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Government Health Insurance Schemes in India
- Ayushman Bharat Yojana (PMJAY)
- Universal health insurance scheme by the Ministry of Health and Family Welfare.
- Provides free healthcare services to over 40% of India’s population.
- Health cover: ₹5 lakh per family per year.
- Covers medicines, diagnostics, pre-hospitalization, and medical treatment costs.
2. Pradhan Mantri Suraksha Bima Yojana (PMSBY)
- Provides accident insurance for individuals aged 18-70 years with a bank/post office account.
- Annual premium: ₹20 per year (auto-debited from bank account).
- Coverage: ₹2 lakh for total disability/death, ₹1 lakh for partial disability.
3. Aam Aadmi Bima Yojana (AABY)
- Launched in 2007 for low-income rural and urban families.
- Covers head of the family (aged 18-59 years).
- Benefits: ₹30,000 for natural death, ₹75,000 for accidental death, ₹37,500 for disability.
- Annual premium: ₹200 (shared equally by state and central governments).
4. Central Government Health Scheme (CGHS)
- Started in 1954 for central government employees and pensioners.
- Covers OPD treatments, hospitalization, AYUSH medicines, diagnostics, and specialist consultations.
- Available in 80 cities, including Delhi, Mumbai, Kolkata, and Pune.
5. Employees' State Insurance Scheme (ESIC)
- Covers workers and their families in case of sickness, maternity, or disability.
- Applicable to factories and establishments with 10 or more employees (some states require 20).
- Benefits: Free medical insurance, cash benefits during sickness, and a dependent pension for work-related injuries.
6. Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS) [Tamil Nadu]
- Family floater policy for economically weaker families in Tamil Nadu.
- Covers 1090 medical procedures and 52 diagnostic procedures.
- Hospitalization coverage: ₹5 lakh per family.
- Eligibility: Families earning less than ₹1.2 lakh per year.
7. Universal Health Insurance Scheme (UHIS)
- Aimed at families below the poverty line.
- Covers hospitalization expenses up to ₹30,000.
- Provides ₹25,000 accidental death benefit and ₹50 daily compensation for 15 days for disability.
8. West Bengal Health Scheme (WBHS)
- Launched in 2008 for West Bengal government employees and pensioners.
- Covers OPD treatment for 18 diseases and indoor hospitalization up to ₹2 lakh.
- Cashless health insurance introduced in 2014.
9. Yeshasvini Health Insurance Scheme [Karnataka]
- Designed for farmers, peasants, and cooperative society members.
- Covers 2128 procedures, including heart diseases, orthopedics, and neurology.
- Treatment is available at Yeshasvini network hospitals across Karnataka.
10. Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) [Maharashtra]
- Covers low-income individuals and farmers in Maharashtra.
- Provides ₹5 lakh family cover for 1209 treatments under 34 specialities.
- No waiting period for pre-existing diseases.
11. Mukhyamantri Amrutum (MA) Yojana [Gujarat]
- Launched in 2012 for poor families in Gujarat.
- Offers ₹3 lakh family floater coverage per annum.
- Covers heart diseases, cancer, neurosurgery, kidney diseases, and neonatal care.
- Kidney, liver, and pancreas transplants covered up to ₹5 lakh.
12. Karunya Arogya Suraksha Padhathi (KASP) [Kerala]
- Provides health insurance coverage of ₹5 lakh.
- Covers 1573 medical procedures, pre-hospitalization (3 days), and post-hospitalization (15 days).
- No restriction on family size, gender, or age.
13. Telangana State Government - Employees and Journalists Health Scheme
- Covers working and retired government employees, journalists, and pensioners.
- Includes cashless treatment at government-registered hospitals.
- Covers OPD treatment for chronic illnesses and follow-up therapies.
14. Dr YSR Aarogyasri Health Scheme [Andhra Pradesh]
- Launched in 2007 for below-poverty-line families.
- Provides ₹5 lakh coverage for 3257 listed treatments.
- Offers free screening and OPD consultations.
