Which Health Insurance to Buy for People below Poverty Line?

Although the penetration of health insurance in India is quite low, people living below the poverty line (BPL) do not have the financial means to afford medical insurance. To ensure medical coverage for BPL families, the government has launched several health insurance policies for the weaker sections of society.

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    Need for Health Insurance Plans for People below the Poverty Line

    Every person requires medical attention at some point in their life. Given the high incidence and extensive spread of different kinds of diseases, such as diabetes, COVID-19, etc., health insurance has become a necessity for all. Besides, medical inflation has made healthcare services expensive leaving no other choice than to opt for a health insurance policy.

    Healthcare services should be accessible to people from all sections of society. But since people below the poverty line have limited income and affording a health insurance policy is a distant dream for them. In fact, poor people who do not have access to basic amenities like food and shelter do not consider health insurance a necessity at all. It does not change the fact that they are equally exposed to various diseases and medical conditions.

    When BPL families face a medical emergency, they are unable to afford the right treatment at the right time. They either settle for poor healthcare facilities or lose their loved ones due to a lack of finances. To ensure that people from low-income groups can avail quality medical services at a meagre price, the Government of India has introduced several health insurance policies for BPL families over the years.

    Health Insurance Plans for below Poverty Line Vs Regular Health Insurance Plans

    Categories

    Health Insurance Plans for below Poverty Line

    Regular Health Insurance Plans

    Premium

    Involves a registration/renewal fee of Rs 30 or a premium of as low as Rs 100 as per the plan

    Premium starting Rs 200 per month

    Premium Payment

    Government pays the full/a part of the premium on behalf of the insured

    Policyholders pay the entire premium themselves

    Sum Insured

    Offers a lower sum insured of up to Rs 3,00,000

    Offers a higher sum insured of up to Rs 1,00,00,000

    Coverage

    Individual/ Floater

    Individual/ Floater

    Pre-existing diseases waiting period

    No waiting period

    2 to 4 years

    Types of Hospitals Offering Treatment

    Public and private hospitals

    Public and private hospitals

    Cashless Treatment

    Available at network hospitals

    Available at network hospitals

    Domiciliary Hospitalization

    Mostly available without any extra premium price

    May lead to a premium hike

    Paperwork

    Paperless schemes

    May involve documentation

    Health Insurance Plans for People below the Poverty Line

    Take a look at the various health insurance policies available for people below the poverty line:

    1. Rashtriya Swasthiya Bima Yojana

    The Rashtriya Swasthiya Bima Yojana offers health insurance coverage to BPL families whose members work in unorganized sectors. Launched by the Ministry of Labour and Employment, it covers the cost of in-patient treatment and transportation up to Rs 1000. It provides a sum insured of Rs 30,000 on a floater basis and also covers pre-existing diseases.

    The estimated annual premium is Rs 750, which will be paid by the central government and state government at a 75:25 ratio. People eligible for this scheme need to pay a registration/renewal fee of Rs 30 only.

    2. Universal Health Insurance Scheme

    The Universal Health Insurance Scheme is offered by four public-sector insurance companies that cover the hospitalization expenses of people living below the poverty line. It comes with a sum insured of Rs 30,000 per family on a floater basis. It provides an accidental death cover of Rs 25,000 and pays a daily compensation of Rs 50 up to a maximum of 15 days in case of loss of income. It also provides maternity expenses of Rs 2500 and Rs 5000 for normal and caesarean delivery respectively.

    People with an annual income of Rs 30,000 or less can apply for this policy. The premium ranges from Rs 300 to Rs 600 depending on the number of family members covered under the scheme. However, the government pays a subsidy of up to Rs 200, Rs 300 and Rs 400 for individuals, a family of five and seven members respectively.

    3. Karunya Health Insurance Scheme

    The Karunya Health Insurance Scheme has been launched by the Kerala Government to provide coverage to lower-income groups against critical illnesses, such as cancer, heart ailments, kidney diseases, hemophilia, etc.  It offers a sum insured of Rs 3,00,000 and also provides reimbursements in case the treatment expenses exceed the estimated amount.

    People with an annual income of below Rs 3,00,000 are eligible to apply for this scheme. Unlike other government health insurance policies, the major part of the premium amount is raised by the state government through a lottery system allowing the beneficiary to pay only a nominal amount.

    4. Mahatma Jyotiba Phule Jan Arogya Yojana

    The Maharashtra Government have introduced the Mahatma Jyotiba Phule Jan Arogya Yojana to provide medical coverage to farmers and people living below the poverty line. It covers the hospitalization cost for medical & surgical procedures under 34 specialities. It comes with a sum insured of Rs 1,50,000 per family on a floater basis but can be enhanced to Rs 2,50,000 per family in case of renal transplant.

    This health insurance scheme does not come with any waiting period and provides coverage from day 1 itself. Moreover, the premium for this scheme is paid entirely by the Maharashtra Government.

    5. Mukhyamantri Amrutum Yojana

    The Mukhyamantri Amrutum Yojana is a health insurance scheme launched by the Gujarat Government to cover the medical expenses of BPL families. It provides coverage for in-patient treatment, pre-hospitalization and post-hospitalization expenses along with transportation charges. It also provides coverage for a few critical diseases, such as cancer, liver and kidney transplant, etc. It offers a sum insured of Rs 3,00,000 to each family but can be extended to Rs 5,00,000 for organ transplant procedures.

    People with an annual income of up to Rs 4,00,000 are eligible to apply for the Mukhyamantri Amrutum Yojana. Moreover, the premium for the policy is paid entirely by the state government.

    Summing It Up

    A major population of India lives below the poverty line, who cannot afford to buy a health insurance policy. Nonetheless, several health insurance policies are available for BPL families, such as Universal Health Insurance Scheme, Rashtriya Swasthiya Bima Yojana, Janashree Bima Yojana, etc. So, if you belong to lower-income groups, enrol in one of the government health insurance schemes to get adequate medical coverage in the time of need.

    Written By: PolicyBazaar - Updated: 13 September 2021

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