Top 10 Government Health Schemes In India

With the rise in medical expenses, health insurance in today’s time has become a must-have. Providing financial assistance to policyholders during the case of a medical emergency, health insurance has immense benefits. Moreover, sometimes it might become challenging for individuals to buy health insurance, given its premium costs. To cater to this and encourage more and more people to buy health insurance plans, the government of India has launched a number of health insurance plans. These health insurance plans make it easier for individuals to enjoy the benefits of health insurance plans at affordable rates. So, read on to understand the top government health insurance schemes in India.

What Is Government Health Insurance?

As the name implies, a government health insurance scheme is a healthcare coverage initiative endorsed and often funded by governmental bodies at the central or state level. Given the uneven accessibility of healthcare and insurance, especially in rural sectors, various central and state administrations have introduced and supported different health insurance plans.

In ensuring the well-being of citizens, governments shoulder the responsibility of fostering robust public health infrastructure, often collaborating with private entities for insurance scheme implementation.

Government-sponsored health insurance schemes generally offer substantial coverage at affordable premiums, promoting universal access to insurance across all societal segments.

List of Top 10 Government Health Insurance Schemes

When searching for government-backed health insurance plans in India, you have a selection of public-funded schemes to consider:

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

The PMJAY is a government health insurance program designed for individuals from economically disadvantaged backgrounds. Under this initiative, each household is eligible for medical coverage up to ₹5 lakh for secondary and tertiary hospital care. Importantly, there are no limitations based on age, family size, or gender for beneficiaries.

2. Awaz Health Insurance Scheme

Launched by the Government of Kerala in 2017, the Awaz Health Insurance Scheme aims to provide health coverage to inter-state workers across the state. Besides offering financial support during medical emergencies, the scheme includes accidental death benefits for the beneficiaries' nominees. Policyholders can claim medical expenses up to ₹15,000, with a death benefit of ₹2 lakh applicable to workers aged 18 to 60.

3. Bhamashah Swasthya Bima Yojana

Among India's range of government health insurance programs, the Bhamashah Swasthya Bima Yojana is tailored for residents of Rajasthan. Those qualifying for benefits under the Rashtriya Swasthya Bima Yojana and the National Food Security Act can also access benefits here. Beneficiaries can claim up to ₹3 lakh for critical illnesses and ₹30,000 for other ailments.

4. Chief Minister's Comprehensive Insurance Scheme

Initiated by the Government of Tamil Nadu, this scheme provides family floater medical insurance to economically marginalised citizens of the state. Eligible citizens and Sri Lankan refugees with proper citizenship documentation can claim hospitalisation expenses up to ₹5 lakh per annum in approved government and private medical facilities across Tamil Nadu.

5. Aam Aadmi Bima Yojana

The Aam Aadmi Bima Yojana supports workers across 48 vocations, including carpentry and weaving. If you're the primary breadwinner of your family, you're eligible for this insurance scheme. By paying an annual premium of just ₹200, you can make claims up to ₹30,000 during the policy term.

6. Central Government Health Scheme (CGHS)

The Central Government Health Scheme is exclusively designated for employees of the Central Government. It encompasses benefits related to hospitalisation, domiciliary treatment, as well as expenses for homoeopathy and naturopathy. Eligible beneficiaries include dependent family members living in CGHS-covered areas, pensioners, Delhi police personnel, freedom fighters, and more.

7. Karunya Health Scheme

Introduced by the Government of Kerala, this program addresses critical illness costs and is accessible to economically disadvantaged individuals. Offering insurance coverage of ₹5 lakh, beneficiaries are required to pay a nominal premium for enrollment. To apply for this government health insurance plan, residents of the state need to submit their Income Certificate along with their Aadhaar card details.

8. Employees State Insurance Scheme

This government scheme targets factory workers, aiming to reduce disabilities and fatalities in factories across India. Initially limited to Kanpur and Delhi factories, the Employees State Insurance Scheme has been extended to over 700,000 factories nationwide.

9. Pradhan Mantri Suraksha Bima Yojana

The Central Government introduced Pradhan Mantri Suraksha Bima Yojana to expand medical insurance coverage in the country. The scheme allows partial disability claims up to ₹1 lakh and total disability or death claims of ₹2 lakh. To qualify for this program, individuals must be aged between 18 and 70, with a savings account linked to a participating bank.

