17 Types of Government Health Insurance Schemes in India

Posted on: May 22, 2024 | 3 mins | Written by: HDFC ERGO Team

17 Types of Government Health Insurance Schemes in India

Every government across the globe tries to work towards the betterment of its fellow countrymen by offering quality healthcare, food, shelter, ensuring empowered infrastructure and other welfare activities. The Indian government is also no exception to this. There are various government health schemes in India that tend to work towards the betterment of the citizens.

What is a Government Health Insurance Scheme?

As the name suggests, government health insurance schemes in India are initiatives introduced and managed by either the central or the respective state government to ensure easy and affordable availability of quality healthcare for fellow citizens. The chief target of this sort of scheme is to enhance the overall healthcare quotient of the state and the country by offering affordable health insurance plans with a promising amount of sum insured. These plans are generally offered every year.

Regular Health Insurance Plans vs Government Health Insurance Scheme

Features	Regular Health Insurance	Government Health Insurance
SUM INSURED	The optimum coverage limit usually reaches INR 1 crore	The optimum coverage limit is up to INR 5 lakhs
PREMIUM	Depending on the plan, it may begin from INR 200/month	INR 100/month onwards or entirely paid by the government
PRIVATE HOSPITAL ROOM	Depending on the plan terms, it is available	May or may not be available
POLICY PURCHASE	Immediate plan purchase possible	Policy purchase may be time-consuming
NETWORK HOSPITALS	Wide network of private hospitals	Wide network of both public and private hospitals
MATERNITY BENEFITS	Available, depending on the plan terms	Available but limited to only one child in most cases
AMBULANCE CHARGES	Available in almost all plans	Only available in certain selected plans
DOMICILIARY TREATMENT	Available depending on the concerned plan terms	Not available
ONLINE RENEWAL	Available	May or may not possess the option for online renewal
CUMULATIVE BONUS	Available for every claim-free year	Not available
HEALTH CHECK-UPS	Covered in certain plans	Not covered
PREMIUM INSTALMENT (MONTHLY)	Depends on the plan chosen	Not available
TAX BENEFITS	Available under the IT Act of 1961	Not available

List of 17 Government health insurance schemes in India

1. Ayushman Bharat Yojana:

Ayushman Bharat Yojana has been designed after careful consideration of the UHC. It targets the overall health sector to ensure uninterrupted care and support for the countrymen. This scheme possesses 2 components: Pradhan Mantri Jan Arogya Yojana and Health & Wellness Centres. 150000 HWCs have been launched for the overall upliftment of the healthcare sector. The PM-JAY has been particularly created for the poor, with a payable premium of just INR 30 and allows health coverage worth INR 5 lakhs/family every year.

2. Awaz Health Insurance Scheme:

This health cover has been introduced by the Kerala government for migrant workers. It even covers coverage for death by accident for the workers. It was launched in 2017 considering over 5 lakh inter-state migrant workers. The health cover is worth INR 15000, while the coverage for death is INR 2 lakhs.

Workers aged between 18 years and 60 years are eligible for this scheme, provided they submit all the relevant documents.

3. Aam Aadmi Bima Yojana:

This has been created considering people involved in 48 typical occupations like fishing, carpentry, handloom weaving, etc. The premium for a plan worth INR 30000 is INR 200 yearly. There must be one earning member or family head in a particular family revolving around the poverty line and must be involved in 1 of the 48 vocations.

4. Bhamashah Swastha Bima Yojana:

This is a comprehensive cashless health insurance policy designed for the residents of Rajasthan. Any economically weak resident of the state may avail of its benefits after enrolment. Anybody who is a part of the RSBY and NFSA is eligible to get this coverage. It covers hospitalisation expenses for critical ailments and general ailments for both OPD and in-patient care, based on the plan terms.

5. Central Government Health Scheme:

This is one of the oldest health insurance schemes in India, working for over 60 years, and covering Central Government employees like Supreme Court judges, Railway Board, employees, etc. As per the policy terms, it covers domiciliary costs, hospitalisation costs, homoeopathy treatment costs, etc. It is currently working in 71 Indian cities.

