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16 Government Health Insurance Schemes in India

472 million Indians were estimated to be covered under various health insurance schemes in the country for the fiscal year 2019. While all Indians are eligible for public-funded health insurance which provides access to quality healthcare in several states, a vast majority of the population also purchase healthcare plans from private providers.

Take Bajaj Allianz Health Insurance, for instance, which is available on Finserv MARKETS and offers comprehensive insurance plans to individuals as well as families. Policyholders can avail cashless facilities at network hospitals PAN India and also take advantage of the high claim settlement ratio to get their health insurance claims settled with ease.

However, alternatively, those looking for affordable health cover sponsored by the government can check out the government health insurance scheme operational in their respective state.

List of Government Health Insurance Schemes in India

Different states in India as well as the central government offer budget-friendly government health insurance schemes on an annual basis. These are comparatively cheaper and also come with a sizable sum assured to provide financial assistance to your family during a medical emergency. Let us take a look at some of them:

  • Ayushman Bharat Yojana

The National Health policy was geared towards the objective of Universal Health Coverage in India by integrating public health services into the welfare of the country and that is how Ayushman Bharat Yojana came into effect in 2018. This government health insurance aims to provide seamless healthcare to every Indian citizen through health and wellness centres (HWCs) and Pradhan Mantri Jan Arogya Yojana (PMJAY). Primary healthcare centres and sub-centres have been modified into new health and wellness centres while PMJAY provides a yearly health cover of ₹5 lakh to every poor family at just ₹30.

  • Aam Aadmi Bima Yojana

Targeted at low-income families of India, Aam Aadmi Bima Yojana provides monetary support to people engaged in 48 vocations such as carpenters, fishermen, handloom weavers and others. To be eligible, a person should be either the head of the family or the earning member of a family which falls either below or around the poverty line.

The scheme provides financial aid in the event of death due to natural causes, and accident as well as a disability that is either partial or permanent. One needs to pay ₹200 per year for health coverage of ₹30,000 under this scheme.

  • Pradhan Mantri Suraksha Bima Yojana

This scheme was launched specifically to increase the coverage of an average Indian against accidental death or disability, against which only 20% were found to be insured in 2016. A person who is a citizen of India, aged between 18 to 70 years and has an account in a bank can avail this scheme.

At an annual premium of merely ₹12, those insured are eligible to receive ₹1 lakh for a disability that is partial. A sum assured of ₹2 lakh is given in the event of death due to an accident or total disability for life. Premium deduction happens annually, directly through the linked bank account under the PMSBY scheme.

  • Rashtriya Swasthya Bima Yojana

Also known as RSBY, this scheme came into effect in 2008 to provide access to better healthcare to unorganised sector workers who fall either below or slightly above the poverty line. Often, they are not able to save enough and are left deprived of money when diagnosed with a medical condition. A maximum cover of ₹30,000 is provided that covers all the members of a family including hospitalisation and pre-existing conditions. A one-time registration cost of ₹30 is charged. However, the premium costs are taken care of by the central government and respective state governments.

  • Central Government Health Scheme (CGHS)

This is perhaps one of the oldest government health insurance schemes, running for the past 60 years. It caters to those employed by the central government including railway board members, judges of the supreme court, etc. and covers their hospitalisation costs in case of a health problem. Homoeopathic and allopathic treatments, along with supportive care for the elderly and others is also provided under the Central Government Health Scheme.

  • Yeshasvini Health Insurance Scheme

The Karnataka government provides healthcare services to farmers associated with the cooperative societies, covering more than 800 medical procedures. Implemented to cover lower and middle-income group workers, Yeshasvini Health Insurance Scheme secures individuals below 75 years of age across the state.

  • Mahatma Jyotiba Phule Jan Arogya Yojana

Farmers in selected districts of Maharashtra who are either below the line of poverty or around it qualify for health insurance of ₹1.5 Lakh. Mahatma Jyotiba Phule Jan Arogya Yojana was also previously known as Rajiv Gandhi Jeevandayee Arogya Yojana. Diseases, as specified in the scheme, are covered from the first day itself unless a waiting period applies.

  • Employees’ State Insurance Scheme (ESIS)

Another vital health care scheme in India is the Employees’ State Insurance Scheme which secures the medical requirements of individuals under the Employee State Insurance Act, 1948. The government health insurance plan offers features such as unemployment allowance, death payout, medical and maternity benefits, financial aid to dependents and more.

  • Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS)

Launched to provide healthcare coverage to low-income families in Tamil Nadu, Chief Minister’s Comprehensive Health Insurance Scheme ensures cashless financial assistance for any medical need. This government mediclaim policy is also known as Amma health insurance that offers an annual sum insured of ₹5 lakh and covers follow-up visits and diagnostic tests.

Not only does Chief Minister’s Comprehensive Insurance Scheme cover the low-income families of Tamil Nadu but also secures Sri Lankan refugees holding citizenship. By providing your income certificate and specified documents at the enrollment centre, you can easily apply for Amma health insurance.

  • Mukhyamantri Amrutum Yojana

This govt health insurance scheme was introduced to the residents of Gujarat, offering a holistic health cover for the diagnosis, treatment and post-hospitalisation care of an ailment. With a sum insured of ₹5 lakh per family, the Mukhyamantri Amrutum Yojana includes 600+ health procedures under the policy. Moreover, the beneficiaries of the government health insurance policy can get coverage for travel charges per hospitalisation and the cost of repatriation of the remains of the insured.

