The Indian government is actively working to upgrade healthcare services throughout the nation. Today, there are multiple schemes offered by the government that provide health insurance coverage and help people avail of free hospitalisation services.  

What is a Government Health Insurance Scheme?

A medical emergency can arise at any time. A Government Health Insurance Scheme is a health policy offered by the government of India to help you and your family bear the heavy medical costs during such circumstances. These policies and schemes are offered on a yearly basis.  

These schemes aim to improve the state's and country's overall healthcare by providing affordable health insurance plans with substantial coverage. 

Who qualifies for Government Health Insurance Scheme? 

The government health insurance schemes are mainly reserved for people with lower and middle income levels. This is to ensure that everyone can access healthcare and medical facilities at affordable prices, irrespective of their income levels.  

Regular VS Government Health Insurance Schemes - Major Differences  

Features 

Regular Health Insurance 

Government Health Insurance Scheme 

Eligibility 

Available to everyone 

Available for lower-income groups  

Premium 

Depends upon the plan purchased 

Starts from INR 100 per month or completely paid by the government 

Sum Insured 

Maximum amount insured is INR 1 crore 

Maximum amount insured of up to INR 5 lakh 

Coverage 

Broader coverage 

Narrow coverage 

Policy Purchase 

Available for instant purchase 

Policy purchase may take time 

Private Hospital Room 

Available 

May or may not be available 

Network Hospitals 

Wide network of private hospitals 

A considerable number of public as well as private hospitals 

Maternity Benefits 

Available 

Available for one child in some cases 

Ambulance Charges 

Available 

Available under a few plans 

Cumulative Bonus 

Available in some plans if the claim isn’t filed in the previous year 

Not available 

Online Renewal 

Can be renewed online 

May or may not be renewed online 

Health Check-up 

Available in some plans 

Not covered 

Tax Benefits 

Available under the Income Tax Act 1961 

Not available 

List of Top 15 Government Health Insurance Schemes in India in 2024 

1. Ayushman Bharat Yojana 

Ayushman Bharat brings free healthcare access to the doorsteps of over 40% of India's people. This scheme provides health insurance coverage of 5 lakh rupees per family. This program offers free medicines, tests, treatments, and pre-hospitalisation care to the most disadvantaged families in India. 

2. Awaz Health Insurance Scheme 

The Awaz Health Insurance Scheme was initiated by the Kerala government for migrant workers. This scheme gives workers up to 15,000 rupees for medical care and 2 lakh rupees if they die in an accident.  

The scheme started in 2017 and helps 5 lakh workers from other states who live in Kerala. Workers between 18 and 60 years old can get this insurance. After giving their fingerprints and other work details, workers will get an Awaz Health Insurance card. 

3. Aam Aadmi Bima Yojana (AABY) 

The Aam Aadmi Bima Yojana (AABY) helps people who work in jobs like carpentry, fishing, and weaving. There are 48 jobs covered by this scheme. Prior to 2013, two similar schemes existed: AABY and Janashree Bima Yojana (JBY). In 2013, JBY became part of AABY. 

 For a minimal annual fee of 200 rupees, you can obtain 30,000 rupees in insurance coverage. To get this insurance, you must be the head of your family or the main earner and work in one of the 48 listed jobs. 

4. Employees' State Insurance Scheme 

Following India's independence, many people found employment in factories. These workers often got hurt or died. Insurance helped with this problem. In 1952, the government started the Employees' State Insurance Scheme to give money to workers who got sick, disabled, or died. 

At first, the scheme only helped people in Kanpur and Delhi, but later it covered more places. In 2015, the scheme got better. Now, more than 7 lakh factories are part of it. 

5. Karunya Health Scheme 

The year 2012 saw the Kerala government laying the foundation of the Karunya Health Scheme. This scheme helps people with serious illnesses like cancer, kidney problems, and heart disease. Poor people can join this scheme. They require an Aadhaar card and income certificate to prove their financial status. 

6. Mahatma Jyotiba Phule Jan Arogya Yojana 

The Maharashtra government launched the Mahatma Jyotiba Phule Jan Arogya Yojana to assist underprivileged citizens with healthcare. This scheme used to be called the Rajiv Gandhi Jeevandayee Arogya Yojana but changed its name in 2017. 

Farmers from some areas and poor people from all parts of the state can join this scheme. It helps the whole family and gives 150,000 rupees for medical care. The scheme covers many illnesses right away, without waiting. 

7. Bhamashah Swasthya Bima Yojana 

Through the Bhamashah Swasthya Bima Yojana, the Rajasthan government offers health insurance to its population. This plan lets people from villages in Rajasthan get medical care without paying cash.  

Those benefitting from the National Food Security Act (NFSA) and the Rashtriya Swasthya Bima Yojana (RSBY) can enrol in this plan as well. This plan pays for hospital stays for regular and serious illnesses, as written in the rules. The plan also includes reimbursement for some out-of-hospital care. 

8. Central Government Health Scheme 

The Indian government started this plan. People who work for the central government can join it, like Supreme Court judges and some railway workers. This plan has helped more than 35 lakh workers and retired workers for 60 years. The plan pays for hospital stays and care at home, as written in the rules. It covers both Allopathy and Homeopathy medicine. 

