# Ayushman Bharat: ₹5 lakh cover for 70-plus, check exclusions 2026-09-30T05:31:54+00:00 | Governance | Indian Opinion Desk Corroboration: 1 independent outlet The Ayushman Bharat scheme offers a ₹5 lakh annual health cover for citizens aged 70 and above, covering hospitalisation and specified treatment packages. Dr S Prakash, CEO of Health Insurance at the General Insurance Council of India, said beneficiaries may still need additional private or top-up policies to manage out-of-pocket expenses. Exclusions, waiting periods, and pre-existing disease conditions can limit the cover. Families should check policy terms, treatment packages, and the five-year moratorium on pre-existing conditions before hospitalisation. Business Today's Neetu Chandra Sharma explained that the moratorium removes restrictions on chronic illnesses after five continuous years of coverage. The programme, launched in 2018, remains India's largest government health insurance scheme, but experts caution that rising medical costs may still leave gaps for senior citizens. ## Indian Opinion Analysis The programme covers hospitalisation and treatments, but exclusions and waiting periods can leave patients with significant out-of-pocket costs. Families who assume the ₹5 lakh cover eliminates all expenses may be caught off guard by co-payments, non-covered procedures, or pre-existing disease clauses. The five-year moratorium helps claimants with chronic conditions, but only after that period. The real gap is between what the scheme says it covers and what a typical senior's hospital bill adds up to. The General Insurance Council's CEO has signalled that even eligible patients should check for additional private or top-up insurance. The insurance regulator next sets the standard policy revisions, which will confirm where the gaps remain. ## Coverage - businesstoday.in Leads with a question on whether government schemes are enough, then describes limits and out-of-pocket risks This brief was synthesised by AI from the source linked above. How this brief was made: an AI model read the report linked above and wrote this brief, which was published automatically without a person reviewing it. Methodology: https://indianopinion.org/ai-use-policy/ Tags: Ayushman Bharat, CGHS, General Insurance Council of India, S Prakash Canonical: https://indianopinion.org/ayushman-bharat-rs5-lakh-cover-for-70-plus-check-exclusions/ License: Summary and commentary (c) Indian Opinion, reusable with attribution. Facts belong to the linked sources. Cite: https://indianopinion.org/ayushman-bharat-rs5-lakh-cover-for-70-plus-check-exclusions/#story-in-brief AI disclosure: Every summary and comment here is written by AI and published automatically, without a person reviewing each article. We do no original reporting. How this works: https://indianopinion.org/ai-use-policy/