17 Different Types of Government Health Insurance Schemes in India

Governments across the world are working to provide good quality healthcare to their citizens. Authorities take steps from time to time for the welfare of the people. This includes creating awareness about medical issues, ensuring adequate infrastructure, and promoting health insurance for the poor. Such steps are also taken by the Government of India in the form of introducing the best Government health insurance Schemes in India for low-income families or the poor in India.

What is a Government Health Insurance Scheme in India?

• A government health insurance scheme is a policy run by the central or state government that is designed to provide adequate medical insurance coverage at an affordable price. Such health insurance policies are usually offered on an annual basis.

Regular Health Insurance Schemes vs Government Health Insurance Scheme

Features	Regular Health Insurance Plan	Government Health Insurance Scheme
Eligibility	Available to all sections of society	Only available to low-income groups
Sum insured	Maximum sum insured up to ₹6 crore	Maximum sum insured up to ₹10 lakh
Premium	₹200 per month (depending on plan)	₹100 per month thereafter or fully paid by the government (depending on plan)
Coverage	Offers broad coverage	Offers narrow coverage
Private hospital rooms	Available (depending on plan)	May or may not be available
Policy Purchase	Policy can be purchased immediately	Policy purchase may take time
Network Hospitals	A large network of listed private hospitals	A large number of public and private network hospitals
Maternity benefit	Available (depending on the plan)	Available (in some cases for only one child)
Ambulance charges	Available under most plans	Available under some plans
Domiciliary Hospitalization Cover	Available (Plan Dependent)	Not Available
Online Renewal	Can be renewed online	Online renewal may or may not be possible
Cumulative Bonus	Available if no claim has been filed in the previous policy year	Not available
Health Checks	Covered under some plans	Not covered
Monthly premium installment facility	Available under some plans	Not available
Tax benefits	Available under Section 80D of the Income Tax Act, 1961	Not available

Types of Government Health Insurance Schemes in India

Take a look at the different types of government health insurance schemes in India offered by the Government of India:

Ayushman Bharat Yojana

• Ayushman Bharat Yojana, also known as Pradhan Mantri Jan Arogya Yojana (PMJAY), is a universal health insurance scheme of the Ministry of Health and Family Welfare, Government of India.PMJAY was launched to provide free healthcare services to more than 40% of the country’s population. This health insurance for the poor in India provides a health cover of ₹5 lakh.
• The PMJAY scheme provides coverage for medicines, diagnostic expenses, medical treatment, and pre-hospitalization costs. Poor or low-income families in India can benefit from this Ayushman Bharat health insurance scheme.

Pradhan Mantri Suraksha Bima Yojana (PMSBY)

• The objective of Pradhan Mantri Suraksha Bima Yojana is to provide accident insurance cover to the people of India. This scheme can be availed by people aged between 18 years to 70 years who have an account in a bank or post office.
• This personal accident insurance policy provides an annual cover of ₹2 lakh for total disability and death cover and ₹1 lakh for partial disability. The premium of this scheme is automatically debited from the policyholder’s bank account.

Aam Aadmi Bima Yojana (AABY)

• Aam Aadmi Bima Yojana is a national health insurance scheme launched in October 2007 to provide compensation for accidental death and disability. It covers the earning member or head of the family between the ages of 18 and 59 years. The AABY insurance scheme is designed for people living in suburban and rural areas as well as landless citizens or tenants living in both urban and rural areas. It also provides scholarships to underprivileged children.
• Under the AABY scheme, the family of the insured is paid a compensation of ₹30,000 in case of natural death and ₹75,000 in case of accidental death. In addition, ₹37,500 is paid as compensation in case of accidental disability. In addition, the annual premium of this scheme of ₹200 is shared equally by the state and central government.

