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We know that nowadays Health is not a luxury, but it has become a necessity….
And hence, the government of India is taking significant steps to create a healthier nation. In 2019, only around 472 million individuals in India had valid medical insurance coverage, which has now increased to 500 million Indians, according to the latest report of 2023.
So, here are 19 important schemes to consider, which have allowed millions of Indians to afford quality medical treatments without fear of financial stress.
As the name implies, a government health insurance scheme is a medical insurance plan that is funded or sponsored by the Government at any level such as federal, state, or local.
India’s healthcare and insurance systems in rural areas are lacking in development, and thus, the national and state governments have introduced and supported several health insurance plans.
These schemes are designed to help low-income families, senior citizens, and people who can't afford private health insurance premiums.
The objectives of regular and government health insurance programs are the same: to keep you covered in an emergency and to make healthcare accessible. Nonetheless, the offerings of both types of policies vary greatly.
Here are some basic differences between a regular health insurance plan and a government health insurance scheme.
India has a number of government health insurance programs that provide access to quality healthcare to different segments of the population. These programs guarantee that medical care must be accessible and affordable to underserved groups.
Here is a list of health schemes in India provided by the Government.
PM-JAY refers to a specialised health insurance policy, which is available to all economically-challenged citizens of India.
One such household can claim medical insurance coverage of up to Rs.5 lakh per year. This plan covers pre-hospitalization bills, prescription drugs, diagnostic fees, and medical care. It is one of the senior citizen health insurance scheme that is covered by the government of India.
Besides this medical coverage, the scheme has also led to the construction of around 1.5 lakh Health and Wellness Centres across the nation.
Number of States and Union Territories Covered:
Andaman and Nicobar Islands | Andhra Pradesh | Arunachal Pradesh | Assam | Bihar |
Chandigarh | Chhattisgarh | DNH and DD | Goa | Gujarat |
Haryana | Himachal Pradesh | Jammu And Kashmir | Jharkhand | Karnataka |
Kerala | Ladakh | Lakshadweep | Madhya Pradesh | Maharashtra |
Manipur | Meghalaya | Mizoram | Nagaland | Puducherry |
Punjab | Rajasthan | Sikkim | Tamil Nadu | Telangana |
Tripura | Uttar Pradesh | Uttarakhand |
Launched by the Kerala government in 2017, this particular insurance policy targets the inter-state labourers in Kerala, who are without medical coverage.
Besides financial assistance during medical emergencies, this scheme also offers a death benefit feature to the policyholder’s family members.
This policy is available to migrant workers who are between the ages of 18 and 60, residing in the state of Kerala. Every policyholder has access to free medical care in state-run facilities for up to Rs. 15,000.
The death benefit feature provides a payout of Rs.2 lakh to surviving family members after the policyholder’s death.
However, this facility is only available to labourers aged between 18 and 60 years. Therefore, senior citizens do not qualify for such coverage.
Bhamashah Swasthya Bima Yojana is a specific initiative to offer healthcare coverage to rural residents of Rajasthan.
One of the policy's features is a Rs. 5 lakh sum guaranteed for medical emergencies and treatments. The fact that female policyholders can use their Bhamashah Swasthya Bima Yojana policy cards to buy rations from approved PDS stores gives them additional benefits.
Another important aspect is that this scheme has no upper limit regarding a policyholder’s age.
In association with the United India Insurance Company, Tamil Nadu offers this impressive family floater medical insurance to the needy public in the state.
The CMCHIS, previously known as Amma Health Insurance, helps low-income families (earning less than 1,20,000/- per annum) afford healthcare by paying for hospital stays, diagnostic tests, and follow-up care.
They can claim hospitalization costs of up to Rs. 5 lakhs, which includes hospitals run by the government and private sector.
Another highly useful health insurance scheme at a nominal price is the Aam Aadmi Bima Yojana or AABY. However, it is only available to individuals engaged in select professions.
The scheme supports 48 different vocations, mostly related to waving, carpentry, fishing and more. Apart from one of the vocations being your profession, the applicant must also be the earning family head.
Policyholders can claim coverage up to Rs.30000 in case of natural death and Rs. 75,000 in case of accidental health from such a plan by paying an annual premium of Rs.200.
Number of States and Union Territories Covered:
Andaman and Nicobar Islands | Andhra Pradesh | Arunachal Pradesh | Assam | Bihar |
Chandigarh | Chhattisgarh | Daman & Diu | Dadra & Nagar Haveli | Delhi |
Goa | Gujarat | Haryana | Himachal Pradesh | Jammu And Kashmir |
Jharkhand | Karnataka | Kerala | Lakshadweep | Madhya Pradesh |
Maharashtra | Manipur | Meghalaya | Mizoram | Nagaland |
Odisha | Puducherry | Punjab | Rajasthan | Sikkim |
Tamil Nadu | Telangana | Tripura | Uttar Pradesh | Uttarakhand |
West Bengal |
Operated by the Central government, this particular insurance plan is aimed to cater to central government employees only.
