Government Health Insurance Schemes: About, Types, Benefits, & More

All About Government Health Insurance Schemes - BimaBandhu

Maintaining good health is more of an individual responsibility. While people across the globe do their part in staying fit and healthy, the governments also work towards providing quality healthcare services and benefits to the citizens. They promote people’s welfare by promoting health insurance and undertake required measures in the form of government health insurance schemes. 

Particularly in India, the government has also undertaken various government health insurance schemes for the citizens. Let’s cover them all in detail.  

What are Government Health Insurance Schemes? 

A govt health insurance scheme is a health insurance initiative powered by the central or state governments in India for the citizens. These schemes are launched with the aim to enhance the health protection quotient within the region by offering insurance policies having adequate sum insured at a low price.  

 

Most government health insurance schemes are offered on an annual basis and help people in our country get the required medical treatment in tough times. 

Difference between Government Health Insurance Schemes and Regular Health Insurance Policies 

Insurance parameter  Regular Health Insurance  Government health insurance schemes
Available Sum insured Range  Up to Rs. 1 crore  Up to Rs. 5 Lakh 
Eligibility  For all  For lower-income groups only 
Coverage  Broad  Narrow 
Premium  Based on the plan chosen  Partially or fully paid by the govt 
Policy purchase  Instant purchase available online  Takes time 
Private hospital rooms  Available as per the plan chosen  May not be available 
Network hospitals  Wide network of private hospitals  Both private and public hospitals included 
Maternity benefits  Based on the plan chosen   Based on the plan chosen 
Domiciliary hospitalization cover  Based on the plan chosen  Not available 
Ambulance charges  Covered under most plans  Covered under a few plans 
Online renewal facility  Available  May not be available 
Cumulative bonus  Given for claim-free year  Not available 
Tax benefits  Available  Not available 

What are the Types of Government Health Insurance Schemes in India? 

Ayushman Bharat Yojana 

  • Universal health insurance scheme by the Ministry of Health and Family Welfare, Government of India 
  • Launched to provide free healthcare services to more than 40% population in India 
  • Offers a health cover of Rs. 5 Lakh 
  • Covers medicines, medical treatment, diagnostic expenses, and pre-hospitalization cost 
  • Highly beneficial for the poor Indian families 

Aam Aadmi Bima Yojana (AABY) 

  • Latest government medical insurance scheme established in the year 2007 
  • Offers insurance coverage to individuals falling into the age bracket of 18-59 years 
  • Tailored for those living in the rural areas and upcountry 
  • Covers landless citizens living in both rural and urban areas 
  • Also provides scholarships to underprivileged children 
  • Earning member/family head is the insured under this scheme 
  • Annual premium of Rs. 200 shared by the central and state government 
  • Provides a compensation of Rs. 30,000 to the family in case of natural death of the insured 
  • Compensation is Rs. 75,000 in case of death resulting from permanent disability 

Pradhan Mantri Suraksha Bima Yojana 

  • Aims to provide accident insurance cover 
  • Meant for people in the age group of 18 to 70 years having a bank account 
  • Provides annual cover of Rs. 2 Lakh for total disability and death and Rs. 1 lakh for partial disability 
  • Automatic deduction of premium from the policyholder’s bank account 

Central Government Health Scheme (CGHS) 

  • This government health insurance scheme was started in 1954 
  • Provides comprehensive medical facilities for pensioners and central government employees living in cities 
  • It is a National Health Company Online Renewal Program 
  • Covers dispensary related services including domiciliary care 
  • Scheme beneficiaries are allowed to get hospitalized every time they fall ill 
  • Provides free X-ray and lab tests 
  • Covers specialist consultations at hospital level and dispensaries for free 

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Janshree Bima Yojana 

  • Designed for poor individuals in the age group of 18-59 years 
  • Includes special features like Shiksha Sahyog Yojana and Women SHG Groups 
  • Covers 45 occupational groups 

Employment State Insurance Scheme 

  • Multi-dimensional government health insurance scheme 
  • Provides socio-economic protection and social security to all workers in India 
  • Commences on the first day of insurable employment along with full medical care insurance (to insured and the families) 
  • Also provides cash benefits in times of physical distress or disability 
  • Offers dependents benefits to women who have lost the capacity to work 
  • Only applicable to permanent factories employing at least ten employees 

Universal Health Insurance Scheme (UHIS) 