9. Chief Minister’s Comprehensive Insurance Scheme 

The Tamil Nadu government created this plan with the United India Insurance Company. This is a family health plan designed to provide quality medical coverage. People can get up to 5 lakh rupees for hospital costs with this plan. Some government and private hospitals work with this plan. People who live in Tamil Nadu and earn less than 75,000 rupees a year can join it. This plan covers more than a thousand medical treatments. 

10. Pradhan Mantri Suraksha Bima Yojana 

The government started Pradhan Mantri Suraksha Bima Yojana to give accident insurance to Indians. In 2016, only 20% of Indians had insurance, but this plan wants to change that. 

People between 18 and 70 years old with a bank account can join this plan. It gives 1 lakh rupees for a partial injury and 2 lakh rupees for a full injury or death. People pay 12 rupees a year for this insurance, and the money is taken from their bank account. 

11. Rastriya Swasthya Bima Yojana 

This plan helps people who work in jobs without a fixed workplace. These people often don't have health insurance. When they get sick, which happens often, they spend all their savings. This means they can never save money. Health insurance can help them. The Indian government's labour department started the Rashtriya Swasthya Bima Yojana. It helps people who work in these jobs and are poor, plus their families (up to five people). 

12. Universal Health Insurance Scheme 

Various rich and poor nations have implemented health plans for their poor populations. In India, the Universal Health Insurance Scheme wants to do this and more. The poorest people between 5 and 70 years old can join this plan. 

This plan offers insurance for one person or a group. It covers hospital stays, accidents, and disabilities. The cost depends on the family size. Individuals who are poor are required to show documents to join the plan. 

13. Yeshasvini Health Insurance Scheme 

The Karnataka government created the Yeshasvini Health Insurance Scheme for farmers who belong to a cooperative group. This plan covers over 800 types of medical treatments for bone, nerve, and heart problems. Cooperative groups help farmers join the Yeshasvini scheme. Farmers can use this plan in special hospitals. The plan also helps the farmer's family. 

14. West Bengal Health Scheme 

In 2008, the West Bengal government introduced this plan for its employees. Retired workers can also join. The plan was renamed the West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme in 2014. This plan covers one person and their family for up to 1 lakh rupees. It pays for doctor visits and surgeries, as written in the rules. The plan does not cover plastic surgery or non-emergency treatments. 

15. Dr YSR Aarogyasri Health Care Trust  

The Andhra Pradesh government created the Dr YSR Aarogyasri Health Care Trust to help poor people in the state. This insurance plan covers many things, like pregnancy care, rehab, and paying for medical bills without cash. It also helps people after they finish treatment. The plan focuses on preventing illness with free checkups and tests. It also covers many long-term illnesses like cancer treatment and dialysis. 

Key Features and Benefits of Government Health Insurance Plans

  • Affordable Premiums: Government health insurance plans are offered at a low cost, making them accessible to a broader population, especially those with limited financial resources.
  • Inclusive Coverage for Low-Income Groups: These plans are designed to encourage people below the poverty line to avail of insurance, ensuring they have access to essential healthcare services.
  • Basic Insurance Assurance: Government-sponsored policies provide a basic level of insurance cover, helping poor and vulnerable populations feel more secure about their health needs.
  • Assurance of Care: These policies are backed by the government, which helps policyholders feel assured about the reliability and continuity of their healthcare coverage.
  • No Lifetime Limits on Essential Benefits: Many government health insurance plans offer essential health benefits without lifetime limits, ensuring ongoing care without the fear of losing coverage.
  • Comprehensive and Standardized Benefits: Government plans usually provide a standardized set of essential health benefits, offering security and comprehensive coverage for a wide range of medical needs.
  • Portability of Coverage: Eligibility for some government health plans continues even if you change jobs or move to a different location, preventing coverage gaps and ensuring continuous protection.
  • Free Preventive Care: These plans often include free preventive care services, such as immunizations and cancer screenings, which promote overall wellness and early detection of health issues.
  • Inclusion of Multiple Healthcare Providers: To ensure better access to healthcare, government plans often include a network of both government and private hospitals, providing a broader choice of healthcare providers for policyholders.

Frequently Asked Questions 

1. Can anyone apply for Government Health Insurance Plans? 

Not everyone can. Different plans have different rules about who can join. You should check what you need to join and what papers you need. 

2. Are the state governments responsible for implementing all government schemes? 

No, not all. The central government and state governments both make health insurance plans. 

3. Can we apply online for Government health insurance schemes? 

Not all of them. Some plans let you pay directly from your bank account, but you can’t buy all of them online. 

4. What is not included in Government Health Insurance Schemes? 

Most government insurance plans don’t cover plastic surgery. Different plans have different things they don’t cover, so you should read the plan carefully to understand it. 

5. How are the premiums calculated for government health insurance policies? 

The cost of the plan depends on how many people you want to cover. Some plans ask you to pay a set amount every year. You should thoroughly review the plan to comprehend the costs involved. 

6. What are the major differences between government and regular health insurance schemes? 

Government health insurance schemes typically prioritise affordability and accessibility for low-income groups, while regular health insurance plans offer broader coverage, more customization, and private hospital options at higher premiums. 

7. Is an Aadhaar card enough to apply for government health insurance schemes? 

To enrol in the state/national health scheme, you will need to submit your Aadhaar card and other necessary documents.