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    Home » What are the Govt Health Insurance Schemes in India?

    What are the Govt Health Insurance Schemes in India?

    AndyBy Andy22/08/2024Updated:22/08/2024No Comments5 Mins Read

    The Indian government offers several health insurance policies to help citizens access easy and cheap healthcare. Such schemes are intended to provide various facilities for the targeted population, particularly the economically less privileged segment.

    • 1. Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)
    • 2. Rashtriya Swasthya Bima Yojana (RSBY)
    • 3. Central Government Health Scheme (CGHS)
    • 4. Employees’ State Insurance Scheme (ESIS)
    • 5. Pradhan Mantri Suraksha Bima Yojana (PMSBY)
    • 6. Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY)
    • 7. Aam Aadmi Bima Yojana (AABY)
    • 8.Janani Suraksha Yojana (JSY)
    • 9. Universal Health Insurance Scheme (UHIS)
    • 10. Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) – Tamil Nadu

    Some well-known government health insurance schemes in India are as follows:

    1. Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)

    The supreme goal of this policy is to cover the First Forty Percent – the vulnerable and the economically less privileged from the medical risks in the form of an annual amount of ₹ 5 lakhs for each family for treatment in Secondary as well as Tertiary care hospitals.

    This covers over 1,500 medical treatments and can include costs before and after hospitalisation. Among the services offered are mobile access to the empanelled hospitals’ cashless and paperless medical facilities and the ability to receive care from anywhere in India.

    2. Rashtriya Swasthya Bima Yojana (RSBY)

    The proposal envisages the provision of health insurance for BPL families, entailing INR 30000 for hospitalisation for the fiscal families. Pre-existing diseases are covered from the initial day of admission in the inpatient facility. 

    The recipients comprise the BPL population, new economy professionals, and the families of employees of unorganised sector companies. Some of the benefits are impaneled hospitals, exclusive Smart/biometric cards for cashless hospitalisation, and a Transport allowance of Rs:1000/—per annum.

    3. Central Government Health Scheme (CGHS)

    The aim is to ensure that they offer all-around medical services to all Central Government employees and pensioners. This includes dental sessions and family planning, among other allowances for medical bills. 

    Perks are for all acknowledged categories of people, for example, employees, pensioners, Members of Parliament, and ex-members of Parliament. 

    Some of the highlighted elements include a network of empanelled hospitals and wellness centres established in the major cities and a cashless treatment program in the private hospitals empanelled with the company under the KCD guidelines.

    4. Employees’ State Insurance Scheme (ESIS)

    It aims to ensure that employees are protected from economic insecurity, which can arise from situations such as sickness, maternity, disability, or death resulting from an employment-related mishap. 

    Measures for medical assistance are insurance of sick, maternity, disability, or dependent employees’ outpatient and hospital care. It is provided to employees getting wages of ₹ 21000/- or less and for employees in factories and establishments under the ESI act. Sickness and maternity periods are paid out in the form of remunerations.

    5. Pradhan Mantri Suraksha Bima Yojana (PMSBY)

    The policy provides risk protection in case of accidental death or disability, offering coverage of ₹2 lakh for full disability, ₹7,500 or 50% of the wage for complete disability, and ₹1 lakh for partial disability. 

    Beneficiaries are adult patients aged 18 to 70 with a savings bank account. The policy features an annual premium of ₹12 and convenience in enrollment and renewal processes.

    Also read: 5 Lesser Known Facts About Senior Citizen Health Insurance

    6. Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY)

    The objective is to offer life insurance coverage for individuals aged 18-50, covering ₹2 lakh for any illness. 

    Benefits include savings bank account holders, with an annual premium of ₹330 for limited comprehensive insurance and coverage up to age 55, provided the policy can be renewed.

    7. Aam Aadmi Bima Yojana (AABY)

    The insurance policy aims to provide coverage to the poor, particularly those without land in rural areas. It covers up to ₹30,000 for natural death, ₹75,000 for accidental death or permanent total disability, and ₹37,500 for partial disability.

     Beneficiaries include rural landless families with a head aged 18-59 and earning members. The policy also offers free scholarships for children in 9th to 12th standard education, with the premium divided 50:50 between the Central and State Governments.

    8.Janani Suraksha Yojana (JSY)

    The aim is to decrease maternal and neonatal mortality by promoting institutional delivery among pregnant women, particularly those from low-income families, through cash incentives, focusing on antenatal care, institutional delivery, and postnatal care.

    9. Universal Health Insurance Scheme (UHIS)

    The program seeks to provide family health insurance to those below the poverty line through cashless treatment in accredited hospitals. It will cover hospitalisation costs up to ₹30,000, personal accident coverage up to ₹25,000, and compensation for lost wages.

    10. Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) – Tamil Nadu

    The initiative aims to offer quality medical care to economically disadvantaged families in Tamil Nadu. It offers coverage up to ₹5 lakh per family per year for specialised procedures, cashless treatment, and over 1,000 medical procedures.

    Public health plans can be defined as plans made by the Government of India to extend necessary and adequate health insurance coverage to different segments of society, particularly the demographic that is more prone to vagaries of ill health and being economically disadvantaged. 

    These schemes guarantee that financial issues do not affect one’s ability to access superior healthcare services. If properly utilised, these schemes help individuals and families ward off heavy medical bills and thus strive to lead healthy lives.

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    Andy

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