Government Health Insurance Schemes in India

For decades, the Indian government has worked to make high-quality healthcare accessible to the economically weaker section of society. As per a report in 2019, only around 450 million people have valid health insurance policies out of 1.3 billion citizens. Thus, only around less than half of the population has health insurance. Considering the high poverty rates, it's easy to see how a big section of the population cannot afford good healthcare services.

To help this section, the Indian government is now launching some health insurance schemes in the country. These government-sponsored health insurance schemes are specifically designed to provide comprehensive health insurance plans to the economically weaker section of the country.

What is a Government Health Insurance Scheme?

It is a type of health insurance plan that is offered by the state and central governments of India. Its main aim is to provide appropriate health coverage at a low premium cost to the economically weaker section of the country. These types of health insurance schemes are usually available on a yearly basis.

Types of Government Health Insurance Schemes in India

There are two types of government health insurance schemes in India.

• Central government health insurance schemes in India: Central government health insurance schemes are the type of health insurance plan offered by the Central Government of India. It aims to provide health insurance plans to the economically weaker section of the country.
• State government health insurance schemes in India: State government health insurance schemes in India are health insurance schemes sponsored by state governments. It provides health insurance schemes to the people who come under BPL (Below Poverty Line) in the states.

Government Health Insurance Schemes vs Other Health Insurance Plans

Government health insurance is quite different from our general health insurance plans in many ways. We have mentioned the basic differences between government health schemes and other health insurance plans in detail:

Particulars	Basic Health Insurance	Government Health Insurance Scheme
Eligibility	Available for everybody	Especially designed for lower-income groups only
Sum Insured	Sum insured up to INR 1 Cr	Sum insured up to INR 5 lakh
Premium	Higher than government health schemes	Less than regular health insurance policies
Coverage	Plan specific coverage	Comprehensive coverage
Network Hospitals	List of impaneled private hospitals (vary from insurer to insurer)	Public and private hospitals
Maternity Benefits	Available(depends on the plan)	Available
Ambulance Charges	Available under maximum plans	Offered under a few schemes
Cumulative Bonus	Available	Not available
Tax Benefits	Available under Income Tax Act 1961	Not available

Government Health Insurance Schemes in India

Health insurance schemes offered by the central or state governments are aimed to provide comprehensive health insurance at low premiums to the citizens of India. These schemes are usually available on a yearly basis. Below mentioned are some of the Government health insurance schemes in India:

• Ayushman Bharat Yojana (PMJAY)

Ayushman Bharat Yojana is also known as Pradhan Mantri Jan Arogya Yojana (PMJAY) sponsored by the Central Government of India. This scheme was launched by Prime Minister Narendra Modi on 28 September 2018. It is a health insurance scheme that aims to provide health cover to economically weaker families in India. The objective of the Ayushman Bharat scheme is to provide health cover to more than 10 crore families which is equivalent to 50 crore Indians, which is about 40% of the total population of the country.

Key Benefits of the scheme

Below mentioned are some of the key benefits of the Ayushman Bharat Yojana (PMJAY):

• Offer health coverage to the whole family
• Both secondary and tertiary care hospitalization covered
• Sum Insured amount is up to 5 Lakhs
• 3 days of pre-hospitalization is covered
• 15 days of post-hospitalization is covered
• Cashless hospitalization in empaneled hospitals (public and private)
• Pre-existing disease is covered from day 1.
• Covers nearly 1400 procedures including the treatment cost, doctor’s fees, room charges, OT charges, ICU, surgeon charges, diagnostic services, etc.

• Aam Aadmi Bima Yojana (AABY)

Aam Aadmi Bima Yojana is an Indian social security scheme that provides financial assistance to low-income families in India in case of death or disability. This scheme was launched on 2nd Oct 2007. To avail of the benefits of the Aam Aadmi Bima Yojana, you need to pay INR 200 premium for a year and should be performing one of the 48 vocations listed in the scheme.