10. Mahatma Jyotiba Phule Jan Arogya Yojana

The Government of Maharashtra initiated the Mahatma Jyotiba Phule Jan Arogya Yojana to extend healthcare coverage to economically disadvantaged segments. Applicable in specific districts, policyholders can claim medical expenses up to ₹1.5 lakh for ailments or diseases from the policy's inception.

Features & Benefits of Governement Health Insurance Plans

Outlined below are the characteristics and advantages of government health insurance schemes in India:

• Providing medical coverage to individuals from economically disadvantaged backgrounds at reasonable rates.
• Ensuring the incorporation of underprivileged individuals into government health insurance initiatives.
• Offering the convenience of cashless treatment for various diseases and serious health conditions.
• Rendering treatment options for impoverished individuals at both private and government-affiliated medical facilities.

Basic Health Insurance Plans vs Government Health Insurance Schemes

The following table highlights the distinctions between Health Insurance Plans and Government Health Insurance Schemes:

Features	Basic Health Insurance	Government Health Insurance
Eligibility	Most individuals are eligible	Mostly available for lower income
Premium	Slightly higher premium	More affordable premium
Sum Insured	Up to ₹1 Crore	Up to ₹5 Lakh
Coverage	Enhanced coverage, add-ons available	Coverage varies
Policy Purchase	Online purchase available	Purchase process can take time
Network Hospitals	Wide network of hospitals	Numerous private & public hospitals
Ambulance Charges	Covered under most plans	Covered under some plans
Maternity Benefit	Available under some plans/add-on	May or may not be available
Private Hospital Room	Available based on policy	Availability varies
Online Renewal	Can be renewed online	Renewal might not be online
Tax Benefits	Available under Section 80D of the Income Tax Act, 1961.	Not available

Conclusion

The government-sponsored health insurance initiatives in India offer medical protection to individuals belonging to economically disadvantaged segments of society, shielding them from the financial burden of medical expenses. Yet, given the swift escalation of healthcare costs, comprehensive coverage that guards against the surging healthcare inflation becomes imperative.

FAQs

Q. What constitutes a Government Health Insurance Scheme?
A. A government health insurance scheme refers to a medical insurance plan backed or financially supported by the government. These schemes usually prioritise public welfare and come with affordable premium options.

Q. Am I eligible to enrol in a Government Health Insurance Scheme?
A. Certainly, you can engage in a government health insurance scheme as long as you meet its eligibility prerequisites. Some of these schemes do not impose specific criteria based on occupation, income level, etc., and are accessible to the general population.
Yet, certain schemes are tailored for specific professions, occupations, or income brackets. It's worth noting that while central government schemes are all-encompassing, state government-initiated health insurance schemes often limit coverage to residents of a particular state.

Q. Do premiums differ across various government health insurance schemes?
A. Indeed, the premiums for different government health insurance schemes do fluctuate. Premium amounts are determined by the scheme's stipulations. Generally, most schemes require an annual fixed premium for both subscription and renewal.

Q. Is every government health insurance scheme orchestrated by the central government?
A. No, numerous health insurance schemes are launched and administered by individual state governments in India. These, alongside central government initiatives, aim to ensure widespread health insurance coverage for the nation's citizens.

Q. What's the premium and scope of coverage for the Pradhan Mantri Suraksha Bima Yojana?
A. For the Pradhan Mantri Suraksha Bima Yojana, the annual premium stands at ₹12. This scheme extends the following coverage to beneficiaries:
₹2,00,000 for accidental death or total disability
₹1,00,000 for partial disability

Q. Which state Government introduced the Karunya Medical Insurance Plan?
A. The Karunya Medical Insurance Plan was introduced by the government of Kerala. This initiative targets providing health insurance coverage to economically disadvantaged segments within the state's population.

Q. When does a company need to register for the Employee State Insurance Scheme?
A. A company must register for the Employee State Insurance Scheme when its employee count exceeds 10.

Q. Should I consider participating in a Government Health Insurance Scheme?
A. Should a government health insurance scheme align with your coverage needs and budget, it's worth considering. Nevertheless, it is advisable to also evaluate and compare medical insurance plans offered by leading insurers in India.

Also Read: National Health Insurance Schemes in India

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.