Government Health Insurance Schemes in India – Mediclaim Policy Types
Medical expenses are mounting each day, making health care unaffordable for many people living in challenging socio-economic conditions in developing countries. Therefore, the central and state governments in India have come up with several insurance policies with nominal or no premium but significant insured sum.
Government health insurance policies aim to offer affordable health insurance to everyone, especially the poor and the destitute. While these schemes are not widely known, they can provide basic medical cover to any Indian citizen, irrespective of their financial standing.
What are the Different Types of Government Health Insurance Schemes in India?
There are over 16 Government health insurance policies offered by central or state governments made for different sections of the population. Some of the most popular schemes are discussed below:
1. Ayushman Bharat
Ayushman Bharat is the Government of India’s flagship health insurance scheme launched in 2017 to provide Universal Health Coverage (UHC). The scheme has two components- Health and Wellness Centres (HWC) and Pradhan Mantri Jan Arogya Yojana (PM-JAY).
HWCs are set up all over the country and provide primary health care, free medicines, diagnostics and maternal/child health services. PM-JAY is the largest free health insurance scheme in the world, providing a health cover of Rs. 5 lakh to roughly 50 crore people.
2. Rashtriya Swasthya Bima Yojana (RSBY)
This scheme offered by the Ministry of Labour and Employment provides healthcare protection and coverage to Below Poverty Line (BPL) families. For a registration fee of Rs. 30, beneficiaries can receive up to Rs. 30,000 covering a long list of illnesses.
The scheme covers pre-existing illnesses and has no applicable age limit. Moreover, people can get cashless and paperless treatment in any enlisted hospital in the country using their smart cards.
3. Employees State Insurance Scheme (ESIS)
Under ESIS, workers in India can get complete medical care from the very first day of their employment. The scheme is applicable for permanent factories employing over 10 people and other businesses employing over 20 people.
The government employee health insurance provides complete healthcare for eligible workers and their dependents. It also provides cash benefits for sicknesses, accidents and temporary or permanent disabilities.
4. Central Government Health Scheme (CGHS)
CGHS provides healthcare services to current and former Central Government employees. Beneficiaries under the scheme also include railway board workers, Supreme Court and High Court judges, members of the parliament, Delhi police personnel and Indian freedom fighters, etc.
CGHS provides a wide range of medical services to eligible employees and pensioners in specific cities. It provides coverage for hospital expenses, home treatment, consultation fees, allopathic treatment, AYUSH treatment, etc.
5. Universal Health Insurance Scheme (UHIS)
This scheme is meant to help the economically weak and deprived citizens of India. It provides essential coverage to the poorest of the poor in the country belonging within the age limit of 5 to 70 years.
UHIS covers medical expenses for individuals and family members and provides benefits from accidental death. Upon hospitalisation, the scheme provides coverage of Rs. 30,000 for a family member and a daily benefit of Rs. 50 per day for an earning head of a family.
6. Pradhan Mantri Suraksha Bima Yojana (PMSBY)
PMSBY is available for all Indian citizens between 18 to 70 years of age who have a bank account. It provides coverage of Rs. 2 lakh for death and permanent disability and Rs. 1 lakh for partial (and permanent) disability for a premium of Rs. 12.
There are also several state government health schemes provided for citizens of respective states. Some of these are:
- Mahatma Jyotiba Phule Jan Arogya Yojana (Maharashtra)
- Awaz Health Insurance Scheme (Kerala)
- West Bengal Health Scheme (West Bengal)
- Mukhyamantri Amrutam Yojana (Gujarat)
- Yeshasvini Health Insurance Scheme (Karnataka)
- Chief Minister’s Comprehensive Health Insurance Scheme (Tamil Nadu)
- Bhamashah Swasthya Bima Yojana (Rajasthan)
- Dr YSR Aarogyasri Health Care Trust (Andhra Pradesh)
- Telangana State Government Employees and Journalists Health Scheme (Telangana)
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Benefits of Getting Government Health Insurance Schemes
The following is a list of benefits of availing of Government health insurance schemes.
1. Nominal Premium
Government medical insurance policies are a form of social security where the state provides financial support to the poor. As market premium rates are often too costly, these policies are necessary to protect such a populace from sky-high medical bills.
2. Comprehensive Coverage
Most govt health insurance policies are suitable for a large section of the population. These schemes provide wide coverage, including accident benefits, hospital-related expenses, and cashless treatments.
3. Applicable Anywhere
National health insurance schemes are applicable to all eligible members across the country. While state health schemes cover citizens of a state, every Indian citizen can access the national schemes.
4. Financial Protection
Rising medical expenses and inflation have made it very difficult for lower-income groups to access healthcare. The primary aim of Government health insurance schemes is to provide monetary protection against expensive and unexpected situations.
5. Hospitalisation Cover
Most Government health schemes provide complete medical assistance at low or no costs upon admission. These cover daycare charges, doctor’s fees, surgery fees, pharmacy bills and more.
Final Word
This is a brief overview of the features and benefits of several Government health insurance schemes in India. While these are a good option for people with weak financial backgrounds, salaried and self-employed people may find them inadequate. As such, they may want a health insurance policy with more extensive coverage and additional benefits.
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FAQs
Ans: Those who belong to BPL can apply for the following policies:
• Rashtriya Swasthya Bima Yojana (RSBY)
• Universal Health Insurance Scheme (UHIS)
• Aam Aadmi Bima Yojana (AABY)
• Several state insurance schemes like RACHI, Karunya Health Scheme etc.
Ans: No. Different Govt health insurance plans are applicable for different sections of the population. For example, schemes like RSBY, UHIS and AABY are aimed at Below Poverty Line (BPL) families. On the other hand, ESIS and CGHS are meant for workers and Central Government employees, respectively.
Ans: Yes. Each Government policy is targeted toward a certain population and has specific terms and conditions. Hence, you should check these conditions before applying.
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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