  • West Bengal Health Scheme

The West Bengal Health Scheme, which is officially known as West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, secures the medical needs of the state government employees. By providing maximum coverage of ₹1 lakh, beneficiaries can avail cashless treatment across empanelled hospitals or Health Care Organisations (HCOs). Such a govt health insurance plan also covers pensioners under the scheme.

  • Karunya Health Scheme

This is the government health insurance scheme that covers chronic conditions such as cancer, heart problems and kidney diseases of the residents of Kerala. An individual needs to furnish their Aadhaar card and an income certificate in order to enrol for this critical illness plan.

  • Awaz Health Insurance Scheme

Awaz Health Insurance Scheme is an initiative launched by the Kerala Government to offer health insurance and accidental death coverage to migrant workers in the state. Such a unique government mediclaim policy ensures that inter-state labourers between the age of 18 to 60 years have the right backup in case of medical emergencies.

One can claim up to ₹15,000 to meet various healthcare expenses with an accidental death coverage of ₹2 lakh available under the plan. Thus, such migrant workers in Kerala can now prioritise their health without worrying about finances.

  • Telangana State Government - Employees and Journalists Health Scheme

The Employees and Journalists Health Scheme (EJHS) is another crucial government health insurance scheme in India. With a cashless facility made available to the state government employees, pensioners, journalists and their dependent family members, the plan replaces the previous reimbursement scheme. EJHS has also introduced new features such as treatment of chronic ailments and post-treatment care to the serving and retired government employees of Telangana.

  • Dr. YSR Aarogyasri Health Care Trust Andhra Pradesh State Government

With the primary focus of providing quality healthcare facilities to the low-income families of Andhra Pradesh, former Chief Minister Dr. YS Rajasekhara Reddy launched this scheme. Residents of the state can avail benefits such as out-patient care, annual coverage of ₹5 lakh, cover for pre-existing ailments, cashless facility, follow-up visits and more. With the help of the Aarogyasri card, beneficiaries can enjoy a seamless process under the Dr. YSR Aarogyasri Health Scheme.

  • Bhamashah Swasthya Bima Yojana

Bhamashah Swasthya Bima Yojana is a govt health insurance scheme introduced by the Rajasthan government. Under this health care scheme in India, beneficiaries can get a cashless facility along with coverage for pre and post hospitalisation and critical illnesses. Individuals who are covered under the Rashtriya Swasthya Bima Yojana and National Food Security Act (NFSA) are eligible under this scheme.

Features of Government Health Insurance Plans

  • Offer insurance cover at low cost to those falling below the poverty line or around it.

  • Ensures that the poor are included in the government policies.

  • Cashless treatment for diseases, critical illness, etc. is provided along with a death or disability benefit as per policy guidelines.

  • The government health insurance schemes in India offer treatment services at private as well as government hospitals.

Basic Health Insurance Plans Vs Government Health Insurance Schemes

Features

Basic Health Insurance

Government Health Insurance

Eligibility

Most individuals are eligible for basic health plans

Eligibility criteria may differ for govt health insurance which is mostly available to lower-income groups

Premium

Premium is slightly higher but you can avail extensive coverage

Premium is much more affordable

Sum Insured

High sum insured is available up to ₹1 crore

Sum insured of up to ₹5 lakh is available

Coverage

Enhanced coverage with access to add-on covers

Coverage may vary based on the plan

Policy Purchase

Health plans can be instantly bought online

Policy purchase/enrollment may take time

Network Hospitals

Wide chain of network hospitals is available

Large number of private and public hospitals are available

Ambulance Charges

Covered under most plans

Covered under a few plans

Maternity Benefit

Available under some plans or as an add-on cover

May or may not be available

Private Hospital Room

Available based on the policy chosen

May or may not be available

Online Renewal

Health insurance can be renewed online

May or may not be possible

Tax Benefits

Available under Section 80D of the Income Tax Act

Not available

Lastly

To conclude, government health insurance schemes allow basic health cover to the economically weaker sections of the society by protecting them against death, disability and common illnesses. However, rising medical expenses and healthcare inflation might require a higher sum assured to safeguard all your dependents.

So, it is recommended to opt for comprehensive health plans to ensure extensive protection against medical emergencies. Head over to Finserv MARKETS and avail health insurance at lucrative rates now!

FAQs on Government Health Insurance Schemes in India

  • ✔️Can anyone buy a government insurance plan?

    Every plan has its own eligibility rules and other application criteria. Check the  scheme details and apply accordingly.

  • ✔️What is the sum insured offered by government schemes?

    Different government schemes offer different health covers. There is no standard sum insured. You will have to check the fine print of the policy applied for to know more details. Usually, sum insured by government schemes is on the lower side as opposed to private insurers.

  • ✔️Does Aadhar card suffice as an identity proof for all schemes?

    Different schemes might require specific documents as a part of their application process.

  • ✔️Is it possible to purchase government health schemes online in India?

    The mode of purchase for government health schemes in India may differ from one insurance plan to another.

  • ✔️How are the premiums for government health insurance schemes in India determined?

    The premiums may vary based on the number of individuals covered under the govt health insurance schemes in India. However, some health insurance schemes by the government of India might require you to pay a pre-decided premium per year. So, it is advised to read the terms of the government scheme.

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