A government health insurance scheme is a medical insurance plan backed by the central or state government. Healthcare facilities, particularly in rural areas of India, are still a concern. To address this, the government has developed a number of health insurance policies to enhance the health standard of the people.
These government schemes provide adequate health insurance at a relatively low cost so that all people, including those in the lower income brackets, can obtain health insurance.
So, let’s learn about the different health insurance schemes the Government of India provides.
17 Health Insurance Scheme is Provided by the Government of India
Here is a comprehensive list of 17 different government health insurance schemes in India:
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Ayushman Bharat Yojana (PMJAY)
The Ministry of Health and Family Welfare, Government of India, launched Ayushman Bharat to provide health insurance to more than 50 crore people of India, which is over 40% of the country’s total population.
It offers an insurance amount of ₹5 lakh, which can be used for expenses such as medicines, diagnostic procedures, treatments, and pre-hospitalisation charges. It particularly targets the most vulnerable families in the country’s poverty bracket.
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Pradhan Mantri Suraksha Bima Yojana (PMSBY)
This scheme aims to offer accident insurance to individuals between the ages of 18 and 70 who have a bank account. It provides ₹2 lakh for accidental death or total disability and ₹1 lakh for partial disability. The premium gets automatically deducted from the policyholder’s bank account.
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Aam Aadmi Bima Yojana (AABY)
AABY was initiated in 2007, targeting persons between the ages of 18 and 59, particularly those from the rural and urban poor who do not own land. The scheme provides a lump sum payout of ₹30,000 in case of natural death and ₹75,000 in case of death due to permanent disability.
It also offers scholarships to children from poor backgrounds. The annual premium of ₹200 is split between the central and state governments.
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Mahatma Jyotiba Phule Jan Arogya Yojana
Introduced by the Government of Maharashtra, this health insurance scheme is specifically designed for low-income families in the state. It offers free medical and surgical treatment in both public and private hospitals.
This government-sponsored scheme covers all pre-existing medical conditions and includes benefits such as hospitalisation costs, follow-up care, and expenses incurred before and after hospitalisation. Each family is entitled to coverage of up to ₹1.5 lakh annually under this policy.
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Central Government Health Scheme (CGHS)
Started in 1954, CGHS provides healthcare for central government employees and pensioners residing in certain cities, such as Delhi, Mumbai, Kolkata, Lucknow, Pune, and Nagpur.
Beneficiaries have access to free consultations, hospitalisations, diagnostic services like X-rays, and laboratory tests at hospitals and dispensaries.
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Employees’ State Insurance Scheme (ESIS)
ESIS provides medical and financial security to workers in permanent factories with more than 10 employees. It covers medical care for the workers and their dependents from the first day of employment. Workers can also receive cash benefits during times of sickness or disability.
Dependents of those who die in occupational accidents receive a monthly pension. This scheme has also extended to businesses with more than 20 employees.
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Bhamashah Swasthya Bima Yojana
Launched by the Rajasthan Government, this health insurance initiative aimed at providing affordable and quality healthcare to the state’s residents. Under this scheme, coverage is offered up to ₹30,000 for general treatments and up to ₹3 lakh for serious health conditions.
Targeting low-income families, this government health insurance plan ensures cashless medical services in both public and private hospitals.
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Awaz Health Insurance Scheme
The scheme offers health insurance of ₹15,000 and an additional coverage of ₹2 lakh in case of accidental death. Launched in 2017, it aims to benefit around 5 lakh inter-state migrant labourers employed in Kerala.
Workers aged between 18 and 60 years are eligible for this scheme. To enroll, they need to provide biometric data and relevant work documents, after which they will receive an Awaz Health Insurance card.
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Telangana State Government Employees and Journalists Health Scheme
The Telangana State Government offers a health scheme for its employees and journalists, including both active workers and retired pensioners. A key feature of this scheme is the provision of cashless treatment.
Under this plan, beneficiaries can visit hospitals listed under the scheme to receive cashless medical services for specific treatments. This ensures that beneficiaries do not need to scramble for funds to cover healthcare costs in times of medical emergencies.
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Universal Health Insurance Scheme (UHIS)
Implemented by public sector insurance companies, this scheme improves healthcare access for underprivileged families. It offers up to ₹30,000 for medical expenses and ₹25,000 for accidental death. The premium rates are ₹200 for an individual, ₹300 for a family of five, and ₹400 for a family of seven.
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Rashtriya Swasthya Bima Yojana (RSBY)
Introduced by the Ministry of Labour and Employment, this scheme offers health insurance coverage to families living below the poverty line. Beneficiaries are entitled to a maximum health cover of ₹30,000, and there is a registration fee of ₹30 to avail of the scheme’s benefits.
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Janshree Bima Yojana (JBY)
JBY targets individuals aged 18-59 from low-income groups and includes features like Women Self-Help Groups and Shiksha Sahyog Yojana. Currently, 45 occupational groups are covered by this scheme.
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West Bengal Health Scheme
Introduced in 2008, this scheme provides health coverage for West Bengal government employees and pensioners. It covers outpatient treatments, medical surgeries, and hospitalisation expenses up to ₹1 lakh on both individual and family floater plans.
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Chief Minister’s Comprehensive Insurance Scheme
This scheme, available to Tamil Nadu residents with an annual income below ₹75,000, offers health coverage up to ₹5 lakh for hospitalisation. Beneficiaries can choose treatment from both private and government hospitals.
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Yeshasvini Health Insurance Scheme
Karnataka’s Yeshasvini Health Insurance Scheme is available for farmers and peasants who are part of cooperative societies. It covers over 800 medical procedures and allows beneficiaries to get treatment at network hospitals. The scheme also extends benefits to family members.
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Mukhyamantri Amrutam Yojana
Launched by the Gujarat government in 2012, this family floater plan provides health coverage up to ₹3 lakh for lower-middle-income families and those living below the poverty line. The policy allows beneficiaries to receive treatment at both government and private hospitals.
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Karunya Health Scheme
The Kerala government launched this scheme in 2012 to provide coverage for chronic illnesses such as cancer, kidney disease, and cardiovascular conditions. This plan is targeted at people living below the poverty line.
The government health insurance schemes play a significant role in increasing health care coverage and providing financial risk protection to the vulnerable section of the Indian population.
Though these plans may not be as comprehensive as private insurance, they offer basic hospitalisation and severe illness coverage for millions at a low cost. These schemes will keep supporting the poor and vulnerable, helping them get quality care without financial strain.