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HEALTH INSURANCE

India's Top Government Health Insurance Schemes

Rohit Sapra Rohit Sapra 14 November 2019

A Health insurance policy is more of a necessity than a luxury. As it has become a crucial part of our lives, the government of India has also introduced a number of health insurance schemes for different sections of the society. Read on to know the top government health insurance schemes and how you can benefit from the same.

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In India, health care costs are constantly rising. There is no doubt that people must have a health insurance plan that secures them from the financial burden in case of a medical emergency. Hence, affordable health insurance coverage that offers quality health care must be made available to people. However, many people find health insurance to be an expensive affair. Therefore, to ensure that everyone benefits, the government of India has introduced several Government Health Insurance Schemes for the utmost benefit of the citizens.

Let’s check out different health insurance schemes offered by the government and its benefits.

Rashtriya Swasthiya Bima Yojana : RSBY scheme has been launched by the Ministry of Labour and Employment, Government of India to offer health insurance schemes to below Poverty Line society of the nation. The beneficiary under this scheme is entitled to hospitalisation expenses up to Rs. 30,000 for illnesses that require hospitalisation. Under RSBY scheme, pre-existing ailments are covered from the start of the policy, and there is no age limit to avail the scheme. You can buy a cover for self, spouse and up to three dependents. The registration fee for the beneficiary is Rs. 30, and the State and Central Government pays the premium.

Employee State Insurance Scheme : Employee State Insurance Scheme is designed to protect the worker population and their dependents. Under this scheme, the beneficiaries are given several cash benefits in case of physical distress due to illness, temporary or permanent disablement. Employee State Insurance Scheme is valid for non-seasonal factory employees, provided the employer has more than 10 employees. The scheme is also applicable to shops, hotels, cinemas, restaurants, road-motor transport enterprises, newspaper establishment employing more than 20 people. The scheme is implemented area-wise in all the states of the country except Sikkim, Mizoram, Manipur, Arunachal Pradesh and Union Territories.

Central Government Health Scheme : The Central Government Health Insurance Scheme (CGHS) is designed to provide comprehensive medical coverage to Central Government employees and their dependents living in the CGHS covered areas. The health care facilities are provided through Allopathic, Yoga, Ayurveda, Sidha, Unani and Homeopathic system of medicine.

Features and benefits of CGHS

  • Domiciliary service
  • Dispensary care
  • Consultation with a specialist at dispensary, hospital and polyclinic
  • Medical tests including x-ray, ECG, and other laboratory tests
  • Hospitalisation cover
  • Medicines requirements
  • Heath education

Aam Aadmi Bima Yojana : The Aam Aadmi Bima Yojana is a social security health scheme for rural, landless households. The scheme was launched on 2nd October 2007. Under this scheme, the head of the family or the breadwinner of the family is covered. The premium for this scheme is Rs. 200, which is paid by the state and central government. The minimum entry age to avail this scheme is 18 years, whereas the maximum age is 59 years.

Features and benefits

  • Aam Aadmi Bima Yojana (AABY) has been set up by the Central Government of India and the contribution made by the government is maintained by the LIC India.
  • The scheme offers an add-on benefit in the form of a scholarship to children of the insured.
  • It gives compensation of Rs. 30,000 in case of natural death of the insured.
  • The scheme gives the compensation of Rs. 75,000 in case of accidental death, total partial or permanent disabilities which covers loss of 2 limbs or 2 eyes.
  • The scheme gives compensation of Rs. 37,500 in case of partial permanent disabilities resulting due to an accident which covers one limb or one eye.

Janashree Bima Yojana: The Government of India launched Janashree Bima Yojana in August 2000. The members of the specific 45 professional groups between the age of 18 and 59 years can get covered under this scheme.

Ayushman Bharat – National Health Protection Mission: The Ayushman Bharat is a national health protection scheme which will cover approximately 10 crore Below Poverty Line families. The scheme provides health cover up to Rs. 5 lakhs per family per year for secondary and tertiary medical care. This health insurance scheme introduced by the government is subsuming the schemes that are in progress and are sponsored by the central government such as Rashtriya Swasthya Bima Yojana and Senior Citizen Health Insurance Scheme.

The primary objective of this scheme is to cooperate flexibility and healthcare system to the states. In order to implement this health insurance scheme, the states would require to have the SHA (State Health Agency).

Features and benefits

  • The benefits offered under this scheme are portable across the nation.
  • The beneficiary can avail cashless benefits from any public or private network hospitals across the country.
  • The scheme offers paperless and cashless transactions.
  • The scheme aims to provide increased benefit cover to over 40% population of the country.
  • The scheme aims to target 10.74 crore poor, vulnerable, deprived rural families and specified occupational categories of urban workers' families.

Universal Health Insurance Scheme:

  • The Universal Health Insurance Scheme is introduced by four public insurance companies to provide health insurance cover to needy families.
  • Under this scheme, the sum assured is limited to Rs. 30,000 on family floater basis for hospitalisation expenses. The scheme also offers accidental health cover of Rs. 25,000 to the policyholder and a compensation of Rs. 50 on a daily basis, in case there is a loss of income.
  • The premium stands at Rs. 200 for an individual policyholder, Rs. 300 for a family of five members, and Rs. 400 for a family of seven members.

The government health insurance schemes offer financial protection to the insurer, spouse, children and family members in case of an eventuality. A health insurance policy is a significant addition that everyone must add to their financial portfolio. To make this possible for each section of the country and achieve the objective of better health care facilities, the government has launched such schemes.

As a responsible citizen, let’s aim to communicate the above-mentioned government health insurance schemes to the needy section of the society. This will not only help them avail health care benefits offered by the government, but also take a step forward to make our nation healthier.

Rohit Sapra
Written by Rohit Sapra
Rohit Sapra, a licentiate, and currently an SME, is a seasoned insurance professional with previous work experience from Kotak and Birla Sun Life Insurance.
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