The health of a nation is a major milestone of a country, every country implements health schemes to save the pole life and give them the best health care. Likewise, India has many health care schemes for BPL families and other people. The individuals who are aware of the health care scheme are on good terms now, but those who are not aware suffer from basic health services. The needy people of India are getting free OPD, free treatment, and free medicines in govt or private hospitals. Today we will elaborate on this govt health insurance scheme that can change the lives of poor families in India.
Govt Health Schemes
The government-backed schemes can come into categories either they are associated with the funds of the central govt or with the funds of the state govt. Individuals with the help of these schemes will get the best health services in India and the premium for the health insurance scheme is generally low, and easily affordable by a BPL family.
Normal VS Govt Health Insurance Schemes
| Features | Normal Health Insurance | Govt Health Insurance |
| Eligibility For Health Insurance | Any person can apply for regular health insurance plans. | The govt mainly targets the BPL families for Health Insurance. |
| Money Insured | An individual can apply for an insurance of Rs 1 crore | The insurance amount can be up to Rs 5 lakh |
| Premium Value | The amount of premium for private insurance companies starts from Rs 200 per month. | Most of the govt insurance plans have no premium or the premium value is very low like Rs 12 per month or Rs 200 per year. |
| Coverage Range | Normal insurance has a broader coverage range | Govt insurance has a narrow coverage range |
| Private Hospital Room | In private insurance, the private hospitals will provide the rooms | In govt insurance plans, private hospitals are also providing the rooms |
| Buy Policy | Apply for a policy online or offline through agents | Apply for Policy online or by visiting the CSC Centers. |
| Network of Hospitals | The insurance will be given for chosen hospitals, check the list of hospitals included before enrolling for the insurance plan | The govt schemes will be valid for any govt or private hospital |
| Maternity Benefits | Check the features of the plan, is maternity is covered or not. | The govt insurance plans may cover a single-child maternity, check the plan |
| Ambulance Charges | Some private plans do not cover ambulance charges | Ambulance charges will not be applied to the insurance scheme |
| Hospitalization Cover | Yes, you will get the insurance for bedding charges | The bedding charges will be given for 15 days, check the plan, vary from plan to plan |
| Online Renewal | Possible | Possible |
| Cumulative Bonus | The person will get the bonus if the plan is not used | There will be no bonus |
| Health Check-up | In some cases, the OPD charges are given for health checkups | Not insured |
| Monthly Premium Facility | You can check the monthly amount or yearly amount while signing any of the health insurance policy | Not Needed |
| Tax Benefits | You will get the tax benefit | Not available |
Types of Govt Health Insurance Yojanas
1. Pradhan Mantri Suraksha Bima Yojana/PMSBY
PM Suraksha Bima Schmes is for the people who met with an accident. The PMSBY schemes will cover the accident charges for the person. The eligibility for the PMSBY schemes is the age of the person should be between 18 years to 70 years old.
If an individual has an accident and gets permanent disability or death, he will get an insurance amount of Rs 2 Lac. In the other case, if the individual gets partial disability, he will be provided with an insurance amount of Rs 1 Lac. The applicants must have a bank account and the premium amount of Rs 20 per year will be subtracted automatically from the bank account as a premium of the insurance policy.
2. Ayushman Bharat Yojana/ABY
ABY schemes are for the poorer section of the country. In total, 40% of the inhabitants of the country are insured under the ABY schemes. The insurance amount will be Rs 5 lac under ABY schemes. The people below the poverty line that is BPL families will receive free treatment in govt or private hospitals, they do not need to pay medicines bills or bedding charges for up to 15 days.
3. Aam Aadmi Bima Yojana/AABY
AABY scheme is an old scheme renamed in 2013. The people who get the insurance under the AABY scheme must be from the age range of 18 years to 59 years. Mainly the AABY scheme is for rural people or village individuals and for people who come from the villages and live in rented houses in urban areas. The AABY schemes will provide scholarships to the children of the BPL families.
The head of the BPL family is the main insured person of the AABY scheme, the head has to deposit a premium of Rs 200 each year under the AABY scheme. The AABY scheme will give an amount of Rs 30000 for the natural death of the head of the family. The coverage of accidental death under the AABY scheme will be Rs 75000.
4. Central Govt Health Scheme/CGHS
The employees whose work is directly under the center govt will get health insurance during the service and after retirement. The CGHS scheme has been running since 1954. The major cities covered under CGHS schemes are Delhi, Lucknow, Kolkata, Mumbai, Pune, etc. Only Indian citizens can avail the benefits of the CGHS insurance scheme. The National Health Insurance company is looking after the CGHS scheme. A person can be registered for the CGHS schemes online and can renew them online.
The main coverage under CGHS schemes is medicine bills, bedding charges, Lab Tests, X-rays, etc. The individuals are also insured for consultation charges in the CGHS scheme.
5. Employment State Insurance Scheme/ESIS
All of the employees working in India in any organization get insurance through the ESIS Scheme. ESIS Scheme is a multidimensional policy. The individuals will get health security and economic protection with the ESIS Scheme. The individuals can claim the insurance under the ESIS Scheme and the scheme will cover the family of the person.