High ranking employees of Indian Railways, Supreme Court judges and other such important workers under the central government can avail benefits from this plan.
It offers hospitalization benefits, as well as domiciliary treatment coverage. Moreover, you can seek homeopathy and allopathy expenses from such a policy as well.
Presently, CGHS is available in 82 Indian cities, covering more than 42 lakh government employees and pensioners.
Guntur | Nellore | Rajahmundry | Vijayawada | Tirupati |
Vishakhapatnam | Dibrugarh | Guwahati | Silchar | Chhapra |
Darbhanga | Gaya | Muzzafarpur | Patna | Chandigarh |
Raipur | Delhi | Faridabad | Ghaziabad | Greater Noida |
Gurgaon | Indirapuram | Sahibabad | Panaji | Ahmedabad |
Gandhinagar | Sonepat | Shimla | Jammu | Srinagar |
Ranchi | Dhanbad | Bengaluru | Thriuvanthapuram | Bhopal |
Gwalior | Indore | Jabalpur | Mumbai | Nagpur |
Pune | Imphal | Shillong | Aizwal | Kohima |
Bhubaneshwar | Cuttack | Berhampur | Ambala | Amritsar |
Jalandhar | Puducherry | Ajmer | Jaipur | Jodhpur |
Kota | Gangtok | Chennai | Tiruchirapalli | Tirunelveli |
Hyderabad | Agartala | Agra | Aligarh | Prayagraj |
Bareilly | Gorakhpur | Kanpur | Moradabad | Lucknow |
Meerut | Saharanpur | Varanasi | Baghpat | Dehradun |
Kolkata | Jalpaiguri |
Karunya Health Scheme is another popular initiative by the Kerala government, the Karunya medical insurance plan offers critical illness coverage to individuals from the economically weaker sections of society.
It offers coverage for secondary and tertiary care hospitalization in both public and private hospitals, up to Rs. 5 lakhs per family annually. It pays for up to 3 days of pre-hospitalization and 15 days of post-hospitalization costs, including medications and diagnostics.
After India’s freedom, a vast number of people were employed in factories because of the working circumstances. This is when the Employees’ state insurance scheme cam into existence.
It was established in 1952 to provide financial protection for covered workers and employees in the event of illness, incapacity, or death.
While the plan was initially restricted to Kanpur and Delhi factories only, it has since been upgraded to support more than 7 lakh factories across India.
Number of States and Union Territories Covered:
Andaman and Nicobar Islands | Andhra Pradesh | Arunachal Pradesh | Assam | Bihar |
Chandigarh | Chhattisgarh | Daman & Diu | Dadra & Nagar Haveli | Delhi |
Goa | Gujarat | Haryana | Himachal Pradesh | Jammu And Kashmir |
Jharkhand | Karnataka | Kerala | Madhya Pradesh | Maharashtra |
Manipur | Meghalaya | Mizoram | Nagaland | Odisha |
Puducherry | Punjab | Rajasthan | Sikkim | Tamil Nadu |
Telangana | Tripura | Uttar Pradesh | Uttarakhand | West Bengal |
The government of India vowed to increase the number of medically covered individuals in the country. The Pradhan Mantri Suraksha Bima Yojana is a step in this direction, offering accidental death and disability benefits to policyholders.
Individuals suffering from partial disabilities can claim up to Rs.1 lakh from the scheme, while those who suffer from total disability can opt for benefits of up to Rs.2 lakh. In case of sudden death, the individuals are offered Rs. 2 lakh. To receive such coverage, you would have to pay yearly premiums of Rs.20, which is directly debited from the account.
Applicants aged between 18 and 70 years holding a savings account in any bank are eligible to avail scheme-related benefits.
Number of States and Union Territories Covered:
Andaman and Nicobar Islands | Andhra Pradesh | Arunachal Pradesh | Assam | Bihar |
Chandigarh | Chhattisgarh | Daman & Diu | Dadra & Nagar Haveli | Delhi |
Goa | Gujarat | Haryana | Himachal Pradesh | Jammu And Kashmir |
Jharkhand | Karnataka | Kerala | Lakshadweep | Madhya Pradesh |
Maharashtra | Manipur | Meghalaya | Mizoram | Nagaland |
Odisha | Puducherry | Punjab | Rajasthan | Sikkim |
Tamil Nadu | Telangana | Tripura | Uttar Pradesh | Uttarakhand |
West Bengal |
The Maharashtra government launched the Mahatma Jyotiba Phule Jan Arogya Yojana medical insurance plan for individuals below the poverty line.
