Government Health Insurance Schemes in India

Today, millions of citizens have availed a multitude of government health insurance schemes in India. While there exists a diverse range of private health insurance providers in the country, the Government of India has also initiated multiple publicly-funded health insurance schemes in the country, for the benefit of the masses. These government health insurance schemes in India are very affordable and can be accessed across all states in the country. In this article, we will take a look at some of these government health insurance schemes like Pradhan Mantri Jan Arogya Yojana, Awaz Health Insurance Scheme, Aam Aadmi Bima Yojana, and many more.

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List of Government Health Insurance Schemes in India

When looking for public-funded health insurance schemes in India, you can choose from the following list of government health insurance schemes:

1. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)

The PMJAY is a government health insurance scheme for individuals belonging to the lower socio-economic strata of society. Under this scheme, each household can get medical coverage of up to ₹5 Lakh for secondary and tertiary hospitalisation care. Furthermore, the government health insurance scheme has no restriction on age, family size or gender for beneficiaries.

2. Awaz Health Insurance Scheme

The Awaz Health Insurance Scheme was launched by the Government of Kerala in 2017 with the intention of providing health insurance to inter-state labourers spread across the state. In addition to providing them with financial assistance in the case of medical emergencies, the scheme also offers an accidental death benefit to the beneficiary’s nominees. A policyholder can claim medical expenses of up to ₹15,000, whereas the death benefit amounts to ₹2 Lakh, which is applicable to all labourers between the ages of 18 and 60.

3. Bhamashah Swasthya Bima Yojana

Of the multitude of government health insurance schemes in India, Bhamashah Swasthya Bima Yojana was initiated to offer insurance coverage to the residents of Rajasthan. Individuals who qualify for benefits under the Rashtriya Swasthya Bima Yojana and the National Food Security Act are also eligible to claim benefits under the Bhamashah Swasthya Bima Yojana. Beneficiaries can get up to ₹3 Lakh for critical ailments and ₹30,000 for illnesses.

4. Chief Minister’s Comprehensive Insurance Scheme

The Chief Minister’s Comprehensive Insurance Scheme was initiated by the Government of Tamil Nadu to provide a family floater medical insurance plan to the economically marginalised citizens of the state. Citizens of the state or Sri Lankan refugees holding citizenship proof can make a claim for hospitalisation expenses of up to ₹5 Lakh per annum across empanelled government and private medical facilities in Tamil Nadu.

5. Aam Aadmi Bima Yojana

Aam Aadmi Bima Yojana was launched to support employees engaged across 48 vocations, including carpentry, weaving, fishing, and so on. To be eligible for the Aam Aadmi Bima insurance scheme, you must be the breadwinner of your family and, if so, can make a claim amounting to ₹30,000 during the policy term by paying a premium of just ₹200 per annum.

6. Central Government Health Scheme (CGHS)

The Central Government Health Scheme is reserved for Central Government employees. It offers benefits pertaining to hospitalisation, and domiciliary treatment in addition to homoeopathy and naturopathy expenses. The beneficiaries of the scheme include dependent family members residing in areas covered under CGHS, pensioners, Delhi police personnel, freedom fighters, etc. 

7. Karunya Health Scheme

Initiated by the Government of Kerala, this scheme covers the cost of critical illness and is applicable to individuals from economically marginalised sections of society. Providing an insurance coverage of ₹5 Lakh, the beneficiaries need to pay a nominal premium to get the benefits. To apply for this government mediclaim policy, citizens of the state must submit their Income Certificate and furnish their Aadhaar card details.

8. Employees State Insurance Scheme

Such a government scheme is applicable to factory workers and is aimed at reducing the number of disabilities and deaths that occur at factories across the country. Initially, the health scheme was only applicable to factories in Kanpur and Delhi, but the Employees State Insurance Scheme has now been extended to over 7 Lakh factories across the country.

9. Pradhan Mantri Suraksha Bima Yojana

The Central Government launched Pradhan Mantri Suraksha Bima Yojana with the aim of increasing the number of individuals in the country with medical insurance. Under this scheme, individuals with a partial disability can make a claim of up to ₹1 Lakh, while in the case of total disability or death, a claim of ₹2 Lakh can be filed. To be eligible for Pradhan Mantri Suraksha Bima Yojana, you must be between 18 and 70 years of age and must possess a savings account in any bank linked to this scheme.

10. Mahatma Jyotiba Phule Jan Arogya Yojana

The Government of Maharashtra launched Mahatma Jyotiba Phule Jan Arogya Yojana to provide health care coverage for the economically weaker sections of society. Applicable to a select few districts in the state, policyholders can make a claim of up to ₹1.5 Lakh for medical expenses for ailments or diseases from day one of issuance of the policy.

  11. Dr. YSR Aarogyasri Health Insurance Scheme

Launched by the Government of Andhra Pradesh, Dr. YSR Aarogyasri Health Insurance Scheme is a plan for low-income families. The health scheme provides numerous benefits to its beneficiaries, such as out-patient care, cashless medical services, pre-existing disease coverage, follow-up facilities and more.

12. Mukhyamantri Amrutum Yojana

Launched by the Government of Gujarat in 2012, Mukhyamantri Amrutum Yojana aims to provide medical coverage to citizens in the state who belong to the lower middle class or fall below the poverty line. As a segment of the family floater policy, beneficiaries can apply for a claim of up to ₹5 Lakh for treatment in a range of medical facilities such as public, private, and trust-based hospitals.