- Renamed in 2024 as Dr. Nandamuri Taraka Rama Rao Vaidya Seva Trust Health Insurance scheme.
15. Awaz Health Insurance Scheme [Kerala]
- Covers migrant workers aged 18-60 years.
- Benefits: ₹25,000 for medical treatments, ₹2 lakh for accidental death, ₹1 lakh for disability.
16. Bhamashah Swasthya Bima Yojana (BSBY) [Rajasthan]
- Launched for families under NFSA and Rashtriya Swasthya Bima Yojana.
- Covers hospitalization expenses up to ₹30,000 for general illnesses and ₹3 lakh for critical illnesses.
- Cashless facility available.
These schemes aim to provide affordable healthcare to different sections of society, ensuring better medical access for the economically weaker sections, government employees, workers, and marginalized communities.
How to Apply ?
The application process varies for each scheme, but the general steps include both online and offline modes.
General Steps to Apply for Government Health Insurance Schemes
Online Application Process
- Visit the official website of the scheme you wish to apply for.
- Register using your Aadhaar card and mobile number.
- Fill in the application form with personal, family, and income details.
- Upload required documents (identity proof, income certificate, etc.).
- Submit the application and note down the reference number for tracking.
- Wait for approval and receive the e-card for cashless treatment.
Offline Application Process
- Visit the nearest government health center or Common Service Centre (CSC).
- Collect the application form for the desired scheme.
- Fill in the required details and attach photocopies of necessary documents.
- Submit the form at the concerned office.
- Verification will be conducted, and upon approval, you will receive an insurance card.
Documents Required for Government Health Insurance Schemes
While requirements vary by scheme, the following are commonly needed:
A. Identity & Address Proof
- Aadhaar Card
- Voter ID Card
- Ration Card
- PAN Card
- Passport or Driving License
B. Income & Eligibility Proof
- Income Certificate (for schemes with income limits)
- BPL (Below Poverty Line) Certificate
- Ration Card mentioning income category
C. Residence Proof
- Electricity Bill / Water Bill
- Domicile Certificate
D. Medical & Special Category Documents (if applicable)
- Disability Certificate (for disabled beneficiaries)
- Medical Reports (for existing conditions in certain schemes)
- Birth Certificate (for age proof in certain schemes like Yeshasvini)
E. Bank Details
- Bank Passbook Copy
- Aadhaar-linked Bank Account Number
Scheme-Specific Application Details
| Scheme Name | Where to Apply? | Eligibility Criteria |
|---|---|---|
| Ayushman Bharat (PMJAY) | https://pmjay.gov.in | BPL families, SECC database |
| Pradhan Mantri Suraksha Bima Yojana (PMSBY) | Any bank or insurance provider | Age 18-70 years, Bank account required |
| Aam Aadmi Bima Yojana (AABY) | LIC offices, government nodal agencies | Age 18-59 years, Rural families |
| Employees' State Insurance Scheme (ESIC) | www.esic.gov.in | Employees in firms registered under ESIC |
| Central Government Health Scheme (CGHS) | www.cghs.gov.in | Central govt. employees, pensioners |
| Mukhyamantri Amrutum (Gujarat) | www.magujarat.com | BPL families of Gujarat |
| Dr. YSR Aarogyasri (Andhra Pradesh) | www.ysraarogyasri.ap.gov.in | Below Poverty Line (BPL) families |
| Karunya Arogya Suraksha Padhathi (KASP) [Kerala] | www.kasp.kerala.gov.in | Families under Socio-Economic Caste Census (SECC) data |
| Yeshasvini Health Insurance Scheme (Karnataka) | District cooperative society offices | Farmers and cooperative members |
Important Notes
- Renewal required annually for PMSBY, AABY, and other insurance-based schemes.
- Some schemes are automatic (Ayushman Bharat, ESIC) based on pre-registered eligibility.
- Cashless treatment is available at empaneled hospitals for most schemes.
- Helpline numbers and district health officers can assist in case of application issues.
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Official Websites
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