Government Health Insurance Schemes in India: Types & Benefits

Every government has a responsibility towards its citizens to provide affordable and accessible healthcare to whoever requires it. And to make this possible, governments launch many different health insurance services so that the common citizen can use these facilities when they need it the most. Similarly, the Indian government has also launched a variety of health insurance schemes that have low premiums and offer a significant sum insured in the hope to make good healthcare available to all.

A government health insurance scheme is a health insurance policy sponsored by a state or the central government. The aim of such schemes is to offer affordable health insurance to the common man and improve healthcare facilities in different strata of society.

Let us take a look at 16 different health insurance schemes available in India today.

1) Aam Aadmi Bima Yojana (AABY)

The Aam Aadmi Bima Yojana is a security scheme that provides benefits to low income individuals in case of death or disability. The scheme is targeted at people working in 48 specific vocations like carpentry, handloom weaving, fishing, cobblers, auto drivers etc.For a premium of Rs. 300 per year, the scheme promises an assured sum of Rs. 30,000 after natural death, and Rs. 75,000 in case of accidental death of the policyholder. Only an earning member or head of the family can be insured under this scheme.

2) Ayushman Bharat Scheme

The Ayushman Bharat Scheme is a health insurance scheme designed to unify the segmented health sector in India. It comprises two components:Health and Wellness Centres (HWC) and the Pradhan Mantri Jan Arogya Yojana (PM-JAY). The Health and Wellness Centres are supposed to be better developed versions of Primary Healthcare CentresThe PM-JAY scheme is a health insurance scheme that offers Rs. 5 lakh as the sum assured per family with a premium of Rs, 30.

3) Awaz Health Insurance Scheme

The Awaz Health Insurance Scheme was introduced in the state of Kerala and targeted at migrant workers. It offers labourers in Kerala a health insurance plan with an insured sum of Rs. 15,000. It also provides a death benefit of Rs. 2 Lakh in case of death of the policyholder.The policy can be obtained by labourers between 18 and 60 years of age, who will be provided with a Awaz Health Insurance Card after proper verification.

4) Central Government Health Scheme (CGHS)

The Central Government Health Scheme is a type of health plan provided by the Central Government of India. Only Central Government employees are eligible for this policy. These include Supreme Court judges, Central Railway Board employees, etc.The CGHS scheme has been around for more than 6 decades and covers hospitalization expenses for policyholders. Alternative medicine like ayurveda and homeopathy are also covered under this scheme.

5) Chief Minister's Comprehensive Insurance Scheme (CMCHIS)

This state government scheme has been promoted by the government of Tamil Nadu for people residing in the state that are earning less than 75000 per annum. Medical expenses upto Rs. 5 lakh can be claimed using this scheme, and many private as well as government hospitals are a part of this scheme. It is basically a family floater plan by the government, in association with the United India Insurance Company.

6) Bhamashah Swasthya Bima Yojana (BSBY)

The BSBY scheme is an insurance initiative by the government of Rajasthan. It covers hospitalization expenses in the form of cashless claims for general as well as critical illnesses. People of all ages are eligible for this scheme and it covers both in-patient as well as out-patient expenses.

7) Employees State Insurance Scheme (ESIS)

After India acquired independence, millions of Indians were employed at factories. During this time the working conditions lead to many accidents and deaths at these factories. Thus, the Employees State Insurance was introduced in 1952 which protected workers financially in case of illness, disability or death.

8) Karunya Health Scheme

The Kerala Government launched this scheme in 2012 and it provides health insurance for certain listed chronic conditions. It is basically a critical illness policy for the poor that aims to cover kidney disorders, heart disorders, cancer, etc.People near or below the poverty line are eligible for this scheme on furnishing vaid Aadhar Card and income certificate.

9) Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)

The Government of Maharashtra was the one to initiate this health insurance policy for the benefit of Maharashtrian people around or below the poverty line. It was targeted mainly at farmers in Maharashtra. The policy offers a family cover of upto Rs. 1.5 lakh for treatment of listed diseases. A great point about this policy is that it does not have a waiting period, and the benefit can be claimed from the first day itself, unless specifically mentioned in the terms of the policy.

10) Mukhyamantri Amrutam Yojana

The Gujarat government initiated the Mukhyamantri Amrutam Yojana in the year 2012 for the benefit of the poor in the state of Gujarat. People under the poverty line and lower middle class families are eligible for the scheme.This scheme is basically a family floater health insurance plan that offers a coverage of upto Rs. 3 lakh per family. The insured can avail treatment from government hospitals, private hospitals as well as trust-run hospitals.

11) Pradhan Mantri Suraksha Bima Yojana (PMSBY)

This policy was launched in 2016, after it was evaluated that only 20% of the Indian population had insurance coverage for accidents. Anone between 18 to 70 years of age and having a bank account is eligible for this policy.The assured sum offered in this scheme is Rs. 1 lakh for partial disability and Rs. 2 lakh for total disability and death due to accident. The premium for this scheme is Rs. 12 per year with the facility of auto-debit from the bank account.

12) Telangana State Government – Employees and Journalists Health Scheme (EJHS)

This particular scheme has been made available by the Telangana government for the benefit of its employees and journalists. The health scheme is a cashless insurance scheme that can be used by current employees of the government as well as retirees and pensioners.

13) Rashtriya Swasthya Bima Yojana (RSBY)

The Rashtriya Swasthya Bima Yojana was introduced by the Indian government to ensure that people working in the unorganized sector, like workers and labourers, had access to a good healthcare plan. Most of them don’t have any insurance and in case of hospitalization they have to pay the expenses out of their pocket.To help them get good healthcare, the Ministry of Labour and Employment launched the scheme that covers labourers and their families.

14) Universal Health Insurance Scheme (UHIS)

This scheme was initiated by the Indian government to provide universal healthcare to persons below the poverty line and their families. It’s aim was to make universal healthcare accessible to these people.The scheme covers hospitalization, accident as well as disability for eligible persons between 5 to 70 years of age. Both individual and group insurance policies can be availed using this scheme.

15) Yeshasvini Health Insurance Scheme

The Yeshasvini Health Insurance Scheme is a health insurance plan devised by the Karnataka government in order to provide healthcare to farmers and peasants associated with co-operative societies. As many as 800 medical procedures are covered under this policy and that includes ORthopedics, Angioplasty, Neurology etc.Benefits of the scheme can be utilized via network hospitals by policyholders and their families.

16) West Bengal Health Scheme (WBHS)

The scheme was announced by the government of West Bengal in 2008, and it aimed at providing healthcare to the government’s employees and pensioners.It covers individuals as well as their families with an insured sum of Rs. 1 lakh. Coverage is offered for OPD and surgeries but excludes cosmetic surgeries and non-emergency procedures.

Top Features and Benefits of Government Health Insurance Plans

- Schemes have very low premiums for a sizeable benefit.- Ensures that people below the poverty line have a healthcare system in place.- Encourages low income group persons to invest in health insurance.

Thus, there are a plethora of different health insurance options available for people below the poverty line from the government. They can utilize these schemes for the betterment of their health and make the most of them.

The information contained herein is generic in nature and is meant for educational purposes only. Nothing here is to be construed as an investment or financial or taxation advice nor to be considered as an invitation or solicitation or advertisement for any financial product. Readers are advised to exercise discretion and should seek independent professional advice prior to making any investment decision in relation to any financial product. Aditya Birla Capital Group is not liable for any decision arising out of the use of this information.