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List of government Mediclaim policies for families

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Looking at how the prices of healthcare facilities are growing, it’s a no-brainer that everyone should be covered by an individual or family health insurance policy with adequate coverage. But think for a moment — how can someone from a lower-income group afford the premium of a good health plan? At times, people in rural areas may have the monetary strength to buy one but don’t have access to the information about the parameters to consider before purchasing the plan. That’s why the government keeps launching Mediclaim policies for families and tries to popularise them. Let’s learn more about these plans.

List of government Mediclaim policies for families

To make healthcare and health insurance accessible and affordable to all sections of society, particularly the economically weak and underprivileged sections of society, the Government of India has launched several government Mediclaim policies. Some key ones are –

1. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)

The largest government health insurance scheme, AB-PMJAY, provides medical coverage of up to Rs 5 lakhs per family per year to the bottom 40% of the population, i.e., the poor and the vulnerable. Some benefits of this government Mediclaim policy for families include coverage for hospitalisation, pre- and post-hospitalisation, lab tests, medicines, and coverage for 1,393 procedures. There is also no waiting period for pre-existing diseases, which is a big relief for parents as they are likely to have pre-existing ailments.

2. Rashtriya Swasthya Bima Yojana (RSBY)

The RSBY provides coverage for people in the unorganised sector, low-income families, and below poverty line (BPL) households. Each family can avail of up to Rs 30,000 annually by paying an annual premium of Rs 30. The policy covers costs incurred on hospitalisation, including pre- and post-hospitalisation.

3. The Pradhan Mantri Suraksha Bima Yojana (PMSBY)

This government medical insurance policy offers a sum insured of up to Rs 2 lakhs to individuals and families in case of death or disability due to accidents. With an affordable premium of Rs 12 per annum, the scheme applies to people between 18 and 70 years of age with a bank account. The scheme also offers Personal Accident Cover of up to Rs 1 lakh for accidental death and disability.

4. The Employees' State Insurance Scheme (ESIS)

All workers in India whose wages do not exceed Rs 21,000 per month are eligible for this scheme. For people with disabilities, this ceiling is Rs 25,000 per month. The benefits include medical coverage for the insured and family, maternity benefit of 26 weeks (extendable by four weeks), death and disability benefits, and extended sickness benefit of up to 2 years (at a rate of 80% of the person’s average daily wages) if the insured suffers from any malignant and long-term ailment.

5. The Aam Aadmi Bima Yojana (AABY)

The AABY provides accidental death and disability benefits. Applicable to people practising in any of the 48 vocations listed in the scheme, such as carpentry, handloom weaving, fishing, sericulture, etc. The scheme also covers landless citizens who are tenants living in both urban and rural areas. In case of accidental death or total permanent disability of the beneficiary, his/her family will get a compensation of up to Rs 75,000; if the beneficiary suffers a partial permanent disability, he/she will receive a compensation of Rs 37,500. In case of natural death, the compensation is Rs 30,000. The scheme covers only the earning member or head of the family.

6. The Central Government Health Scheme

This health insurance scheme covers working and retired Central Government employees and their dependents. All costs incurred on hospitalisation, pre- and post-hospitalisation, diagnostic tests, medicines, consultation with specialists, AYUSH treatments, etc., are covered.

7. Universal Health Insurance Scheme (UHIS)

The UHIS covers BPL (i.e., Below Poverty Line) and APL (i.e., Above Poverty Line) families. The benefits include hospitalisation expenses of up to Rs 30,000 and accidental death and disability cover. The applicant must be between 5 and 70 years old. Children aged between 3 months and 5 years can also be covered under UHIS if either of the parents is enrolled in the scheme.

Conclusion

To ensure low-income groups do not face any financial constraints during medical emergencies or planned procedures, the government of India launched several health insurance schemes offering medical coverage for the insured and their families. However, if the coverage is inadequate, you can buy health insurance online as a backup. If you still want to enhance the coverage, you can opt for add-ons like critical illness insurance, OPD cover, etc.

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

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