However, only select district residents of Maharashtra can apply. The main objective is to give lower-class patients access to high-quality healthcare and cashless medical facilities.
The program provides health coverage of Rs. 1.5 lakh to 5 lakh per family year for treatment that necessitates hospitalization.
The government launched this scheme for those who are unable to pay standard health insurance plans and seeks to guarantee access to medical care.
It offers coverage of up to Rs. 5 lakhs annually per family, and policyholders can receive cashless treatment at government hospitals by showing their health cards.
This scheme is an umbrella plan that includes different kinds of policies for Andhra Pradesh residents:
Know More about: Dr YSR Aarogyasri Health Care Trust Andhra Pradesh State Government
Mukhyamantri Amrutum Yojana is specific scheme which was launched in 2012 as part of a Gujarat government initiative. It aims to assist the state’s citizens belonging to the lower middle class and those below the poverty line.
All policyholders receive an amount insured of Rs. 3 lakh as a part of the family floater policy. However, in the event of specialized treatments, such as a kidney, liver, or pancreas transplant, the sum insured rises to Rs. 5 lakhs.
Labourers and those individuals working in the unorganized sector often lack any health insurance coverage. However, like others, these people also face sickness and accidents. Thus, the need for medical coverage is just as pronounced for them as it is for others.
The Ministry of Labour and Employment of the Indian Government launched the Rashtriya Swasthya Bima Yojana, offering a coverage of Rs. 30,000 per family in a year on a family floater basis by paying a premium of just Rs. 30 per annum. However, only 5 family members are covered under this yojana.
Number of States and Union Territories Covered:
Assam | Bihar | Chandigarh | Chhattisgarh | Gujarat |
Haryana | Himachal Pradesh | Jharkhand | Karnataka | Kerala |
Madhya Pradesh | Manipur | Meghalaya | Mizoram | Nagaland |
Odisha | Pondicherry | Punjab | Rajasthan | Tripura |
Uttar Pradesh | Uttarakhand | West Bengal |
In 2008, the West Bengal government introduced the West Bengal Health Scheme for its workers and pensioners. It was renamed in 2014 as “West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme 2014”.
It offers a sum insured of Rs. 2 lakh to the employee and his/her family members. The plan supports surgery costs and OPD treatments in certain cases.
Another vital point to remember is that apart from present employees, this plan also has provisions similar to those of pensioners.
This is one of the most affordable government health insurance schemes backed by the Indian government. Applicants aged between 5 and 70 years can opt for such coverage.
Also, individuals who can be categorized as below the poverty line can avail its benefits after submitting the necessary documents.
Hospitalization, accidental disability and more are covered under this policy. However, the policy premium depends on the size of your family and the number of covered individuals.
Know More about: Universal Health Insurance Scheme
The Karnataka State Government promotes the Yeshasvini Health Insurance Scheme. It is intended for peasants and farmers who are part of cooperative societies.
This insurance package covers approximately 800 treatments, including angioplasty, neurology, and orthopedics.
However, beneficiaries need to visit network medical facilities only to seek the necessary financial assistance during treatment.
The Telangana state government offers comprehensive medical coverage to its employees and journalists. Besides existing employees, this policy covers retired or ex-employees as well.
Cashless treatment is the primary advantage of this scheme, enabling policyholders to seek treatment without facing financial shortcomings.
Government health insurance schemes in India are desirable primarily because they are available at a fraction of the cost of typical plans.
The above-listed options are some of the most popular government-backed medical coverage facilities available to people, who cannot afford one otherwise.
The Andhra Pradesh government used a novel approach to introduce the Rajiv Aarogyasri Community Health Insurance Scheme (RACHI), one of the most well-known government health insurance programs.
The Trust aims to give low-income individuals who cannot afford health insurance access to medical coverage. Under the Aarogyasri Health Insurance Scheme, any household with a yearly income of INR 5 lakh or less is eligible for coverage.
The recipients receive health cards, which they can use to receive cashless care at any network hospital.
To give all government employees access to healthcare, the Karnataka government created the Jyothi Sanjeevini Scheme (JSS). Employees will need to register with the Arogya Suraksha Trust in order to participate in the initiative.
The goal of this scheme is offering state government employees and their families cashless healthcare services. This plan provides coverage for catastrophic illnesses needing tertiary care up to Rs. 1.5 lakh annually.
Yes! You can buy certain government health insurance schemes online in India. Wondering How? So, there are a few platforms that make the process of getting a Government health insurance scheme easier. It includes:
Different government health insurance schemes in India require different documents. Here are general documents that are typically required for government health insurance.
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