the largest health assurance scheme in the world, and offers ₹5 lakh insurance coverage to a family per year for secondary and tertiary hospitalisation in any government hospital or at any empanelled private hospital across the country. The scheme targeted over 12 crore poor and vulnerable families (approximately 55 crore beneficiaries) that form the bottom 40% of the Indian population, as per its website. Some States that already had health insurance schemes for their residents, have merged their schemes with the AB PM-JAY.
In September this year, the Centre announced that the scheme would now be extended to all senior citizens aged 70 and above, irrespective of their income status. This extended scheme is known as the Ayushman Bharat Vay Vandana, and is part of the PM-JAY scheme. This was to benefit approximately 4.5 crore families, with six crore senior citizens, with ₹5 lakh free health insurance cover on a family basis. All senior citizens of the age 70 and above, irrespective of their socio-economic status, are eligible to avail of this. A separate beneficiary card (orange and white) is given to beneficiaries of AB-Vay Vandana.
What is the registration process for senior citizen cards?
The registration process for the scheme has been streamlined by the National Health Authority (NHA) in such a way that senior citizens can obtain the Ayushman Bharat Vay Vandana card online, on the official portal (beneficiary.nha.gov.in) or through the NHA’s Ayushman app. Senior citizens who are not tech-savvy can apply for the card at a PM-JAY empanelled hospital.
Following the extension of AB PM-JAY to all senior citizens irrespective of income criteria, the scheme caught on amongst a lot of elderly residents, who wanted to apply for it.
However, instead of applying for the PM-JAY’s Ayushman Bharat’s health insurance card, many started applying for the Ayushman Bharat Health Account (ABHA) card, which is also issued by the NHA, and is managed under the Ayushman Bharat Digital Mission (ABDM).
This is what happened with V. Rajalaksmi, a septuagenarian residing in Madipakkam. “I have been trying to get the Ayushman Bharat health insurance card for the past several years, but initially, I was not eligible to apply, as my children were working and I did not fall under the right income bracket. However, after the recent announcement of the extension of the scheme for all senior citizens, my daughter tried applying for it, but ended up downloading the ABHA card. When she enquired at a few hospitals in our area, they told her that this card was not valid for health cover. Following a call with the PM-JAY customer care, she again applied for, and finally managed to get the proper AB PM-JAY health insurance card for me,” she says.
What is the ABHA card?
The ABHA card (a blue and white card) is not a health insurance card. This is just a tool introduced by the Centre to provide patients with a hassle-free experience for access to their medical records. The ABHA card is a medical account of sorts, with a unique health identification number. It is linked to a unified health interface for the digital storage of medical records, for patients to be able to seamlessly access their records from anywhere in the country.
A 14-digit health ID number is allotted every Indian citizen, irrespective of their income levels. In addition to the 14-digit number, citizens are also given a dedicated email address or ‘ABHA address’ with the suffixes @abdm or @ndhm. Information such as health insurance details, history of medication, hospitalisation etc., can be stored in the ABHA digital account.
For instance, if you are a resident of Chennai and are visiting relatives in Mumbai, and, while there, want to avail of a medical service, instead of answering the doctor’s enquiries about your medical history, your digital ABHA card may come in handy, as it will contain your complete medical history, consultation details and prescriptions as well.
To create an ABHA account, you can log on to https://abha.abdm.gov.in/abha/v3/ where you can use your Aadhar card or driving license, and a unique health ID number will be issued you. Once this is done, you can use your ABHA number to sign up for an ABHA address and ensure that the health records created for you are shared only with you, the website states. To enable health data sharing, it is recommended that you create an ABDM ABHA address and link it with your ABHA number.
To then access your digitally stored medical records, you can download the ABHA mobile app or the Aarogya Setu app, or other ABDM enabled apps.
What you need to know
Think of it this way: The blue and white ABHA card is just a digital locker storing your medical history, and serves as a medical identification (ID) card. The orange and white AB PM-JAY is your health insurance card that comes with ₹5 lakh health insurance coverage. It is this card that enables you, if you are an eligible senior citizen to get a cashless treatment at an empanelled hospital.
Ajay Kannan, deputy general manager, billing, at Kauvery Hospital in Chennai, explains, “We are one of the empanelled hospitals for the government’s health insurance scheme. The Tamil Nadu Chief Minister’s Comprehensive Health Insurance Scheme and the PM-JAY schemes are merged now. This means that if patients are within Tamil Nadu, the free health coverage can be availed of using the TN card or the AB PM-JAY card. If patients are outside of Tamil Nadu, they can claim with their PM-JAY cards. Patients must however have the correct AB PM-JAY card and not the ABHA card.”
Having both cards will enable you to have access to your digital medical records and avail of the insurance at government or private empanelled hospitals. But it is important to know what exactly you are applying for.
| Parameters | AB PM-JAY Card | ABHA Card |
| Purpose | Health insurance cover of Rs. 5 lakh per year for a family. | A digital repository that provides access to all your health records. |
| Eligibility | Designed initially as a scheme for poor and vulnerable families. Now extended to all senior citizens over 70 irrespective of income status | Available to all Indian citizens, irrespective of income status. |
| Benefits | Provides cashless hospitalisation and health insurance coverage to the extent of Rs. 5 lakh per year, per family | Provides a unique 14-digit identification number and a dedicated email address for access to digitally-stored medical records |
Published - November 22, 2024 05:00 pm IST