Key benefits of the Scheme

The following are the key features of the Aam Aadmi Bima Yojana:

• Minimum and Maximum entry age is 18 and 59 Years respectively.
• Scholarship benefits of INR 100 from 9th grade to 12th grade every month.
• Death benefits
• Disability benefits (Partial disability: INR 37,500 and Permanent disability: INR 75,000)
• Accidental benefits of INR 75K
• Death due to natural causes
• Simple and fast claim process

• Central Government Health Scheme (CGHS)

The Central Government Health Scheme (CGHS) was started in New Delhi in the year 1954. It is a comprehensive healthcare scheme designed specifically for Central Government employees and their dependents. Central Government Health Scheme (CGHS) is available in 71 Indian cities such as Kolkata, Lucknow, and Mumbai. Allopathic, Yoga, Ayurveda, Sidha, Unani, and Homeopathic treatments are available through Wellness Centers (formerly known as CGHS Dispensaries) or polyclinics.

Key Benefits of the Scheme

Below mentioned are the key benefits of the Central Government Health Scheme (CGHS):

• Domiciliary care.
• Dispensary services
• Specialist consultation facility for dispensary, polyclinics, and hospitals.
• X-ray, ECG, and laboratory examinations.
• Hospitalization
• F. W. and M. C. H services
• Health education to the beneficiaries.

• Mukhyamantri Amrutum Yojana

Mukhyamantri Amrutum Yojana was launched on 4th September 2012 by the Government of Gujarat. It aims to provide health insurance of INR 3 Lakhs per family to the lower middle income and the BPL (below poverty line) group. Mukhyamantri Amrutum Yojana allows you to get medical treatment from public, private and trust-run hospitals without any hassles. It is a comprehensive health insurance scheme offered by the Gujarat State Government that covers the entire medical emergency cycle, from diagnostics to post-hospitalization treatment.

Key Benefits of the Scheme

• Offered comprehensive coverage
• Cashless hospitalization in both public and private hospitals
• 698 diseases covered
• Covers the travel expense of INR 300
• INR 5 lakh for organ transplant procedures
• Monthly health checkups

• Rashtriya Swasthya Bima Yojana (RSBY)

Rashtriya Swasthya Bima Yojana (RSBY) is a health insurance scheme by the Central Government of India. It provides health insurance coverage to individuals who are working in an unorganized sector of India.

Key Benefits of the Scheme

• Wide Coverage
• No age limit
• No waiting period
• Transportation cost covered up to INR 1K
• Limited exclusions
• Sum insured 30K per worker
• Offer coverage up to 5 members of a family

• Bhamashah Swasthya Bima Yojana

Bhamashah Swasthya Bima Yojana is a health insurance scheme launched on 13 December 2015 offered by the State Government of Rajasthan. This health insurance scheme is specifically designed for the residents of Rajasthan. It offers cashless facilities to IPD patients. It offers cashless treatment at the public and private network hospitals. All families covered under  Rashtriya Swasthya Bima Yojana (RSBY) and National Food Security Act (NFSA) can register for this scheme.

Key Benefits of the Scheme

• Sum insured 30K for general treatment
• Sum insured 3 Lakh for critical illnesses
• Pre-hospitalization for 7 days
• Post-hospitalization for 15 days
• OPD treatments are also covered
• All hospitalization expenses are covered
• Transportation cost covered from INR 100 to 500 for polytrauma and cardiac cases.

Benefits of Government Health Insurance Schemes

Below mentioned are some of the benefits of government health insurance schemes:

• Low premium price
• Offer coverage for entire family members
• BPL families can also avail of good medical treatment because of these Government health insurance schemes
• Offer cashless treatment in both public and private network hospitals

Some Other Important Government Health Insurance Schemes

• Mukhyamantri Chiranjeevi Swasthya Bima Yojana
• West Bengal Health Scheme
• Pradhan Mantri Suraksha Bima Yojana (PMSBY)
• Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY)
• Dr YSR Aarogyasri Health Insurance Scheme
• Chief Minister Comprehensive Health Insurance Scheme

Conclusion

In India, there are many types of health insurance schemes of the central and state government. These health insurance plans are designed to provide health insurance coverage to all the people of India with comprehensive coverage benefits at affordable premiums. If you want to take advantage of any of these schemes, then you can check whether you are eligible for any of these schemes or not. You can also compare the coverage benefits and costs of the policy.

 

Disclaimer: The information published in this article is for the reader′s reference only. The content of this information is to provide an overview of your health insurance needs and should not be relied upon for personal, medical, legal, or financial decisions; you should consult an appropriate professional for specific advice. The Company makes no representations about the suitability, reliability, timeliness, and accuracy of the information, services, or any other items mentioned on this subject for any purpose whatsoever.

*Standard Plans Terms and Conditions apply.