Health insurance is an essential part of everyone’s life. It helps in getting the requisite monetary compensation in times of unprecedented medical costs and conditions. While many people buy health insurance for themselves, certain people are provided health insurance by the government either due to specific economic reasons or because of their employment status.

This does not imply that only these two categories of people can avail the benefits of the health insurance schemes of the government of India. Let us learn about the top government health insurance schemes in India.

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What Does Government Health Insurance Mean?

Government Health Insurance refers to healthcare schemes provided by the government of India with affordable or free medical coverage for the citizens, especially those coming from the vulnerable sections of the society. These govt schemes aim to provide financial protection through funding medical treatment against illnesses and diseases.

The government health insurance schemes have a primary aim and that is to reduce the financial burden from the shoulders of the people of India and help them access medical treatment without worrying about payment.

Need For Government Health Insurance

Government health insurance schemes have been set up to improve public health and improve people’s financial stability. There is a dire need for such schemes because:

• Low-income groups: Government health insurance schemes provide medical coverage to people from the vulnerable sections of society who can’t afford private insurance.

• Access to quality healthcare services: The government scheme ensures that people from rural areas receive quality healthcare services just like everybody else.

• Preventive healthcare: Many government health insurance schemes organise regular health check-ups for early detection of diseases which helps them in starting preventive treatments at an early stage.

• Preventing medical debt: As the government takes responsibility for covering heavy medical bills, it protects people from falling into the cycle of debt taken for medical treatment purposes.

• Emergency health service access: In times of emergencies, the Government health insurance schemes help people access quality healthcare immediately without any financial barriers.

Difference Between Government Health Insurance & Private Health Insurance Schemes

Criteria	Government health insurance	Private health insurance
Provider	Government agencies or public sector organisations	Private insurance companies
Eligibility	Usually for low-income groups, govt. employees and vulnerable populations	Open for everyone
Premium amount	Low or free	Varies based on chosen policy, coverage, health status, age, and other risk factors
Coverage amount	Lower, with fixed coverage amounts (like Rs. 5 lahks under PMJAY)	Higher coverage, ranging from a few lakhs to a crore
Funding	Funded by the government through taxes or subsidies	Funded by individual policyholders
Target groups	Low-income groups, govt. employees and vulnerable populations	Middle to high-income individuals or families

Overview Of The Top 5 Government Schemes

Name of the scheme	Target group	Coverage amount	Premium	Features
Ayushman Bharat PM Jan Dhan Arogya Yojana (PMJAY)	Economically weaker sections	Up to Rs. 5 lakh per year	Free	Covers hospitalisation and medical procedures
Rashtriya Swasthya Bima Yojana (RSBY)	BPL families and workers from the unorganised sector	Up to Rs. 30000 per family per year	Rs. 30 per annum	Provides cashless hospitalisation at registered hospitals for a family up to 5 members
Employees’ State Insurance Scheme (ESIS)	Employees with less than Rs. 21000 salary per month and their families	Full medical care and hospitalisation	1.75% taken from the employee's salary and 4.75% from the employers	Covers medical care including maternity. disability, and other care
Central Government Health Scheme (CGHS)	Central govt. employees, pensioners, and their families	No limit specified	Fixed annual contribution based on pay grade	Provides OPD services, hospitalisation, and consultation.
Aam Aadmi Bima Yojana (AABY)	Rural landless households	Rs. 30000 in case of natural death and up to Rs. 75000 in case of accidental deaths	Rs. 200 per annum (50% subsidy borne by the government)	Life insurance with additional health insurance for accidental death and disability)

What Is The Bhamashah Swasthya Bima Yojana?

The government of Rajasthan launched the Bhamashah Swasthya Bima Yojana (BSBY), an insurance scheme designed to address the existing gap between people and inaccessibility to proper healthcare systems when needed. Beneficiaries receive coverage of up to Rs. 5 lakhs per year under the scheme including hospitalisation, surgery, and others through registered hospitals under the scheme.

What Is The Mahatma Jyoti Phule Jan Arogya Yojana?