The good part of the ESIS Scheme is that the insurance will start from the beginning day of the job. The working company of the individual should have more than 10 employees. The company can be a shop, restaurant, hotel, newspaper organization, IT Start-Up company, and similar.
6. Janshree Bima Yojana/JBY
JBY Scheme is for individuals who are in the age group of 18 years to 59 years and fall in the BPL family group. Special coverage is given to women under the SHG groups/ Self Help Groups or Sikha Sahyog Groups under the JBY Scheme. The JBY Scheme supports 45 occupational groups.
7. CM’s Comprehensive Insurance Scheme/CM CIS
CM CIS Scheme is a Tamil Nadu State insurance scheme. The CM CIS Scheme is for poor families. The families of Tamil Nadu state can get the benefit of more than 1000 medical procedures under the CM CIS Scheme. The insurance money and other things of the CM CIS Scheme will be taken care of by UIIC/United India Insurance Company Limited for the CM CIS Scheme.
The insured amount under the CM CIS Scheme will be Rs 5 lacs. An individual with a family income of lower than Rs 75000 can apply for the CM CIS Scheme. The individuals can visit the private hospital or govt hospital for treatment.
8. Universal Health Insurance Scheme/UHIS
The UHIS Scheme will provide the insurance to the BPL families. The scheme will insure each member of the family. The head of the family can claim medical expenses for every member and the UHIS Scheme will cover the sudden death of a person. The UHIS Scheme has the target to give insurance to disabled persons and improve the overall health of the family of the BPL section.
The money under the UHIS Scheme is managed by four insurance companies. The medical claim of Rs 30000 for one family member will be given under the UHIS Scheme. The person admitted to the hospital, will get RS 50 daily up to 15 days for the treatment under the UHIS Scheme.
9. WB Health Scheme
The people who are retired from the service are allowed to apply for the WB Health Scheme. The govt of West Bengal started the scheme in 2008. The individuals who a members of the WB Health scheme will be provided with the amount of Rs 1 lac of any family member. The individual can also claim the OPD charges and surgeries under WB Health Schemes.
10. Yeshasvini Health Insurance Scheme/YHIS
YHIS Insurance Scheme is an initiative of Karnataka govt. The Karnataka govt gives insurance cover to the farmers and the peasants under the YHIS Insurance Scheme. The person who has applied for the YHIS Insurance Scheme can go for the nearly 800 medical procedures under the scheme.
The YHIS Insurance Scheme has ensured the cooperating organizations to be aware of the farmers and peasants for the YHIS Insurance Scheme. They must be registered for the YHIS Insurance Scheme and get medical benefits. The person who has enrolled in the YHIS Insurance Scheme can get insurance for his family.
11. Mahatma Jyotiba Phule Jan Arogya Yojana/MJPJAY
A scheme named MJPJAY scheme is run by the Maharashtra govt. The farmers who lie below the BPL line are the major center of the MJPJAY scheme. The farmer’s family will get insurance of Rs 1.5 lac for the illness mentioned in the MJPJAY scheme. The MJPJAY scheme has zero waiting time. If a person has applied for the MJPJAY scheme, he is eligible to get the insurance form on the day of registration.
12. Mukhyamantri Amrutam Yojana/MAY
MAY Insurance Scheme is a Gujarat State Insurance policy. The Gujarat State has commenced the insurance policy of MAY for the weaker section of the state. All the individuals from the lower middle salary group are eligible for the MAY Insurance Scheme. The person who is head of the family and all other members will get the insurance benefits under the MAY Insurance Scheme. The insurance amount under the MAY Insurance Scheme will be Rs 3 lacs. The person can get the treatment in a private or govt hospital in Gujarat.
13. Karunya Health Scheme/KHS
Kerala govt has started the KHS Scheme for the benefit of Kerala people from any chronic illnesses. The individuals from Kerala are insisted on availing the benefit of free treatment under the KHS Scheme. Illnesses like Cancer, Kidney transplants, etc will be insured under the KHS Scheme. The BPL families who will show income proof along with the Aadhar Card can register for the KHS Scheme. This scheme was started in 2012 in Kerala.
14. Telangana Employees/Journalists Health Scheme/EJHS
EJHS Scheme is especially for the employees and journalists of the Telangana state. The individuals who are in service those who are retired or those who are getting pensions are eligible for the EJHS Scheme. There will be a cashless treatment facility for the people of Telangana. This means no need to worry about money in case of any medical emergency, just visit any hospital in Telangana, private or govt, and you will get the treatment under the EJHS Scheme.
15. Dr. YSR Aarogyasri Health Care Trust/YSR-HCT
YSR-HCT Trust is a trust of Andhra Pradesh. The AP govt runs a health insurance scheme with the collaboration of YSR-HCT Trust. There are four plans for helping the needy people of AP state as mentioned below.
- Dr. YSR-HCT Trust- For BPL families
- Arogya Raksha Plan- For individuals falling above the poverty line
- Working Journalist Health Plan- They will get cashless treatment
- Employee Health Plan- It is for the AP state govt employees.