  13. Rashtriya Swasthya Bima Yojana

Rashtriya Swasthya Bima Yojana is one of the various government health schemes in India that was launched by the Ministry of Labour and Employment. This scheme offers medical coverage to labourers, and other individuals engaged in unorganised sectors and covers their families as well against health emergencies.

  14. West Bengal Health Scheme

Launched by the Government of West Bengal in 2008, West Bengal Health scheme offers insurance coverage to State Government employees. The employee and their family members can get a sum insured of up to ₹1 Lakh, which covers costs pertaining to OPD treatment, surgery, hospitalisation, and so on.

  15. Universal Health Insurance Scheme

The Universal Health Insurance Scheme was launched by the Central Government and covers individuals between the ages of 5 and 70 years. Healthcare expenses pertaining to accidental disability, hospitalisation, and treatment are covered up to ₹15,000, excluding maternity costs.

  16. Yeshasvini Health Insurance Scheme

The Yeshasvini Health Insurance Scheme was introduced for the residents of Karnataka in 2013. Workers who belong to the lower-middle and middle-income groups of the informal sector are covered under such a government medical insurance plan. 

  17. Pradhan Mantri Atmanirbhar Swasth Bharat Yojana (PMASBY)

The Pradhan Mantri Atmanirbhar Swasth Bharat Yojana aims to create an IT-enabled disease surveillance network to bridge the gap in public healthcare facilities. Such a government medical insurance scheme was first announced in February 2021 in Parliament. The scheme shall support about 17,788 existing rural health and wellness centres and set up 11,024 such centres in urban areas.

  18. Telangana State Government - Employees and Journalists Health Scheme

The Employees and Journalists Health Scheme was launched by the Aarogyasri Health Care Trust to serve government employees, journalists, pensioners, and dependent family members. Policyholders can get cashless healthcare facilities at network hospitals without worrying about coverage as the scheme has no upper limit when it comes to the sum insured amount.

  19. Mukhyamantri Chiranjeevi Yojana

Introduced to provide affordable healthcare to the economically weaker sections of society, the Mukhyamantri Chiranjeevi Yojana was launched by the Chief Minister of Rajasthan. Offering insurance coverage of ₹5 Lakh and 1,576 medical treatments, the Chiranjeevi Yojana covers major ailments at a nominal premium price of ₹850.

  20. Swasthya Sathi Scheme

The Swasthya Sathi Scheme was introduced on December 30, 2016, by the Chief Minister of West Bengal. Providing a basic health insurance coverage of ₹5 Lakh per family, the government health insurance plans enable policyholders to seek cashless hospitalisation. The Swasthya Sathi Scheme doesn’t require beneficiaries to make any financial contributions toward the insurance policy.

Features & Benefits

The features and benefits of government health insurance plans in India are as listed below:

  • They offer medical coverage to those belonging to economically weaker sections of society at an affordable cost.

  • They ensure the inclusion of the poor in government health insurance policies.

  • They offer the advantage of cashless treatment for a range of diseases and critical illnesses.

  • They offer treatment facilities for the poor at both private and government-run hospitals.

Basic Health Insurance Plans Vs Government Health Insurance Schemes

The table below elucidates the difference between Basic Health Insurance Plans and Government Health Insurance Schemes:

Features

Basic Health Insurance

Government Health Insurance

Eligibility

Most individuals are eligible for basic health plans

Mostly available for those from lower income groups

Premium

Slightly higher premium

More affordable premium

Sum Insured

Up to ₹1 Crore

Up to ₹5 Lakh

Coverage

Enhanced coverage, with access to add-on covers and customisation

Coverage varies from plan to plan

Policy Purchase

The plan can be purchased online

Policy purchase can take some time

Network Hospitals

A wide chain of network hospitals is available

A large number of private and public hospitals are available

Ambulance Charges

Covered under most plans

Covered under some 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

Can be renewed online

Might not be possible to renew the plan online

Tax Benefits

Available under Section 80D of the Income Tax Act, 1961.

Not available

Conclusion

The Government Health Insurance Schemes in India provide medical coverage to those from the economically weaker sections of society and financially safeguard them against medical care expenses. However, with rapidly rising medical costs, having extensive coverage against rising healthcare inflation is a must. With health insurance policies on Bajaj Markets, you can get speedy claims, affordable premium rates, lucrative add-on covers and more!

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FAQs on Government Health Insurance Schemes

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

    The premiums for government health insurance plans in India are determined on the basis of the number of individuals concerned. Certain schemes may also require you to pay a predetermined sum as a premium per year.

  • ✔️Are all government health insurance schemes in India backed by the Central government?

    While certain schemes are backed by the Central government, there are many that are backed by the state governments as well. 

  • ✔️What was the Mahatma Jyotiba Phule Jan Arogya Yojana formerly named?

    The Mahatma Jyotiba Phule Jan Arogya Yojana was formerly referred to as the Rajiv Gandhi Jeevandayee Arogya Yojana up until 2017.

  • ✔️Can government health insurance schemes in India be purchased online?

    While some such schemes are enabled by direct bank debit facilities, not all of them can be purchased online. Carefully run through the list of health schemes in India for more details on the same.

  • ✔️What are the exclusions of government health insurance schemes in India?

    Generally, cosmetic procedures are not a part of government insurance policies. Different plans might have different exceptions. Therefore, it is advised to read the respective policy wordings carefully to know the exceptions and advantages of the health insurance scheme.

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