Top 10 Government Health Insurance Schemes in India

Top 10 Government Health Insurance scheme

Here’s a detailed explanation of the Top 10 Government Health Insurance Schemes in India, including their about, benefits, and eligibility criteria:

1. Ayushman Bharat Yojana

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is India’s ambitious health protection scheme. It offers health protection to the vulnerable population. Each eligible family receives up to ₹5 lakh per year in health insurance for secondary and tertiary care.

Benefits

• Provides for hospitalisation; the costs of admission; pre- and postoperative measures; tests; and medication.

• Available to any member of the family with no restrictions to the number of children, spouses, parents, etc.

• It covers expensive ailments, including cancer, heart disease and kidney failure.

• Offers online cashless facilities in various public & private empanelled hospitals across India.

Eligibility

• Families which are classified under the Socio-Economic Caste Census (SECC) 2011.

• The targeted category includes households living in rural areas with no adult person in the age group of 16-59 years, the SC/ST category, and households with persons earning in a manual occupation.

• Small-scale traders, rag pickers, domestic workers and any family in the urban area who depends on daily wage earners.

2. Pradhan Mantri Suraksha Bima Yojana (PMSBY)

This government yojana offers indemnity to people for accidental death or disability for a premium of ₹ 12, per annum. It is intended to safeguard the socially vulnerable and the labour force.

Benefits

• The daily allowance is ₹500 and pays ₹2 lakh for accidental death or total disability and ₹1 lakh for partial disability.

• It includes accidental deaths and injuries due to road traffic, falls or any sort of accident.

• Immediate financial assistance for families of policyholders claiming the benefits in case of sudden deaths due to the emergence of some financial problems.

Eligibility

• Applicants have to be between the ages of 18 to 70 years.

• A savings bank account connected with an Aadhaar card is required for enrolment Rural Financial Inclusion Index.

3. Aam Aadmi Bima Yojana (AABY)

AABY targets offering prospects of life and disability insurance to landless families in rural areas so that they will be financially secure in the case of accidental or nominal demise.

Benefits

• Rs. 30000 for natural death and Rs.75000 in case of Accidental death.

• Stipend of ₹100 per month for two children of up to class 12 studies.

• There are specific payments for disability: ₹37,500 for partial disability and ₹75,000 for total disability.

Eligibility

• Poor farmers, unemployed farm folks, and families who have no regular formal income.

• Families living below the poverty line(BPL) or just above the poverty line.

Also Read: New India Assurance Health Insurance

4. Central Government Health Scheme (CGHS)

The central government health scheme offers broad health insurance to central government employees, pensioners and dependents. The facilities include all types of medical services and availing of treatment at empanelled hospitals with no cost deductions from the CGHS account.

Benefits

• Includes outpatient services, hospitalisation, drugs, and tests.

• Has specialised treatments and serves patients in need of operations or when they are expecting.

• Emergency ambulance services.

Eligibility

• Civil servants, pensioners, and dependents.

• Autonomous and semi-government organisations under the central government employees.

5. Employees' State Insurance Scheme (ESIC)

ESIC is for organised sectors and there is the provision of medical & other facilities at a token amount recoverable from both employer & employee.

Benefits

• Medical care for employees and dependant family members either on or out-patient basis.

• Benefits for persons with disability and maternity leave allowance.

• Amounts realised from funeral expenses and financial help to the dependents in the event of the insured’s death.

Eligibility

• Salary earners who earn up to ₹21,000 a month.

• The establishment of an employer also requires them to sign up under the provisions of the ESIC Act.

6. Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS)

The Tamil Nadu government has come up with an affordable health insurance plan for families earning up to ₹72,000 per annum called CMCHIS.

Benefits

• Offers up to ₹ 5 lakh per year for the top critical illnesses of cancer, kidney failure, and cardiovascular diseases.

• It comprises operations, diagnostic procedures and other physiotherapy services.

• Government-accredited public and private hospitals provide cashless treatments.

Eligibility

• Drivers and establishment owners of Tamil Nadu possess income certificates.

• Vulnerable economic groups; families with an income below the poverty level.

Also Read: Major Update About Removal Of GST From Health & Life Insurance

7. Universal Health Insurance Scheme (UHIS)

UHIS was envisaged to cover health risks for below-poverty-line families, mainly hospitalisation and maternity expenses.

Benefits

• Provides up to ₹30,000 for hospitalisation expenses for a family of five individuals.

• Consists of; Maternity benefits, Accident coverage and death compensation.

• Treasury options option available at participating empanelled hospitals.

Eligibility

• Class BPL status families or families belonging to the economically weaker section.

• Applicants must attach their income and family certificates.

8. Yeshasvini Health Insurance Scheme

This scheme by the Karnataka government is a mutual scheme whereby the state waives health insurance premiums for farmers and members of the rural cooperatives.

Benefits

• Provides treatment cost, accident operations, and other complicated treatments.

• Online transactions for cashless treatment in some of the empanelled hospitals in Karnataka.

• The structure also pays special attention to the health needs of the country’s countryside as well as the issue of their cost.

Eligibility

• List of registered members of societies in the field of cooperative societies in the state of Karnakata.

• Must have worked for at least three months in a cooperative society if the course is in the social sciences.

9. Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY)

This scheme was initiated by the Maharashtra government for families belonging to the economically weaker section of society with an emphasis always on the need for free and cashless hospitalisation services.

Benefits

• It includes treatment for complicated diseases/conditions including heart ailments, cancer, and certain organ transplants.

• Providing up to ₹ 1,50,000 annually to each family.

Eligibility

• The eligible population should consist of families with yellow or orange ration cards in Maharashtra.

• Per capita income constraint of ₹1 lakh per annum.

Also Read: Niramaya Health Insurance Scheme

10. Mukhyamantri Amrutum (MA) Yojana

This government flagship scheme by the Gujarat government is to provide health insurance to BPL families for getting the treatment of critical illness at an affordable rate.

Benefits

• Available up to ₹ 2 lakh per family in case of severe diseases and operations.

• From diagnostic tests, prescriptive drugs, and follow-up visits after treatment among others.

• It also provides cashless treatment in hospitals in which it has empanelled.

Eligibility

• The person should belong to the state of Gujarat and fall under the BPL category.