What are the Government Health Insurance Schemes?

Government health insurance schemes in India are crucial for delivering affordable healthcare services to the population, particularly for economically disadvantaged groups.

These initiatives aim at offering protection against health-wise expenses to guarantee that everyone gets needed medical services without necessarily incurring costs. These centre-linked schemes are funded by the Central or State Government and aim at providing primary and secondary health care at modest premium rates.

Go through this blog to learn about the various government health insurance schemes available in India, their benefits, eligibility criteria, and more.

What are the Different Government Health Insurance Schemes Available in India?

Here is a detailed overview of 17 government health insurance schemes in India:

1. Central Government Health Scheme (CGHS)

Launched in 1954, this government-backed insurance plan is designed specifically for central government employees. All central government employees can benefit from this scheme.

It includes hospitalisation benefits along with coverage for domiciliary treatments. Additionally, you can claim expenses for homoeopathic and naturopathic treatments under this plan.

2. Ayushman Bharat Yojana (PMJAY)

Ayushman Bharat is a universal health insurance program initiated by the Ministry of Health and Family Welfare, Government of India. The Pradhan Mantri Jan Arogya Yojana (PMJAY) was launched to deliver free healthcare services to over 40% of the country’s population, providing a health cover of ₹5 lakh.

This scheme encompasses expenses related to medicines, diagnostic tests, medical treatments, and pre-hospitalisation costs. It aims to assist the most disadvantaged families in India, allowing you to access essential healthcare services without financial strain.

3. Pradhan Mantri Suraksha Bima Yojana (PMSBY)

The Government of India provides this scheme to avail benefits for accidental death and disability to policyholders. If you have a partial disability, you can claim benefits of up to ₹1 lakh from this scheme. For those facing total disability or in the event of death, the coverage can go up to ₹2 lakh.

To avail of this protection, you need to pay an annual premium of just ₹12. This scheme is open to applicants aged 18 to 70 who have a savings account in any bank, allowing you to take advantage of the benefits it offers.

4. Employees’ State Insurance Scheme (ESIS)

ESIS is a social security and health insurance measure developed for the employees of the organised sector regulated by the Employees State Insurance Corporation (ESIC) under the Ministry of Labour and Employment. ESI protects both you and your family from the financial pressures of medical bills, it has cashless and cash reimbursement options.

5. Awaz Health Insurance Scheme

The Kerala government introduced the Awaz Health Insurance Scheme in 2017, specifically designed for interstate labourers in Kerala who lack medical insurance. This scheme provides financial support for medical emergencies and includes a death benefit for the policyholder’s family.

Under this scheme, you can receive medical coverage of up to ₹15,000. Additionally, in the event of the policyholder’s passing, the family is eligible for a ₹2 lakh payout. However, this scheme is restricted to labourers aged 18 to 60, so senior citizens are not eligible for coverage.

6. Mahatma Jyotiba Phule Jan Arogya Yojana

The Maharashtra government’s Mahatma Jyotiba Phule Jan Arogya Yojana is designed to support low-income families with comprehensive health coverage. Under this scheme you will be able to enjoy cashless medical and surgical facilities from both governmental and private empanelled hospitals.

These inclusions include any complications which existed even before the onset of the illness, hospital expenses, subsequent care, and everything that resulted in hospitalisation as well as expenses before and after hospitalisation. With this policy, your family is entitled to annual coverage of up to ₹1.5 lakh, ensuring extensive medical support for qualifying households.

7. Dr YSR Aarogyasri Health Care Trust

The Andhra Pradesh Government, through the Dr. YSR Aarogyasri Health Care Trust, has launched four health welfare initiatives aimed at supporting people during medical emergencies. The scheme focuses on providing healthcare support to economically disadvantaged individuals, while the Arogya Raksha scheme is designed for those above the poverty line (APL), offering medical coverage.

Additionally, the Working Journalist Health Scheme ensures cashless treatment for designated medical procedures specifically for journalists. Lastly, the Employee Health Scheme delivers health coverage to state government employees, ensuring that various groups receive the necessary medical assistance.

8. Aam Aadmi Bima Yojana

The Aam Aadmi Bima Yojana (AABY) offers affordable health insurance targeted specifically at individuals in certain occupations. This scheme is accessible to those in 48 professions, including weaving, carpentry, and fishing.

To qualify, you need to be the primary income earner in your household and work in one of these specified fields. With a modest annual premium of ₹200, this policy provides coverage of up to ₹30,000, making it a valuable option for those in eligible vocations.

9. Universal Health Insurance Scheme (UHIS)

The Universal Health Insurance Scheme is an affordable health insurance option offered by the Indian government. Individuals between the ages of 5 and 70 are eligible, and those categorised as below the poverty line can access its benefits by submitting the required documents.

This plan provides coverage for hospitalisation, accidental disability, and additional medical needs. The policy premium varies based on family size and the number of covered members.

10. West Bengal Health Scheme

Introduced in 2008, the West Bengal Health Scheme offers medical cover to government employees and pensioners. With coverage up to ₹1 lakh for both individual and family floater plans, this scheme also includes OPD treatments and surgeries as per policy terms.

11. Chief Minister’s Comprehensive Insurance Scheme

Offered in partnership with United India Insurance, this Tamil Nadu government scheme provides families with an annual health cover up to ₹5 lakh for over 1,000 procedures. Those with an annual income below ₹75,000 qualify and can seek treatment at both private and government hospitals under this plan.

12. Mukhyamantri Amrutum Yojana

The scheme is a targeted program introduced in 2012 by the Gujarat government to support lower middle-class citizens and those living below the poverty line. Under this initiative, beneficiaries can access a family floater policy that provides coverage of up to ₹3 lakh. You can receive medical treatment at various healthcare facilities, including trust-based hospitals as well as public and private hospitals.

13. Yeshasvini Health Insurance Scheme

This scheme, supported by Karnataka’s state government, is specifically designed for farmers and those associated with cooperative societies. Covering over 800 procedures, including neurology, orthopaedics, and angioplasty, this scheme provides healthcare access through network hospitals for both members and their families.

14. Telangana State Government Employees and Journalists Health Scheme

Telangana introduced this scheme to provide cashless healthcare access to government employees and journalists, covering both active and retired personnel. Beneficiaries can avail treatment without needing immediate funds for emergencies, ensuring prompt medical care at approved hospitals.

15. Bhamashah Swasthya Bima Yojana

The Bhamashah Swasthya Bima Yojana is a targeted initiative designed to provide healthcare coverage to the rural population of Rajasthan. If you qualify for benefits under the Rashtriya Swasthya Bima Yojana or the National Food Security Act (NFSA), you are also eligible to enrol in this scheme. An important feature of this program is that there is no upper age limit for policyholders, allowing individuals of any age to access its benefits.

16. Janshree Bima Yojana

Designed for economically weaker sections, Janshree Bima Yojana targets people aged 18-59. This scheme includes unique features like SHG Groups for women and Shiksha Sahyog Yojana. Currently, it supports 45 occupational groups, providing them with a safety net in times of need.

17. Karunya Health Scheme

In Kerala, the Karunya Health Scheme provides critical illness cover for low-income families. Conditions such as kidney ailments, cancer, and cardiovascular diseases are covered. Enrollment requires proof of income and an Aadhaar card.

Thus,  government health insurance schemes in India are essential for providing affordable healthcare to economically weaker sections. These programs include provisions for specific cost to be incurred in availing health facilities for the families. By staying informed and applying for these schemes, you can secure vital medical assistance for yourself and your loved ones, enhancing your overall health security.