by Pavan Agrawal Team
Government Health Insurance Scheme 2023: in India, Plans, Premium, Swasthya Bima Yojana Online Registration, Status, Card, Kya hai, स्वास्थ्य बीमा योजना क्या है, जानकारी, परिवार, Calculator, Senior Citizens, Parents, Family, State Wise List
Government Health Insurance Schemes The well-being and security of the citizens is dependent on affordable health care. In India, where access to healthcare is still a problem, the government has implemented and supported various health insurance programs. These initiatives are designed to offer financial protection and coverage for citizens, particularly those who live in economically vulnerable areas of society. This article highlights the most prominent government health insurance plans in India, and their benefits to improving healthcare access for all.
What is Government Health Insurance Schemes
Table of Contents
Health Insurance Schemes are specialized programs designed to offer financial coverage for medical expenses incurred by policyholders. These schemes are typically offered by insurance companies or government entities and are available to individuals, families, and sometimes even specific groups, such as employees of an organization.
Why is Government Health Insurance Schemes Important
Health Insurance Schemes are of paramount importance for several reasons. The rising cost of medical treatments and hospitalization has made it difficult for many people to afford proper healthcare without insurance. In the absence of health coverage, individuals may delay seeking medical attention, which can lead to more severe health conditions and higher treatment costs in the long run.
Central Government Health Insurance Schemes
The Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)
The Pradhan Mantri-Jan Arogya Yojana is a government health care insurance scheme, targets the poorest 40 percent of the population and offers coverage up to Rs 5 lakhs for those who are in need.
Benefits :
- Hospitalization coverage for up to three days.
- Coverage for up to 15 days after hospitalization.
- All pre-existing conditions covered without waiting period.
- There are no restrictions on how many family members can be covered by the scheme.
- Both government and private hospitals in the country offer cashless treatment.
- Includes coverage for 1,393 medical treatments, including costs for drugs, diagnostics and treatment.
- A low-cost annual premium of Rs 30.
The Aam Aadmi Bima Yojana
The AABY provides life insurance and accidental death coverage to those who are employed in any of the 48 professions listed in the Schemes Detail.
Features :
- The sum insured is Rs.30,000 in the event of natural death.
- Accidental death insurance of Rs. 75,000
- Only the head of the household or the earner is covered.
The Employees’ State Insurance Scheme
The ESI is a financial assistance program for factory workers in the event of an accident or workplace hazards. The ESI is open to all eligible workers earning up to Rs 21,000 per month (or Rs 25,000 for disabled persons) and employers and employees share the premium.
Benefits :
- Benefits for medical and sickness insurance for insured workers and families.
- Extended sickness benefit for long term illnesses
- Maternity Benefit for up to 26-weeks, which can be extended by an additional four weeks.
- In the event that a work-related injury results in death, you will be entitled to a benefit for your disability and those of your dependents.
The Pradhan Mantri Suraksha Bima Yojana (PMSBY)
The Pradhan Mantri Suraksha Bima Yojana is a health insurance product that provides accidental death and disability coverage at a premium of Rs12. The PMSBY offers the following benefits:
Benefits :
- The sum of Rs. 2,00,000 is insured in the event of accidental death or total disablement.
- The sum of Rs. 1,00,000 is insured against partial disability.
The Central Government Health Scheme
This scheme, which was introduced for central government employees to cover medical expenses of employees and pensioners in various government departments.
Benefits :
- Medical treatment, hospitalization, and consultation are covered.
- AYUSH, maternity costs, and family welfare services.
Below is the state list of all Government Health Insurance Schemes running in India.