Central Government Health Scheme (CGHS)

• The Central Government Health Scheme was launched in 1954 to provide comprehensive health care facilities to Central Government officials and pensioners residing in the country. This government insurance scheme is operational in 80 cities including Kolkata, Mumbai, Lucknow, Delhi, Nagpur and Pune.
• The CGHS scheme has the following main components:
• OPD treatment availed at wellness centres as well as government and empanelled hospitals.
• Reimbursement of hospitalisation expenses for treatment at government or private hospitals.
• All pharmacy-related services including AYUSH medicines.
• Investigations or laboratory investigation services like X-ray, MRI etc. will be provided free of cost at government and CGHS-empanelled diagnostic centres.
• Free specialist consultation at polyclinics, government and empanelled hospitals.
• Reimbursement of medical expenses incurred on prosthetic limbs, hearing aids etc.

Employees State Insurance Scheme

• The Employees State Insurance Scheme is a multi-faceted national health insurance scheme that provides medical coverage, maternity insurance, sickness benefit, disability benefit and dependent benefits to all employees in India. It provides full medical insurance to workers and their families and pays cash benefits in times of sickness or temporary/permanent disability. In addition, dependents of workers injured in occupational accidents are eligible for a monthly pension known as dependent benefit.
• The ESIC scheme is applicable to all permanent factories and establishments with more than 10 employees. However, some states have extended the scheme to various establishments and businesses, including shops, restaurants, road and motor transport and newspaper units that employ 20 or more people.

Chief Minister Comprehensive Health Insurance Scheme (CMCHIS)

• The Chief Minister Comprehensive Health Insurance Scheme is a scheme of the Tamil Nadu State Government that works in collaboration with United India Insurance Company Limited. It is a family floater health insurance policy designed to provide quality healthcare services to economically weaker families in the state. This medical insurance for low-income people covers 1090 medical procedures along with 52 diagnostic procedures and 8 follow-up procedures.
• Under the CMCHIS scheme, eligible people can claim hospitalization expenses up to ₹5 lakh in both private and government hospitals. Tamil Nadu residents whose annual family income is less than ₹1.2 lakh per annum are eligible to enroll under this scheme.

Universal Health Insurance Scheme (UHIS)

• The Universal Health Insurance Scheme was implemented to provide medical and personal accident cover to families living below the poverty line. While this mediclaim policy covers hospitalization expenses of each member of the family, it provides accidental death and disability benefits to the earning member or head of the family.
• The main drivers of the Universal Health Insurance Scheme are four public sector general insurance companies that provide health insurance for citizens below the poverty line, especially financially challenged citizens. They cover hospitalization expenses up to ₹30,000, accidental death benefit of ₹25,000 and disability compensation of ₹50 per day for a maximum of 15 days.

West Bengal Health Scheme (WBHS)

• The Government of West Bengal launched the West Bengal Health Scheme in the year 2008 to provide better medical facilities to its employees. Gradually, the scheme was made available to retired and family pensioners, IAS, IFS and IPS employees, and retired AIS officers.
• Under the WBHS scheme, both individual and family floater coverage is available up to ₹2 lakh per indoor treatment. The scheme covers all indoor medical treatments and OPD treatments for 18 diseases. Also, cashless health insurance was introduced in 2014, due to which the scheme was renamed as ‘West Bengal Health Cashless Medical Treatment Scheme 2014 for All Employees and Pensioners’.

Yashaswini Health Insurance Scheme

• The Karnataka state government launched the Yashaswini Health Insurance Scheme for farmers, cultivators, and members of any cooperative society. Beneficiaries can avail medical treatment at identified Yashaswini network hospitals across the state. Moreover, the coverage benefits can be extended to the beneficiary’s family members.
• This government health insurance scheme covers 2128 procedures, including 1650 medical procedures and 478 ICUs. However, it mainly provides coverage for heart diseases, orthopedics, neurological diseases, gynecological diseases, visceral diseases, ENT, and ophthalmology diseases.

Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY)

• The Maharashtra government launched the Mahatma Jyotirao Phule Jan Arogya Yojana to provide medical insurance coverage to all families in the states. This health insurance for low-income individuals is especially helpful for people living below the poverty line and farmers in Maharashtra.
• The MJPJAY plan offers family health cover of up to ₹5 lakh for 1209 treatments under 34 specialties. The best part about this policy is that there is no waiting period for pre-existing illnesses, and it can be claimed from day one.