The Mahatma Jyoti Phule Jan Arogya Yojana (MJPAY) is a health insurance scheme launched by the government of Maharashtra for people from economically weaker sections of society with an annual income of up to Rs. 1 lakh. The Sarkari Yojana covers the cost of hospitalisation, surgery, and other specific medical treatments through registered hospitals under the scheme. The scheme provides a coverage of up to Rs. 1.5 lakh per year per family.

What Is The Janshree Bima Yojana?

The Janshree Bima Yojana is a social security scheme launched by the government of India in the year 2000 for people from economically weaker sections of society, marginalised communities, and workers from the unorganised sector. It provides a financial coverage of Rs. 2 lakh in case of natural death and Rs. 4 lakh in cases of accidental deaths or complete disability. The premium amount of the insurance is affordable as most of the amount is subsidised by the government.

What Is The Universal Health Scheme?

The Universal Health Scheme was launched by the government of India in the year 2003 to provide accessible and affordable healthcare coverage to all citizens, especially those from the economically weaker sections of society. Here, beneficiaries are provided with monetary protection for hospitalisation, surgeries, and some outpatient services. The scheme highlights cashless treatment at registered hospitals.

Rashtriya Swasth Bima Yojana

The RSBY is a central government health insurance scheme for BPL families, poor households and unorganised sector workers. The govt scheme helps in getting an insurance cover of up to Rs. 30,000 per family annually. The scheme covers both pre-hospitalisation and post-hospitalisation expenses along with the actual hospitalisation charges. It is an excellent scheme to help those in need.

Read More: Pradhan Mantri Suraksha Bima Yojana (PMSBY): Affordable Accident Insurance For All

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

AB-PMJAY is a government health scheme that was introduced to cover the medical expenses of almost 40% of the population of India. It is a highly beneficial govt health insurance scheme that annually provides up to ₹5 lakhs in health coverage per family for secondary and tertiary care hospital treatment. The scheme covers the cost of hospitalisation for serious illnesses, such as cancer, heart disease, kidney failure, and many more.

Employee’s State Insurance Scheme

The Employment State Insurance Scheme (ESIS) is a social welfare scheme as it not only caters to socioeconomic protection but also provides social welfare benefits to its beneficiaries. The scheme is for employees and workers who can claim medical insurance under the scheme. The families of such workers can also claim the benefits of this govt health scheme.

Pradhan Mantri Suraksha Bima Yojana (PMSBY)

PMSBY is a government medical insurance scheme that provides annual life insurance coverage of up to ₹2 lakhs. The policy is offered exclusively to people aged 18-70 years. The scheme is designed to provide financial protection to individuals and families in the event of death or disability due to accidents.

The govt scheme also provides personal accident cover of up to ₹1 lakh for accidental death and disability. The scheme helps families stabilise their expenses and be financially strong.

Read More: IRDAI Issues New KYC Requirement Norms For Policyholders: What You Need To Know?

Central Government Health Scheme (CGHS)

CGHS is a central government-funded health scheme that provides health coverage to government employees and their dependents/families. The scheme provides coverage for hospitalisation expenses, including pre and post-hospitalisation expenses.

The scheme also covers the cost of medicines, medical tests, and diagnostic tests. CGHS scheme benefits can only be availed by visiting CGHS dispensaries or medical care centres. Also, read these latest guidelines about the CGHS Scheme here.

Aam Aadmi Bima Yojana (AABY)

This government healthcare insurance scheme was launched in October 2007. It majorly applies to people between the age groups of 18 and 59. The AABY insurance scheme is designed for all citizens who live in the countryside or rural areas. It also includes landless citizens who are tenants who live in both urban and rural areas and provides scholarships to deserving students.

Read More: Farmers Pay Rs 32,440 Crore Premium Under PMFBY; Claims Worth Over Rs 1.64 Lakh Crore Cleared

Conclusion

These government health insurance schemes are very beneficial for those who can not afford to buy health insurance plans for themselves and their families. Government medical insurance schemes help you get the requisite financial help in times of medical emergencies. It also helps families sustain in the event of the death of a member of the family.

For more information, stay connected to Jaagruk Bharat as we bring you details about different government schemes! For any questions and queries, or if you wish for us to cover any particular topic, drop your comment on the Jagruk Bharat community page!