Government Health Insurance Schemes in India

Only around 472 million individuals in India out of the 1.3 billion citizens have valid medical insurance coverage, according to a 2019 report.

Thus, not even half of the population has any coverage against medical expenses. Add to that the substantial poverty rates, and you can comprehend that a large section of society cannot afford quality healthcare services.

So, how can major medical services become more accessible to the Indian public?

Well, the answer is, with the help of innovative and helpful health insurance schemes, backed by the Indian government.

Here are some of the most important schemes to consider, which has allowed millions of Indians to afford quality medical treatments and procedures when the need arises.

1. Pradhan Mantri Jan Arogya Yojana under Ayushman Bharat

PM-JAY refers to a specialised health insurance policy, which is available to all economically-challenged citizens of India.

One such household can claim medical insurance coverage of up to Rs.5 lakh per year by paying premiums of Rs.30 annually.

Besides this medical coverage, the scheme has also led to the construction of around 1.5 lakh Health and Wellness Centres across the nation.

2. Awaz Health Insurance Scheme

Launched by the Kerala government in 2017, this particular insurance policy targets the inter-state labourers in Kerala, who are without medical coverage.

Besides financial assistance during medical emergencies, this scheme also offers a death benefit feature to the policyholder’s family members.

You can claim medical coverage of up to Rs.15000 from such a plan. The death benefit feature provides a payout of Rs.2 lakh to surviving family members after the policyholder’s death.

However, this facility is only available to labourers aged between 18 and 60 years. Therefore, senior citizens do not qualify for such coverage

3. Bhamashah Swasthya Bima Yojana

This is a specific initiative to offer healthcare coverage to rural residents of Rajasthan.

Individuals who are eligible to claim benefits from the Rashtriya Swasthya Bima Yojana and the National Food Security Act (NFSA) are also eligible to opt for this scheme.

Another important aspect to remember is that this scheme has no upper limit when it comes to a policyholder’s age.

4. Chief Minister’s Comprehensive Insurance Scheme

Tamil Nadu, in association with the United India Insurance Company, offers this impressive family floater medical insurance to the needy public in the state.

Specifically, individuals earning less than Rs.75000 annually are eligible for this scheme. If you avail this offer, you can claim up to Rs.5 lakh as hospitalisation expenses at select government and private medical facilities.

5. Aam Aadmi Bima Yojana

Another highly useful health insurance scheme at a nominal price is the Aam Aadmi Bima Yojana or AABY. However, it is only available to individuals engaged in select professions.

The scheme supports 48 different vocations, mostly related to waving, carpentry, fishing and more.

Apart from one of the vocations being your profession, the applicant must also be the earning family head.

Policyholders can claim up to Rs.30000 as coverage from such a plan by paying an annual premium of Rs.200. 

6. Central Government Health Scheme

Operated by the Central government, this particular insurance plan is aimed to cater to central government employees only.

High ranking employees of Indian Railways, Supreme Court judges and other such important workers under the central government can avail benefits from this plan.

It offers hospitalisation benefits, as well as domiciliary treatment coverage. Moreover, you can seek homoeopathy and naturopathy expenses from such a policy as well.

Presently, CGHS is available in 71 Indian cities. Nevertheless, expect more cities to be added to this list eventually.

7. Karunya Health Scheme

Another popular initiative by the Kerala government, the Karunya medical insurance plan offers critical illness coverage to individuals from the economically weaker sections of society.

From cancer to cardiac conditions, all of these health problems are categorised as chronic illnesses. Keep in mind that financial coverage for critical illnesses is limited under most standard policies.

To opt for this scheme, you would need to submit your income certificate, along with a photocopy of your Aadhaar card. 

8. Employees’ State Insurance Scheme

If you are a factory worker, this government initiative concerns your welfare. To reduce the number of deaths and disabilities in Indian factories post the country’ independence, the government launched this insurance facility for factory employees.

While the plan was initially restricted to Kanpur and Delhi factories only, it has since been upgraded to support more than 7 lakh factories across India. 

9. Pradhan Mantri Suraksha Bima Yojana

The government of India vowed to increase the number of medically covered individuals in the country. The Pradhan Mantri Suraksha Bima Yojana is a step in this direction, offering accidental death and disability benefits to policyholders.

Individuals suffering from partial disabilities can claim up to Rs.1 lakh from the scheme, while those who suffer from total disability/death can opt for benefits of up to Rs.2 lakh. To receive such coverage, you would have to pay yearly premiums of Rs.12.

Applicants aged between 18 and 70 years holding a savings account in any bank are eligible to avail scheme-related benefits.

10. Mahatma Jyotiba Phule Jan Arogya Yojana

The Maharashtra government launched this particular medical insurance plan for individuals below the poverty line.

However, only select district residents can apply. Policyholders can claim financial benefit for the diseases, marked inclusions, from the first day of coverage. The maximum coverage amount is up to Rs.1.5 lakh.

11. Dr YSR Aarogyasri Health Care Trust Andhra Pradesh State Government

Rather than being one scheme, this is an umbrella plan that includes four different kinds of policies for Andhra Pradesh residents.

One benefits the poor, while another is targeted to individuals above the poverty line. The third variety covers journalists, offering cashless treatment. Lastly, another part of this umbrella scheme caters to state employees only.

12. Mukhyamantri Amrutum Yojana

This specific scheme was launched in 2012 as part of a Gujarat government initiative. It aims to assist the state’s citizens belonging to the lower middle class and those below the poverty line.

A sum insured of Rs.3 lakh is available to beneficiaries as part of a family floater policy. You can seek treatment at a variety of medical facilities, including trust-based hospitals, public and private hospitals.

13. Rashtriya Swasthya Bima Yojana

Labourers and those individuals working in the unorganised sector often lack any health insurance coverage. However, like others, these people also face sickness and accidents. Thus, the need for medical coverage is just as pronounced for them as it is for others.

The Ministry of Labour and Employment is responsible for offering such policies workers in the unorganised sector and their families (up to 5 people).

14. West Bengal Health Scheme

West Bengal state government employees can benefit from this particular medical insurance scheme. It was introduced in 2008 and offers a sum insured of Rs. 1 lakh to the employee and his/her family members. The plan supports surgery costs, as well as OPD treatments, in certain cases.

Another vital point to remember, apart from present employees, this plan also has similar provisions to pensioners. 

15. Universal Health Insurance Scheme

This is one of the most affordable government health insurance schemes backed by the Indian government. Applicants aged between 5 and 70 years can opt for such coverage.

Also, individuals who can be categorised as below the poverty line can avail its benefits after submitting the necessary documents.

Hospitalisation, accidental disability and more are covered under this policy. However, the policy premium depends on the size of your family and the number of covered individuals. 

16. Yeshasvini Health Insurance Scheme

Farmers in Karnataka, associated with a co-operative, can take advantage of financial benefits from this scheme.

These people can acquire medical coverage against more than 800 procedures across various medical fields.

However, beneficiaries need to visit network medical facilities only to seek the necessary financial assistance during treatment.

17. Telangana State Government – Employees and Journalists Health Scheme

The Telangana state government offers comprehensive medical coverage to its employees and journalists. Besides existing employees, this policy covers retired or ex-employees as well.

Cashless treatment is the primary advantage of this scheme, enabling policyholders to seek treatment without facing financial shortcomings.

Government health insurance schemes are desirable, primarily because they are available at a fraction of the costs when compared to typical plans.

The above-listed options are some of the most popular government-backed medical coverage facilities available to people, who cann

ot afford one otherwise.