Alyssa Lane
In the US, Medicare is the federal health insurance program for people aged 65 and over. However, if you are under 65, you may still be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease). In India, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme provides health insurance for all senior citizens aged 70 and above, regardless of their income. This scheme covers a wide range of medical expenses, including medical examinations, treatment, consultations, medical implants, accommodation, and food services during hospitalization, and complications arising during treatment.
| Characteristics | Values |
|---|---|
| Name of the scheme | Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) |
| Target group | Senior citizens aged 70 and above |
| Annual coverage | ₹5 lakh per family |
| Application process | Visit the official website, get your Aadhaar card or ration card verified at a PMJAY kiosk, provide family identification proofs, and obtain an e-card with a unique AB-PMJAY ID |
| Additional benefits | Medical implants, accommodation and food services during hospitalization, and coverage for complications arising during treatment |
| Other options for seniors over 65 | Medicare in the US, which includes Part A (hospitalization, home or skilled nursing, and hospice) and Part B (medical insurance) |
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What You'll Learn
Medicare eligibility
Medicare is health insurance for people aged 65 or older. However, you may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also known as Lou Gehrig's disease).
Some people get Medicare automatically, while others have to actively sign up. This depends on whether you start receiving retirement or disability benefits from Social Security before turning 65. If you are already receiving Social Security benefits, you will likely get Medicare automatically. However, if you are not yet receiving Social Security benefits, you will likely need to sign up for Medicare.
The process of signing up for Medicare can vary depending on your specific situation. If you are already receiving retirement or disability benefits from Social Security at least four months before turning 65, you should follow the steps outlined on the Medicare website. On the other hand, if you are waiting until you are 65 or older to receive retirement benefits from Social Security, there is a different path to follow. Additionally, if you have End-Stage Renal Disease (ESRD), you will need to provide specific information during the sign-up process.
It is important to note that there is a yearly period, from November 1 to January 15, when individuals can enroll in a Marketplace health insurance plan. Losing health coverage or experiencing certain life events, such as moving, getting married, or having a baby, may qualify you for a Special Enrollment Period, allowing you to enroll outside of the regular period.
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Private insurance options
In the United States, Medicare is the cheapest health insurance with the best benefits for people aged 65 and older or those with a qualifying disability. However, if you are over 70 and do not qualify for Medicare, you can purchase private insurance.
If you are over 70 and do not qualify for Medicare, you can purchase private insurance through the Health Insurance Marketplace. The Health Insurance Marketplace is a government-run website where you can compare and purchase health insurance plans. You can use the Marketplace to buy an insurance plan if you have lost your job-based health plan or do not qualify for Medicare.
When you fill out a Marketplace application, you will find out if you qualify for a private plan with premium tax credits and lower out-of-pocket costs, depending on your income and household size. You may also qualify for free or low-cost coverage through the Medicaid program in your state.
If you are looking for a private insurance company, Blue Cross Blue Shield (BCBS) has the best overall health insurance plans, which are well-rated and widely available.
In India, the government has approved the inclusion of health insurance for all senior citizens aged 70 and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme, regardless of their income.
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Special Enrollment Periods
In the United States, Medicare is health insurance for people aged 65 or older. Seniors who paid Medicare taxes for 10 years or more receive Part A without charge in 2025. Medicare eligibility typically begins at age 65. The Initial Enrollment Period lasts seven months, starting three months before the 65th birthday and ending three months after.
However, there are Special Enrollment Periods that accommodate specific situations, such as continued employment with health coverage past age 65. Special Enrollment Periods are periods of time outside of Open Enrollment when you can enroll in or change your Marketplace plan. You qualify for a Special Enrollment Period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.
In India, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme provides health insurance for all senior citizens aged 70 and above, regardless of their income.
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Switching insurance plans
In the United States, Medicare is a federal health insurance program for people aged 65 and above, as well as certain younger people with disabilities. Seniors who are 65 or older and retired can use the Health Insurance Marketplace to purchase an insurance plan. Seniors who are already covered by insurance schemes such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), or Ayushman Central Armed Police Force (CAPF) can choose to retain their current coverage or switch to the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
If you have retiree coverage and want to switch to a Marketplace plan, you can do so outside the yearly Open Enrollment Period if you qualify for a Special Enrollment Period due to certain life events, such as losing health coverage, moving, getting married, having or adopting a baby, or if your household income falls below a certain amount. During the Open Enrollment Period, which runs from November 1 to January 15, you can drop your current coverage and switch to a Marketplace plan.
If you have Marketplace coverage and qualify for a Special Enrollment Period, you can switch to a plan from the same category, such as Bronze, Silver, Gold, or Platinum. Switching to a different category may be possible in certain situations during a Special Enrollment Period. If you qualify for "cost-sharing reductions" or "extra savings," you must select a Silver plan to take advantage of these savings.
If you have retiree coverage and voluntarily drop it to switch to a Marketplace plan, you won't be eligible for premium tax credits and other savings based on your income. However, if you are eligible for retiree coverage but are not enrolled, you may qualify for premium tax credits and lower out-of-pocket costs based on your household size and income.
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Income-based plans
In the United States, Medicare is a federal health insurance program for people aged 65 and over, certain people with disabilities, and people with end-stage renal disease (ESRD). There are different ways to get Medicare coverage, including a Medicare Advantage Plan (like HMO or PPO). To get Medicare drug coverage, you must join a plan run by an insurance company or another private company approved by Medicare.
Medicaid, on the other hand, is a joint federal and state program that provides free or low-cost health coverage to Americans, including some low-income individuals, families, children, pregnant women, the elderly, and people with disabilities. Even if you already have Medicare, you can dual-enroll in both Medicaid and Medicare to lower your medical costs. Income limits for Medicaid vary depending on where you live. In 40 states and Washington, D.C., you can qualify for Medicaid if your income is around $21,000 as a single person (about $44,000 per year for a family of four). Higher income limits are in place in Alaska and Hawaii.
The yearly period from November 1 to January 15 is when people can enroll in a Marketplace health insurance plan. If you qualify for a Special Enrollment Period, you can enroll in a Marketplace plan outside the annual Open Enrollment Period. You may qualify for a Special Enrollment Period if you've experienced certain life events, such as losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.
In India, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme provides health insurance for all senior citizens aged 70 and above, regardless of their income. Senior citizens who are not currently covered under AB PM-JAY will receive up to ₹5 lakh per year on a family basis.
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Frequently asked questions
Medicare is the federal health insurance program for people aged 65 and over. If you are under 65, you may be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease).
You can start signing up for Medicare three months before your 65th birthday.
In India, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme provides health insurance for all senior citizens aged 70 and above, regardless of their income.
