Individual Insurance

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The government health insurance schemes in India are medical insurance plans, which are affordable and can be accessed across all states and the rural regions in the country. In this article, we will discuss the 17 important Types of government health insurance schemes to consider which are usually offered on an annual basis.

Various Government Health Insurance Schemes in India

1. Pradhan Mantri Jan Arogya Yojana (PM-JAY) under Ayushman Bharat

Ayushman Bharat is a flagship scheme of the Government of India initiated to achieve the vision of Universal Health Coverage(UHC). It comprises two interrelated components- Health and Wellness Centers (HWCs) and Pradhan Mantri Jan Arogya Yojana (PM-JAY). The Government announced the creation of 1,50,000 HWCs by transforming the existing subcenters and primary health centers. Under the PM-JAY scheme launched on 23rd September 2018 by Shri Narendra Modi, each household can claim medical insurance coverage of up to Rs. 5 lakhs per family on an annual basis by paying Rs. 30 as a premium. This is considered one of the best mediclaim policy for family. 

2. Awaz Health Insurance Scheme

The scheme was launched by the Government of Kerala in 2017 to provide health insurance to 5 lakh inter-state migrant workers. Individuals aged between 18 to 60 years are eligible to be covered under this mediclaim policy scheme and can claim up to Rs. 15,000 as medical expenses (mediclain policy). Moreover, Rs. 2 lakhs as the death benefit amount.

3. Bhamashah Swasthya Bima Yojana

This was initiated to offer insurance coverage to the rural people of Rajasthan. Rashtriya Swasthya Bima Yojana and National Food Security Act beneficiaries are also eligible for this insurance policy. Beneficiaries can get up to Rs. 3 lakhs for critical ailments and Rs. 30,000 for illness. Furthermore, this scheme has no upper limit when it comes to the policyholder’s age.

4. Central Government Health Scheme (CGHS)

Reserved for central government employees such as Supreme Court judges, pensioners, etc. to offer hospitalization and domiciliary treatment benefits. It covers the entire range of medical systems such as homeopathy, ayurveda, allopathy, Unani, yoga etc. This scheme is active for 6 decades and is available in 71 cities and also expect to add more cities to the list.

5. Chief Minister’s Comprehensive Insurance Scheme

Initiated by the Government of Tamil Nadu in association with United India Insurance Company Ltd. to offer family health Insurance plan to the economically marginalized citizens of the state. Individuals earning less than Rs. 75,000 annually are eligible for this scheme and can claim up to Rs. 5 lakh per annum as hospitalization expenses at government and private facilities.

6. Karunya Health Scheme

Initiated by the Government of Kerala in 2012 and provides critical illnesses cover such as Cancer, kidney ailments, heart-related, etc to the economically weaker sections of the society. The beneficiaries need to pay a nominal premium and get coverage of Rs. 5 lakh. Aadhar Card and Income Certificate are mandatory to apply for this scheme.

7. Mahatma Jyotiba Phule Jan Arogya Yojana

Rajeev Gandhi Jeevandayee Aarogya Yojana was renamed Mahatma Jyotiba Phule Jan Aarogya Yojana in 2017 and was launched by the Government of Maharashtra to provide health coverage to individuals who are below the poverty line. The beneficiaries further claim the maximum coverage of Rs. 1.5 lakh for medical expenses.

8. Employee’s State Insurance Scheme

This applies to factory workers to reduce the ailments and deaths in factories across the country.  Earlier, it was only applicable in the state of Kanpur and Delhi, but it got upgraded in the year 2015 and now it is extended to over 7 lakh factories in India.

9. Pradhan Mantri Suruksha Bima Yojana

Launched by the Central Government to offer accidental and disability benefits to the policyholders. One must be between 18 to 70 years of age and possess a savings account in any bank for eligibility for this scheme. Furthermore, under this health Insurance policy Individuals suffering from partial disability can claim up to Rs. 1 lakh, while Rs. 2 lakh for those suffering from total disability or death for a premium of Rs.12 yearly.

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

The Andhra Pradesh Government along with Dr YSR Aarogyasri Trust has come up with four beneficial welfare schemes. These are as follows:-

  • Dr YSR Aarogyasri-This is dedicated to the welfare of poor people. The scheme benefits the holders of Dr YSR Aarogyasri Cards with an annual income of less than 5 lakh rupees where the government bears the entire medical expense once the hospital bill crosses ₹1000.
  • Aarogya Raksha-To benefit people above the poverty line.
  • Working Journalist Health Scheme- For journalists and offer cashless treatment.
  • Employee Health Scheme-For the benefit of the State government employees.

11. West Bengal Health Scheme

West Bengal launched this scheme in 2008 to provide insurance coverage to state government employees and also to pensioners. Finally, In 2014, this scheme got updated and was called West Bengal Health for All Employees and Pensioners. The employee and family members can get insured for up to Rs. 1 lakh.

12. Universal Health Insurance Scheme

This covers the individual below the poverty line between the ages of 5 and 70 years including the expenses of accidental disability, and also hospitalization of up to Rs. 15,000, excluding maternity costs. Furthermore, This scheme offers individual and group health insurance too and its premium varies according to the size of the family.

13. Yeshasvini Health Insurance Scheme

Promoted by the Karnataka State Government and is meant for the farmers and peasants associated with cooperative society. More than 800 procedures are covered in this insurance policy and the benefits are also extended to the family members of the main beneficiary. 

14. Pradhan Mantri Atmanirbhar Swasth Bharat Yojana (PMASBY)

It aims to create an IT-enabled disease surveillance network to bridge the gap in public healthcare facilities. This scheme will support about 17,788 existing rural health and wellness centers and set up 11,024 centers in urban areas as well.

15. Telangana State Government – Employees and journalists Health Scheme

Launched to serve government employees, journalists, pensioners, and dependent family members equally. The highlight of this scheme is it provides cashless treatment to the beneficiaries as per the terms and conditions.

16. Rashtriya Swasthya Bima Yojana

This scheme started on 1st April 2008 and was controlled by the Ministry of Labor & Employment. On 1st April 2015, it came under the Ministry of Health and Family Welfare to provide medical coverage belonging to the below-poverty line laborers, and other individuals in unorganized sectors. Moreover, The beneficiaries are provided with insurance coverage of up to Rs. 30,000 per annum on a floater basis which, as a family health insurance policy, in addition to the five members of the family.

17. Aam Aadmi Bima Yojana

This plan launched on 2nd October 2017 as a social security scheme targeted towards low-income families in India. Managed through Life Insurance Corporation of India, it provides death and disability cover to persons across 48 identified vocational/ occupational groups/unorganized workers/rural landless households. insurance plan covers death due to natural causes or due to an accident, and also partial or permanent total disability.

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