6. Chief Minister’s Comprehensive Insurance Scheme:

This has been launched by the Tamil Nadu State Government in association with the United India Insurance Company Ltd. Unlike individual health insurance, this is a family floater plan, allowing hospitalization cost coverage up to INR 5 lakhs. Tamil Nadu residents earning less than INR 75000 are eligible for this scheme. It covers 1000+ medical procedures.

7. Employees’ State Insurance Scheme:

This scheme was launched back in 1952, allowing financial coverage for illnesses, disabilities, and deaths of workers and employees. Over 7 lakh factories are currently a part of this health scheme.

8. Karunya Health Scheme:

This is a special critical illness plan introduced by the Kerala government to offer financial support to the poor people. It covers kidney ailments, cancer, heart issues, etc. BPL people can enroll themselves, by providing genuine income certificates and Aadhaar cards.

9. Mahatma Jyotiba Phule Jan Arogya Yojana:

The Maharashtra government introduced this scheme for BPL people of the state in selected districts with a family coverage benefit worth INR 1.5 lakhs.

10. Mukhyamantri Amrutum Yojana:

This is an initiative of the Gujarat government offering yearly family floater benefit of INR 3 lakhs. BPL and lower-middle-class families qualify for this cover.

11. Pradhan Mantri Suraksha Bima Yojana:

Individuals aged between 18 and 70 years of age possessing a bank account are eligible for this accident health cover. For partial disability, it offers INR 1 lakh and for total disability/death, it offers INR 2 lakhs. The premium value is INR 12.

12. Dr YSR Aarogyasri Healthcare Trust Andhra Pradesh State Government:

4 schemes operate under this plan:

a. Dr YSR Aarogyasri is dedicated to the welfare of the poor.

b. Aarogyashri is designed for the benefit of APL families.

c. Working journalist health scheme allows cashless treatments of listed procedures.

d. Employee health scheme is for the benefit of the designated state government employees.

13. Telangana State Government – Employees and Journalists health scheme:

The beneficiaries are allowed cashless treatment at network hospitals according to the plan terms.

14. Rashtriya Swastha Bima Yojana:

This is targeted at BPL people involved in the unorganized sector. It can ensure efficient financial support during medical emergencies.

15. Universal Health Insurance Scheme:

It allows both individual and group health coverage for BPL people aged between 5 years and 70 years. The premium value depends on the family size. It covers accidents, disabilities, and hospitalization.

16. Yeshasvini Health Insurance Scheme:

The Karnataka State Government introduced this for peasants and farmers. It allows family floater coverage through network hospitals and covers 800+ procedures.

17. West Bengal Health Scheme:

It allows coverage worth INR 1 lakh for the beneficiary and his/her family, covering OPD surgeries, as per the plan terms. It covers both employees and pensioners.

Top features and benefits of Government Health Insurance Plans

Some of the most highlighting benefits of government health insurance schemes in India include:

• Affordable

• Ideal for BPL families

• Assurance to the policyholders

• Allows uninterrupted care without any lifetime limits

• Offer secure, standardized, comprehensive health benefits

• Despite job/location changes, certain government HI plans continue offering uninterrupted coverage

• Allows free screenings, immunizations, etc. as per plan terms

• Includes both government and private healthcare facilities for enhanced scope

Conclusion

Government health schemes in India play a crucial role in securing the overall infrastructure of the healthcare sector. It secures the health of the poor and vulnerable section of the society.

FAQs

1. Is a government health plan available to all?

No, every plan has different eligibility criteria. Availability depends on the fulfilment of those criteria.

2. May I purchase government health plans online?

Not all government health plans offer online purchase facilities. You must clarify before purchasing.

3. Is an Aadhaar card enough as identity proof for purchasing a government health scheme?

An Aadhaar card may be essential but may not be enough, depending on the specific plan requirement.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

Which is Better: Government Health Insurance Plans or Private Medical Insurance Policy?

Digital Health Incentive Scheme: Meaning, Benefits and more

What is the Universal Health Insurance Scheme (UHIS)? How to Enroll In Universal Health

Employees Deposit-linked Insurance Scheme: Eligibility, Features, and Benefits

What Is Karunya Health Insurance Scheme? How To Apply