Kerala's senior citizens: What are their health insurance options?

It's no secret that one in every five people in Kerala is a senior citizen. According to the India Ageing Report 2023, published by the United Nations, one in 10 people in Kerala is aged 75 or older. The report also notes that the life expectancy for men over 60 in the state is 18 years, while for women it is 22 years, which also indicates a significant rise in the number of widows among our elders.

Among these senior citizens, one in four has no stable source of income. Worse still,  more than 50% suffer from chronic conditions such as arthritis, hypertension, diabetes, asthma, and cardiac diseases, with many facing multiple illnesses that require continuous medical attention for the entire life term.

A worrying statistic is that four out of five senior citizens in Kerala are not covered by medical insurance. While some private insurance companies offer health plans for the elderly, these plans often come with high premiums, strict terms, and mandatory medical examinations for those joining after age 70.

State government initiatives
1)Karunya Arogya Suraksha Padhati (KASP)
KASP is Kerala’s revised version of the centrally sponsored Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. It provides family floater coverage of Rs. 5 lakh per year for socially and economically backward families. Senior citizens in such families are included under this coverage, ensuring that the total family coverage extends up to Rs 5 lakh.

The Senior Citizens Health Insurance component of the KASP provides individuals aged 60 and above with an additional coverage of Rs 30,000. For families with an annual income below Rs 3 lakh, up to Rs 3 lakh is available from the Karunya Benevolent Fund for critical illnesses, including cancer. This scheme has no upper age limit, making it accessible to all senior citizens.

2)Vayomithram mobile clinics and Day Homes
The State Social Security Mission has implemented mobile clinics under the Vayomithram initiative to meet the medical needs of people aged 65 and above. Some local self-government bodies have set up Day Home projects to support the elderly with daily care and social engagement.

3)Ayushman Vaya Vandana Scheme for the elderly
The Ayushman Vaya Vandana scheme provides financial assistance of up to Rs 5 lakh to senior citizens aged 70 and above, regardless of their social or economic status. Enrollment to he scheme can be completed via the Ayushman Mobile App, which issues a Vaya Vandana card.

The card can be used to cover comprehensive treatment costs for approximately 2,000 medical procedures across 27 specialities, in both government and private hospitals within and outside the state. The specialities include general medicine, surgery, orthopaedics, cardiology, oncology and more, while covered procedures include dialysis, hip replacement surgery, knee treatment, angiograms and pacemaker implantation.

Senior citizens who already have private insurance or are eligible for ESI benefits can also make use of the Ayushman Vaya Vandana scheme alongside their existing coverage. The scheme also covers out-of-pocket expenses, helping cover the costs of attendants or aides and ensuring that elderly patients receive complete support.

Wait continues for Vaya Vandana in Kerala
With the central and state governments yet to reach a consensus on sharing the premium costs, the Vaya Vandana scheme, rolled out by the centre last year, will not be implemented in Kerala for the time being. For the majority of senior citizens with no stable source of income, recurring medical treatment expenses remain a major challenge. In fact, the existing healthcare coverage schemes are not fully effective, even for senior citizens with better financial standing.

The pressing health coverage issues faced by the elderly in the state can be addressed only if the benefits of the Vaya Vandana scheme are extended to all senior citizens. However, this will be possible only if the state and central governments set aside their differences and come to a mutual agreement.