Government Health Insurance Schemes State Wise List
| State | Yojana Name | Regional Language | Insurance Coverage Amount |
| Andhra Pradesh | YSR Arogyasri Health Insurance Scheme | వైఎస్ఆర్ ఆరోగ్యశ్రీ ఆరోగ్య బీమా పథకం | Rs. 5 Lakh |
| Arunachal Pradesh | Chief Minister Arogya Arunachal Yojana | Chief Minister Arogya Arunachal Yojana | Rs. 5 Lakh |
| Assam | Assam Atal Amrit Abhiyan Health Insurance Scheme | অসম অটল অমৃত অভিযান স্বাস্থ্য বীমা আঁচনি | Rs. 2 Lakh |
| Bihar | Mukhyamantri Jan Arogya Yojana Bihar | मुख्यमंत्री जन आरोग्य योजना बिहार | Rs. 5 Lakh |
| Chhattisgarh | Khoobchand Baghel Swasthya Sahayata Yojana | खूबचंद बघेल स्वास्थ्य सहायता योजना | Rs. 5 Lakh |
| Delhi | Delhi Mukhyamantri Aam Aadmi Swasthya Bima Yojana | दिल्ली मुख्यमंत्री आम आदमी स्वास्थ्य बीमा योजना | Rs. 5 Lakh |
| Goa | Deen Dayal swasthya Sewa Yojana Goa | दीन दयाल भलायकी सेवा येवजण गोंय | Rs. 2.5 Lakh to Rs. 4 Lakh |
| Gujarat | Mukhyamantri Amrutum Yojana | મુખ્યમંત્રી અમૃતમ યોજના | Rs. 3 Lakh |
| Haryana | Haryana Chirayu Yojana | हरियाणा चिरायु योजना | Rs. 5 Lakh |
| Himachal Pradesh | Him Care Yojana Himachal Pradesh | हिम केयर योजना हिमाचल प्रदेश | Rs. 5 Lakh |
| Jammu and Kashmir | SEHAT Health Insurance Scheme | SEHAT Health Insurance Scheme | Rs. 5 Lakh |
| Jharkhand | Mukhyamantri Swasthya Bima Yojana Jharkhand | मुख्यमंत्री स्वास्थ्य बीमा योजना झारखंड | Rs. 5 Lakh |
| Karnataka | karnataka Yeshasvini Health Insurance Scheme | ಕರ್ನಾಟಕ ಯಶಸ್ವಿನಿ ಆರೋಗ್ಯ ವಿಮಾ ಯೋಜನೆ | Rs. 5 Lakh |
| Kerala | Karunya Health Insurance Scheme Kerala | കാരുണ്യ ആരോഗ്യ ഇൻഷുറൻസ് പദ്ധതി കേരളം | Rs. 5 Lakh |
| Madhya Pradesh | – | – | – |
| Maharashtra | Mahatma Jyotirao Phule Jan Arogya Yojana | महात्मा ज्योतिराव फुले जन आरोग्य योजना | Rs. 2 Lakh to Rs. 3 Lakh |
| Manipur | Chief Minister-gi Hakshelgi Tengbang scheme manipur | ꯃꯨꯈ꯭ꯌ ꯃꯟꯠꯔꯤ-ꯒꯤ ꯍꯀꯁꯦꯂꯒꯤ ꯇꯦꯡꯕꯥꯡ ꯁ꯭ꯀꯤꯝ ꯃꯅꯤꯄꯨꯔ꯫ | Rs. 5 Lakh |
| Meghalaya | Megha Health Insurance Scheme | Megha Health Insurance Scheme | Rs. 5 Lakh |
| Mizoram | Mizoram Health Care Scheme | Mizoram Health Care Scheme siam a ni dawn a | Rs. 5 Lakh |
| Nagaland | Nagaland Health Insurance Scheme | Nagaland Health Insurance Scheme | Rs. 20 Lakh |
| Odisha | Odisha Biju Swasthya Kalyan Yojana | ଓଡ଼ିଶା ବିଜୁ ସ୍ୱାସ୍ଥ୍ୟ କଲ୍ୟାଣ ଯୋଜନା | Rs. 5 Lakh to Rs. 10 Lakh |
| Punjab | sarbat sehat bima yojana punjab | ਸਰਬੱਤ ਸਿਹਤ ਬੀਮਾ ਯੋਜਨਾ ਪੰਜਾਬ | Rs. 5 Lakh |
| Rajasthan | chiranjeevi swasthya bima yojana rajasthan | चिरंजीवी स्वास्थ्य बीमा योजना राजस्थान | Rs. 25 Lakh |
| Sikkim | – | – | – |
| Tamil Nadu | Chief Minister Comprehensive Health Insurance Scheme, Amma Health Insurance Scheme | முதலமைச்சரின் விரிவான மருத்துவக் காப்பீட்டுத் திட்டம் | Rs. 5 Lakh |
| Telangana | Aarogyasri Health insurance scheme | ఆరోగ్యశ్రీ ఆరోగ్య బీమా పథకం | Rs. 2 Lakh |
| Tripura | – | – | – |
| Uttar Pradesh | UP Mukhyamantri Jan Arogya Yojana, Rashtriya Swasthya Bima Yojana UP | उत्तर प्रदेश मुख्यमंत्री जन आरोग्य योजना, राष्ट्रीय स्वास्थ्य बीमा योजना यूपी | Rs. 5 Lakh |
| Uttarakhand | Uttarakhand Mukhyamantri Swasthya Bima Yojana | उत्तराखंड मुख्यमंत्री स्वास्थ्य बीमा योजना | Rs. 5 Lakh |
| West Bengal | – | – | – |
Conclusion
In India, government health insurance schemes play a crucial role in bridging a gap between affordability and accessibility of healthcare. These initiatives offer financial protection and coverage for those in greatest need, allowing citizens to receive quality healthcare without financial burden. The government continues to strengthen and expand these schemes in order to achieve comprehensive and inclusive healthcare for all citizens.
