India’s government offers several health insurance schemes to provide affordable and accessible healthcare to its diverse population. These schemes target various segments of society, ensuring that both economically weaker sections and government employees have access to medical services. This blog will explore some of the key government health insurance programs in India.
Ayushman Bharat Yojana (PMJAY)
Ayushman Bharat Yojana, also known as Pradhan Mantri Jan Arogya Yojana (PMJAY), is one of the largest health insurance schemes in the world, aiming to cover over 500 million beneficiaries. It provides a health cover of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization across public and private empaneled hospitals in India. The scheme focuses on the poor and vulnerable sections of society, covering most medical treatments, including surgery, medical and daycare treatments, medicines, diagnostics, and transport.
Central Government Health Scheme (CGHS)
The Central Government Health Scheme provides comprehensive healthcare facilities to the Central Government employees, pensioners, and their dependents residing in CGHS-covered cities. Established in 1954, CGHS covers all the expenses related to healthcare, including general medications, specialized treatments, and even some of the wellness and preventive care measures. Beneficiaries can avail themselves of the healthcare services from empaneled hospitals and diagnostic centers.
Employee State Insurance Scheme (ESIS)
Administered by the Employee State Insurance Corporation, this scheme is tailored for Indian workers in the non-seasonal industrial sectors. ESIS provides medical, monetary, and disability benefits. Eligibility depends on the employee’s earnings, with the ceiling set to a monthly wage of ₹21,000. This scheme ensures that employees and their dependents are covered against various health-related eventualities.
Rashtriya Swasthya Bima Yojana (RSBY)
Rashtriya Swasthya Bima Yojana was launched to provide health insurance coverage for Below Poverty Line (BPL) families, offering a cover of ₹30,000 per family per annum on a family floater basis. It covers most of the diseases, providing cashless insurance for hospitalization in public as well as private hospitals. Although RSBY has now been subsumed under PMJAY, it laid the groundwork for broader coverage and inclusivity in health insurance.
Other Schemes
- Aam Aadmi Bima Yojana (AABY): A social security scheme for rural landless households, providing protection against natural and accidental death and disability.
- Janashree Bima Yojana (JBY): Offers life insurance cover to people below the poverty line or marginally above the poverty line.
Conclusion
Government health insurance schemes in India are crucial in improving the affordability and accessibility of healthcare services. These programs play a significant role in safeguarding the health of India’s economically weaker sections and government employees, ensuring that medical care is not a financial burden. As India continues to expand and improve its healthcare infrastructure, these schemes are key to achieving universal health coverage.
