Top 7 Govt Health Insurance Schemes in India

Health insurance schemes in India are designed to provide financial protection to individuals and families from unexpected medical costs. In India, there are several government health insurance schemes that provide coverage to people from all walks of life, including the poor and the elderly. For the benefit of its people, the government of India launched public health insurance schemes. These programmes enable people to obtain the benefits of medical insurance at a low cost.

This blog will discuss the top 7 government health insurance schemes in India that are available to citizens.

1. Rashtriya Swasthya Bima Yojana (RSBY)

RSBY is a government-backed healthcare insurance scheme that provides financial protection to unorganised sector workers, poor families, and below poverty line (BPL) households. The scheme provides coverage of up to  ₹30,000 per family annually for hospitalisation expenses, including pre and post-hospitalisation expenses. The premium for the scheme is subsidised by the government, making it more affordable for the target population.

2. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)

AB-PMJAY is a government-backed health scheme that annually provides up to ₹5 lakhs in health coverage per family for secondary and tertiary care hospital treatment. The scheme covers the cost of hospitalisation for serious illnesses, such as cancer, heart disease, kidney failure, etc. PMJAY was established to provide free healthcare services to more than 40% of the country's population.

3. Employment State Insurance Scheme

Employment State Insurance Scheme is a multifaceted national healthcare scheme because it provides social security as well as socioeconomic protection to all Indian workers. Furthermore, it provides the same benefits to those who rely on workers protected under this scheme. Every worker's insurance coverage begins on the first day of insurable employment. They are provided with comprehensive medical insurance for themselves and their families.

4. Pradhan Mantri Suraksha Bima Yojana (PMSBY)

PMSBY is a government-backed medical insurance scheme that provides annual life insurance coverage of up to ₹2 lakhs to people aged 18-70 years. The scheme is designed to provide financial protection to individuals and families in the event of death or disability due to accidents. The scheme also provides personal accident cover of up to  ₹1 lakh for accidental death and disability.

5. Universal Health Insurance Scheme (UHIS)

PMJJBY was put in place to assist families living below the poverty line. It pays for the medical expenses of every member of the family. A cover is provided in the event of death as a result of an accident. The primary drivers of this scheme are four public sector general insurance companies that have been working to improve healthcare for the underprivileged and especially the economically disabled citizens of India.

6. Central Government Health Scheme (CGHS)

CGHS is a government-sponsored health scheme that provides health coverage to government employees and their dependents. The scheme provides coverage for hospitalisation expenses, including pre and post-hospitalisation expenses. The scheme also covers the cost of medicines, medical tests, and diagnostic tests.

7. Aam Aadmi Bima Yojana (AABY)

This is one of the most recent healthcare insurance schemes, having been established in October of 2007. It primarily applies to people between the ages of 18 and 59. The AABY insurance scheme is designed for all citizens who live in the upcountry and in rural areas. It also includes landless citizens who are tenants who live in both urban and rural areas. It also includes providing scholarships to deserving children.

Wrapping Up

Government health insurance programmes are intended to protect individuals and families from unforeseen medical costs. These schemes provide coverage for hospitalisation expenses, pre and post-hospitalisation expenses, as well as medical tests and medicines. Thus, these schemes are a great way for individuals and families to protect themselves from unexpected medical costs. You can buy these plans from private insurance platforms also. Insurers like Niva Bupa can help you find the best-suited medical insurance plan for yourself that fits your budget.

FAQ

1. How can I check if I am eligible for government health schemes in India?

You can check your eligibility by:

• Visiting the official website of the scheme
• Entering your mobile number, Aadhaar number, or ration card details
• Using the State Health Agency portal for regional schemes
  Eligibility is usually based on income level, socio-economic criteria (SECC data), and category (e.g., BPL, rural households, etc.).
  
   

2. What is the process to apply for government health insurance online?

Here is a general process:

1. Visit the scheme’s official portal (e.g., PM-JAY, Ayushman Bharat, or state-specific sites).
2. Register using your Aadhaar number or mobile number.
3. Fill in the application form with personal and family details.
4. Upload required documents.
5. Submit the form and wait for verification and approval.
   Once approved, you’ll receive a beneficiary ID or e-card for availing services.
   
    

3. Can I use multiple government health insurance schemes at the same time?

No, in most cases, you cannot use multiple government health insurance schemes simultaneously for the same treatment. However:

• You may be eligible under more than one scheme (e.g., Central + State), but only one will cover the cost per hospitalisation.
• If one scheme does not cover the full amount, the remaining cost may not be automatically covered by another.

4. What documents are required to enroll in a government health insurance plan?

Common documents include:

• Aadhaar card
• Ration card or BPL card
• Income certificate
• Address proof
• Passport-size photographs
• In some cases, SECC data confirmation or caste certificate may also be required
  
   

Always check the scheme-specific documentation requirements on the official website.

5. How much coverage does a typical government health insurance scheme offer?

Coverage varies by scheme. For example:

• PM-JAY (Ayushman Bharat) offers up to ₹5 lakh per family per year for secondary and tertiary care.
• State-specific schemes may offer coverage ranging from ₹1 lakh to ₹5 lakh or more, depending on the policy.
• Coverage generally includes hospitalisation, pre- and post-hospitalisation expenses, diagnostics, and medicines.