Mukhyamantri Amrutam (MA) Yojana

• The Mukhyamantri Amrutam Yojana was launched by the Government of Gujarat in the year 2012 to provide quality medical and surgical care for major illnesses to poor people living in the state. People belonging to the low-income group and living below the poverty line are eligible to enroll in this scheme.
• The MA plan offers family floater health insurance coverage of up to ₹3 lakh per year. Under this health insurance for poor people, policyholders can avail cashless medical treatment for heart diseases, cancer, neurosurgery, kidney diseases, burns, and newborn or infant diseases covering 698 procedures in private, government, and trust-run hospitals. Moreover, kidney, liver and kidney + pancreas transplants get a cover of up to Rs 5 lakh.

Karuna Arogya Suraksha Yojana (KASP)

• The Kerala government launched Karuna Arogya Suraksha Yojana to provide secondary and tertiary care hospitalization to poor and vulnerable families in the state. It offers health insurance coverage of ₹5 lakh for 1573 medical procedures. Moreover, it covers pre-hospitalization expenses up to 3 days and post-hospitalization expenses up to 15 days.
• People in Kerala who are living below the poverty line can enroll themselves in this health insurance for poor in India. Moreover, it provides coverage to the entire family with no restrictions on family size, gender, or age.

Telangana State Government – Employees and Journalists Health Scheme

• The Telangana government launched the Employees and Journalists Health Scheme for its employees including working and retired journalists and pensioners. In this scheme, beneficiaries and their families can avail cashless treatment at hospitals registered with Rajiv Arogyasri Health Care Trust. The coverage includes in-patient treatment, OPD treatment for chronic diseases, and follow-up treatment.

Doctor YSR Arogyasri Health Scheme

• The Andhra Pradesh government launched the Dr YSR Arogyasri Health Scheme in 2007 to provide universal health coverage to people living below the poverty line in the state. It provides end-to-end cashless coverage of ₹5 lakh for listed diseases at government and private empanelled hospitals. In 2024, the scheme was renamed as Dr Nandamuri Taraka Rama Rao Vaidya Seva Trust Health Insurance Scheme
• This health insurance for citizens below the poverty line covers 3257 listed inpatient treatments in 31 categories as well as free checkups and OPD consultations.

Awaaz Health Insurance Scheme

• The Kerala government launched the Awaaz Health Insurance Scheme in 2017 to provide medical insurance and personal accident insurance coverage to migrants in the state. It provides a sum insured of ₹25,000 for medical treatment to beneficiaries aged between 18 years to 60 years. Apart from this, accidental death benefit of ₹2 lakh and disability compensation of ₹1 lakh is also available for insured migrants.

Bhamashah Health Insurance Scheme (BSBY)

• The Bhamashah Health Insurance Scheme was launched by the Rajasthan government to provide cashless hospitalization facility to families identified under the National Food Security Act (NFSA) and Rashtriya Swasthya Bima Yojana in the state. It covers inpatient treatment expenses up to ₹30,000 for common ailments in 1715 packages. The scheme also provides critical illness insurance coverage of up to Rs 3 lakh.
• Apart from this, this government health insurance scheme also provides up to 7 days of pre-hospitalization expenses and up to 15 days of post-hospitalization expenses.

Rashtriya Swasthya Bima Yojana (RSBY)

• The Rashtriya Swasthya Bima Yojana was launched by the Ministry of Labor and Employment to provide medical insurance coverage to families living below the poverty line. It provides family floater coverage for in-patient treatment expenses up to ₹30,000. The scheme also covers travel expenses of ₹100 per day up to a limit of ₹1000.

Features and Benefits of Government Health Insurance Schemes in India

Some of the key features and benefits of government health insurance schemes in India are given below:

• Government health insurance schemes in India are offered at a low cost.
• With medical insurance for low-income people, BPL families can also avail insurance benefits.
• These schemes cover both in-patient and OPD treatments.
• Government mediclaim policies ensure coverage for poor people.
• The scheme provides treatment in both private empanelled and government hospitals for better healthcare.
• Government health insurance schemes in India cover pre-existing diseases (PEDs) from day one.
• Beneficiaries of these schemes can avail cashless medical treatment in empanelled hospitals.
• Government health schemes provide standardised yet comprehensive medical coverage.

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