  • Meant for BPL (Below Poverty Line) families 
  • Covers the medical expenses for every family member, up to Rs. 30,000 
  • Aimed to improve healthcare facilities for underprivileged and the economically disabled citizens 

Chief Minister’s Comprehensive Insurance Scheme 

  • Backed by Tamil Nadu state government 
  • Launched in association with the United India Insurance Company Ltd.  
  • Family floater policy that provides quality healthcare services and covers more than 1,000 medical procedures 
  • Meant for Tamil Nadu residents who have an annual income of less than Rs. 75,000 
  • Hospitalization expenses up to Rs. 5 Lakh in both government and private hospitals covered under this government health insurance scheme 

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Yeshasvini Health Insurance Scheme 

  • Promoted by the Karnataka State Government 
  • Useful for peasants and farmers  
  • Covers more than 800 medical procedures 
  • Co-operative societies help farmers get enrolled in this Indian government health insurance scheme 

West Bengal Health Scheme 

  • Launched by the Government of West Bengal in 2008 for its employees 
  • Available for pensioners 
  • Available in both individual and family floater modes with a sum insured of up to Rs. 1 lakh 
  • Covers OPD treatment and surgeries as defined in the scheme terms 

Mukhyamantri Amrutam Yojana 

  • Initiated by the Gujarat government in 2012 to benefit poor people in the state 
  • Meant for lower-middle-income groups and those below the poverty line 
  • Provides a family floater health insurance policy with a cover of up to Rs. 3 lakh per family 
  • Supported by private, government, and trust-run hospitals 

Mahatma Jyotiba Phule Jan Arogya Yojana 

  • Govt health insurance scheme introduced by Maharashtra Government 
  • Meant for BPL groups and farmers in Maharashtra 
  • Offers a family health cover of up to Rs. 1.5 Lakh for specific illnesses 
  • Does not have a waiting period 

Telangana State Government Employees and Journalists Health Scheme 

  • Meant for journalists and employees in Telangana (employed, pensioners, and retired) 
  • Beneficiaries can avail cashless treatment in the registered hospitals under this government medical insurance scheme 

Karunya Health Scheme 

  • Kerala Government launched this government health insurance scheme in 2012 
  • Provides health cover for listed chronic illnesses to the poor 
  • Individuals in the BPL group can avail the benefits of this scheme 
  • Requires a copy of the Income certificate and Aadhar card from the beneficiary 

Dr YSR Aarogyasri Health Care Trust 

  • Launched with four other health welfare schemes by the Government of Andhra Pradesh 
  • Offer medical cover at the time of medical emergency 

Government Health Insurance Schemes in India at a Glance 

  • Ayushman Bharat Yojana 
  • Aam Aadmi Bima Yojana (AABY) 
  • Central Government Health Scheme (CGHS) 
  • Janshree Bima Yojana 
  • Employment State Insurance Scheme 
  • Universal Health Insurance Scheme (UHIS) 
  • Chief Minister’s Comprehensive Insurance Scheme 
  • Yeshasvini Health Insurance Scheme 
  • West Bengal Health Scheme 
  • Mukhyamantri Amrutam Yojana 
  • Mahatma Jyotiba Phule Jan Arogya Yojana 
  • Telangana State Government Employees and Journalists Health Scheme 
  • Karunya Health Scheme 
  • Dr YSR Aarogyasri Health Care Trust 

What are the Top Features and Benefits of Government Health Insurance Schemes? 

  • Govt health insurance schemes are offered at a very low price 
  • BPL families can avail the benefits of these schemes easily 
  • They ensure coverage for those falling under BPL groups 
  • They also provide medical treatment under both private and government hospitals 

Why does the central and state government launch various government health insurance schemes? 

These schemes are launched for the welfare of Indian citizens, especially the needy so that they can get the benefits of medical insurance. 

Can anyone buy government health insurance schemes? 

Individuals can enroll in different government health insurance schemes based on their eligibility criteria. 

Are all govt health insurance schemes provided by the central government? 

No. The state governments also initiate several government medical insurance schemes along with the central govt. 

Can I buy government health insurance schemes online? 

Not every government scheme dedicated to health insurance can be purchased online. 

What is the sum insured I can get with govt health insurance schemes? 

There is no specific sum insured provided by all. Each scheme offers different health insurance coverage. 

What are the exceptions or exclusions in government health insurance schemes? 

Read the scheme-related documents carefully for such details. 

Where can I get more details about different govt health insurance schemes? 

Research online or dig deeper at BimaBandhu(.in)

 

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