Check What is 5 Lakh Health Insurance by the Government of India?
Health insurance in India has gone through a significant evolution in recent years. It reflects the country's growth awareness of financial protection against healthcare costs. With these government schemes' help, every person in India can access better medical services.
Then, understanding people's issues and the financial crisis, the government's 5 lakh rupee health insurance becomes helpful to a significant portion of India's population. Many people must be aware of the Pradhan Mantri Jan Arogya Yojana (PM-JAY) or any other medical scheme. That's why this article gives you a proper idea about health insurance in India.
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What are Government Health Schemes?
Indian government Health schemes are generally Health insurance that the government provides. Now, there are various health schemes that both the central and state governments offer. However, here we will mainly talk about the central government's health schemes and how important the 5 lakh insurance govt scheme is.
This 5 lakh health insurance, commonly known as Pradhan Mantri Jan Arogya Yojana (PM-JAY), is a scheme that provides Medical coverage of 5 lakh to each family. Their primary focus is to provide good quality medical services to the over 12 crore poor and vulnerable families. Through this Scheme, an average of 55 crore beneficiaries don't have to worry about financial expenses.
The Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a flagship health insurance scheme the Government of India introduced under the Ayushman Bharat program. This Scheme was launched on the 23rd of September 2018, and till now, it has helped thousands of people.
Benefits of Government Health Insurance Plans
The 5 lakh health insurance by the government has many unique features and benefits,
1. Health Coverage for the Poor
One of the most significant benefits of PM Jay Health insurance is that it will cover 5 lakh rupees per family yearly for secondary and tertiary hospitalisation.
Health insurance plans mainly focuses on poor and honourable families from the bottom 40% of the Indian population. The Pradhan Mantri Jan Arogya Yojana ensures that the financial situation does not become a barrier to accessing necessary healthcare.
2. Comprehensive health coverage
Through this Health scheme, the poor or financially troubled families can receive a wide range of medical services. That manages up to 3 days of pre-hospitalisation, then 15 days post-hospitalisation and during hospitalisation expenses. Hence, This comprehensive coverage includes surgeries, diagnostic tests, hospital stays, medicine, etc.
Additionally, PM-JAY includes coverage for secondary and tertiary care, which often involves more complex and costly treatments.
3. Cashless and Paperless Transaction
Central government's 5 lakh insurance scheme allows users cashless access to health care services. In the Scheme, the beneficiaries do not need to pay the expenses for covered treatments. Instead, the costs are directly settled between the hospital and the insurance provider.
So, with the help of this, the patient or the family members don't have to face issues and go through the hustle to manage the cash or excessive paperwork.
4. No age or gender restrictions
Prime Minister 5 lakh health insurance is eligible for beneficiaries of any age, gender, or family size. Hence, no one has to worry about not receiving the health scheme's benefits. Also, there is no necessary premium that people have to pay, making it an accessible option for low-income families who might struggle with health insurance costs.
This Scheme is also eligible to be used all over India. Not only that, beneficiaries can visit both public and private hospitals in India to utilise the cashless service of this Scheme.
With the help of this feature, the beneficiaries can take advantage of their net worth and choose from a range of geographically convenient hospitals that fulfill their healthcare needs and requirements. So, without much worry, poor or financially vulnerable families can use the expertise of private hospitals to get access to high-quality care.
6. Awareness
The PM-JAY allows people and families to seek medical care without fear or delay. Due to a lack of financial stability, a lot of people and families avoid medical support and are getting more ill. That's why in this medical Scheme, individuals can take advantage of approximately 1929 medical procedures, including treatment drug supplies, physician fees, surgery charges, surgeon charges, etc.
Also, if an individual has any pre-existing physical issue or condition, then the 5 lakh health insurance premium will cover the charges from day one.
7. Focus on vulnerable populations
This medical Scheme provides a perfect solution for the vulnerable population, focusing on poor and economically disadvantaged individuals and families. As a result, it reduces health service differences and improves overall health outcomes in poor communities.
After researching and based on data from people going through economic hardship, I found that this Scheme is mainly designed for people experiencing financial hardship.
Top Government Health Schemes in India
1. Pradhan Mantri Jan Arogya Yojana (PM- JAY)
Its flagship health insurance scheme provides coverage of up to ₹5 lakh per family per year for secondary and tertiary hospitalizations.
2. Health and Wellness Centers
It is part of the Ayushman Bharat flagship scheme that provides comprehensive primary healthcare services through a Health and Wellness Centres network.
3. Pradhan Mantri Suraksha Bima Yojana (PMSBY)
From the age group of 18 years to 70 years provides accident insurance coverage with a sum assured of ₹2 lakh for accidental death or total disability and 1 lakh for partial disability under the Suraksha Bima Yojana Scheme.
4. Central Government Health Scheme (CGHS)
Provides healthcare services to central government employees, pensioners, and their dependents whenever they fall ill. Central Government Health Scheme service is available in Kolkata, Mumbai, Delhi, Lucknow, Nagpur, and Pune.
5. Employee State Insurance Scheme (ESIS)
Employee State Insurance Scheme provides health insurance to employees in the social security sector and social economic protection to all workers in India.
list of Services and Treatments Covered by Government Health Plans
All over India, multiple government health plans are available, and different plans provide different services and treatment coverage. So,
- Coverages by Pradhan Mantri Jan Arogya Yojana (PM-JAY)
The central government's 5 lakh insurance scheme covers the expenses of surgical procedures, diagnostic tests, high-cost treatment, hospital room charges, maternity benefits, etc.
- Coverages by Health and Wellness Centers
Being another component of the Ayushman Bharat Scheme, like PM-JAY, this medical Scheme provides outpatient services, diagnostic services, essential drug supplies, Maternal and child health services, etc.
- Coverages by Pradhan Mantri Suraksha Bima Yojana (PMSBY)
This scheme covers all the charges from hospital rooms to medicine, diagnostic tests, surgeries, fees, etc. Only accessible to people and their families experiencing death or disability due to accidental causes.
- Coverages by Central Government Health Scheme (CGHS)
The CGHS, one of the most famous Health schemes, covers the patient’s outpatient services like diagnostic tests, medicine, hospitalisation, hospitalisation, surgery, medicine, diagnostic tests, emergency services, maternity benefits, surgical procedures, etc.
- Coverages by Employee State Insurance Scheme (ESIS)
Then, for the working individual, the ESIS covers hospitalisation fees, minor treatment, prescription drugs, diagnostic tests, emergency medical care, surgical procedures, cash benefits, etc.
FAQs
Ques 1. Who is eligible for the central government's 5 lakh insurance scheme?
Ans. The Ayushman Bharat - PMJAY scheme covers low-income families based on the SECC 2011 data. So, this medical Scheme is exclusively for economically weaker sections.
Ques 2. How do you get 5 lakh rupees of health insurance from the government?
Ans. Check eligibility on the PM-JAY website or local CSCs, apply for an Ayushman Bharat card, and receive coverage upon verification.
Ques 3. Is 5 lakh health insurance on bank deposits?
Ans. No, the ₹5 lakh insurance is health coverage, not related to bank deposits or savings. The medical expenses will be handled directly by the insurance provider and the medical organisation.
Ques 4. Is the Ayushman Bharat card and Scheme free of cost?
Ans. Yes, the Ayushman Bharat scheme and card are free for eligible beneficiaries, with no application or coverage charges.