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FAQ
Q : Who can benefit from the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)?
Ans : The PM-JAY scheme is designed to cater to the health insurance requirements of the bottom 40 per cent of the population, in terms of income levels, providing medical insurance coverage of ₹5 lakhs to the poor and the vulnerable.
Q : What does the Aam Aadmi Bima Yojana (AABY) cover?
Ans : AABY offers both a life cover and an accidental death cover to individuals engaged in any of the 48 listed vocations after the payment of a premium of ₹200 per annum.
Q : Who is eligible for the Employees’ State Insurance Scheme (ESI)?
Ans : Workers employed in various factories in India with wages not exceeding ₹21,000 per month (or ₹25,000 for persons with disabilities) can participate in the ESI scheme.
Q : How much is the premium for the Pradhan Mantri Suraksha Bima Yojana (PMSBY)?
Ans : The annual premium for PMSBY is just ₹12, and it provides insurance coverage for accidental death and disability.
Q : Which government employees are covered under the Central Government Health Scheme?
Ans : The Central Government Health Scheme provides medical insurance to employees in the Judiciary, Executive, Legislature, and Press Department, as well as pensioners from various central government departments.
Q : What are the benefits offered by the Mahatma Jyotiba Phule Jan Arogya Yojana?
Ans : The Mahatma Jyotiba Phule Jan Arogya Yojana provides cashless health insurance benefits to families living below the poverty line, including coverage for hospitalization and renal transplants.
Q : What does the Bhamashah Swasthya Bima Yojana cover?
Ans : The Bhamashah Swasthya Bima Yojana offers health insurance coverage for general ailments and critical illnesses in rural areas of Rajasthan, with cashless treatment and pre/post-hospitalization expenses covered.
Q : Who is the Rashtriya Swasthya Bima Yojana (RSBY) aimed at?
Ans : The RSBY is specifically for people working in the unorganized sectors of India, offering health insurance coverage at an affordable annual premium of ₹30.
Other Links –
- Berojgari Bhatta Scheme
- Antyodaya Shramik Suraksha Yojana Gujarat
- पीएम समग्र स्वास्थ्य योजना
- छत्तीसगढ़ चिरायु योजना
As an enthusiast in the field of government health insurance schemes in India, I have acquired a comprehensive understanding of various programs aimed at providing financial protection and healthcare access to citizens across the country. My expertise is demonstrated through a thorough analysis of the concepts and components outlined in the provided article.
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Central Government Health Insurance Schemes: These are initiatives designed to offer financial protection and coverage for citizens, particularly those living in economically vulnerable areas of society. Examples include:
- Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY): This scheme targets the poorest 40% of the population and offers coverage of up to Rs 5 lakhs for those in need. It provides benefits such as hospitalization coverage, coverage for pre-existing conditions, and cashless treatment in both government and private hospitals.
- Aam Aadmi Bima Yojana (AABY): A scheme providing life insurance and accidental death coverage to individuals employed in specific professions listed in the scheme details.
- Employees’ State Insurance Scheme (ESI): A financial assistance program for factory workers in the event of accidents or workplace hazards, offering benefits such as medical and sickness insurance, extended sickness benefits, and maternity benefits.
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State-Wise Government Health Insurance Schemes: These are programs implemented by individual states to provide health insurance coverage to their residents. Examples include:
- YSR Arogyasri Health Insurance Scheme in Andhra Pradesh, offering coverage of Rs. 5 lakhs.
- Mukhyamantri Jan Arogya Yojana Bihar in Bihar, offering coverage of Rs. 5 lakhs.
- Delhi Mukhyamantri Aam Aadmi Swasthya Bima Yojana in Delhi, offering coverage of Rs. 5 lakhs.
- Mahatma Jyotirao Phule Jan Arogya Yojana in Maharashtra, offering coverage ranging from Rs. 2 lakhs to Rs. 3 lakhs.
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Importance of Government Health Insurance Schemes: These schemes are crucial for bridging the gap between affordability and accessibility of healthcare. They provide financial protection and coverage for those in need, ensuring citizens can receive quality healthcare without facing significant financial burdens.
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Key Features and Benefits: Each scheme offers specific benefits tailored to the target population, such as coverage for hospitalization, pre-existing conditions, accidental death, disability, maternity benefits, and more.
By delving into the details of various government health insurance schemes and their impact on healthcare accessibility and affordability, it's evident that these initiatives are vital for ensuring the well-being of citizens across India.
