Government Health Insurance Schemes in India

A government health insurance scheme is a central or state government-backed policy designed to provide adequate medical insurance coverage at an affordable price. Every year, the Indian government strives to provide quality and affordable healthcare services to all of its citizens, particularly to those who are unable to afford the costly private healthcare services. To achieve these objectives, the central government and various state governments have introduced different government health insurance schemes that provide free or low-cost health insurance to the lower-income families, senior citizens, workers and other vulnerable groups.

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      Regular Health Insurance Plans vs Government Health Insurance Scheme

      Features Regular Health Insurance Plans Government Health Insurance Scheme
      Eligibility Available to all sections of society Available to lower-income groups only
      Sum Insured Maximum sum insured of up to ₹6 crore Maximum sum insured of up to ₹10 lakh
      Premium ₹200 per month onwards (depending on the plan) ₹100 per month onwards or fully paid by the government (depending on the plan)
      Coverage Offers broader coverage Offers narrow coverage
      Private Hospital Room Available (depending on the plan) May or may not be available
      Policy Purchase Policy can be purchased instantly Policy purchase may take time
      Network Hospitals Wide network of empanelled private hospitals A large number of public and private network hospitals
      Maternity Benefits Available (depending on the plan) Available (only for a single child under some cases)
      Ambulance Charges Available under most plans Available under a few plans
      Domiciliary Hospitalisation Cover Available (depending on the plan) Not available
      Online Renewal Can be renewed online May or may not be renewed online
      Tax Benefits Available under Section 80D of the Income Tax Act 1961 Not available

      List of Government Health Insurance Schemes

      Here's a quick look at all the central and state government health insurance schemes:

      No. Central Government Schemes State Government Schemes
      1 Ayushman Bharat Yojana (PMJAY) West Bengal Health Scheme (WBHS)
      2 Pradhan Mantri Suraksha Bima Yojana (PMSBY) Yeshasvini Health Insurance Scheme (Karnataka)
      3 Aam Aadmi Bima Yojana (AABY) (Inactive) Mahatma Jyotirao Phule Jan Arogya Yojana (Maharashtra) (Integrated With PMJAY)
      4 Central Government Health Scheme (CGHS) Mukhyamantri Amrutum (MA) Yojana (Gujarat) (Integrated with AB-PMJAY)
      5 Employees' State Insurance Scheme (ESIC) Karunya Arogya Suraksha Padhathi (Kerala) (Integrated With AB-PMJAY)
      6 Universal Health Insurance Scheme (UHIS) (Inactive) Employees and Journalists Health Scheme (Telangana)
      7 Rashtriya Swasthya Bima Yojana (RSBY) (Inactive) Dr YSR Aarogyasri Health Scheme (Andhra Pradesh) (Integrated with AB-PMJAY)
      8 Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) Awaz Health Insurance Scheme (Kerala)
      9 Surakshit Matritva Aashwasan Yojana (SUMAN) Bhamashah Swasthya Bima Yojana (Rajasthan) (Inactive)
      10 Pradhan Mantri Matru Vandana Yojana (PMMVY) Chirayu Ayushman Haryana (Haryana) (Integrated with AB-PMJAY)
      11 Mission Vatsalya Chief Minister's Comprehensive Health Insurance Scheme (Tamil Nadu)
      12 Niramaya Health Insurance Scheme Aarogyasri (Andhra Pradesh)
      13 Janani Suraksha Yojana (JSY) HIMCARE (Himachal Pradesh)
      14 Rashtriya Arogya Nidhi (RAN) Rajiv Aarogyasri Scheme Telangana
      15 Scheme for Adolescent Girls (SAG) (Integrated With Saksham Anganwadi & Poshan 2.0) Arogya Karnataka Scheme / AB-ArK (Karnataka) (Integrated with AB-PMJAY)
      16 Nikshay Poshan Yojana (NPY) Ayushman Bharat Yojana Uttar Pradesh
      17 Atal Amrit Abhiyan (Assam) (Integrated with AB-PMJAY)
      18 Gopabandhu Jan Arogya Yojana (Odisha) (Integrated with AB-PMJAY)
      19 Mukh Mantri Sarbat Sehat Bima Yojana (Punjab) (Integrated with AB-PMJAY)

      Although this table gives an overview of the schemes, it is necessary to consider that each of them has different eligibility criteria, different coverages, and different benefits that should be considered. It is time to focus on each of them, starting from those initiated by the central government.

      Central Government Health Insurance Schemes:

      1. Ayushman Bharat Yojana (PMJAY)

        The Ayushman Bharat Yojana or PMJAY is a universal health insurance program managed by the Ministry of Health and Family Welfare in the government. The program gives health coverage of up to ₹5 lakh for hospitalisation under secondary and tertiary care treatments to economically weak and vulnerable families in India. The program includes medicine, diagnostic tests, and pre-hospitalisation expenses, and the beneficiaries can get connected through an ABHA ID card.

        Category Details
        Launched By Ministry of Health and Family Welfare
        Coverage Amount Up to ₹5 lakh/family/year
        Eligibility Economically weaker families (SECC database)
        Key Benefit Cashless hospitalisation, PED covered from day 1
        Linked To ABHA ID Card
        Key Beneficiaries  Economically weaker families based on SECC database 
      2. Pradhan Mantri Suraksha Bima Yojana (PMSBY)

        PMSBY is a government-sponsored insurance plan that gives individual accident coverage for all individuals between 18 to 70 years of age with savings accounts at banks and post offices. ₹2 lakh is payable in case of death or permanent disablement, while ₹1 lakh is payable for partial disablement. The premium is deducted automatically every year.

        Category Details
        Launched By Ministry of Finance
        Coverage Amount ₹2 lakh (death/total disability), ₹1 lakh (partial)
        Eligibility Bank/post office account holders, 18–70 years
        Key Benefit Auto-debited low-cost annual premium
        Type Personal accident insurance
        Key Beneficiaries  Bank/post office account holders aged 18-70 years
      3. Aam Aadmi Bima Yojana (AABY) (Currently Inactive)

        The AABY, a governmental insurance scheme that was launched to give compensation to families in case of any accidental death and disability of the earning member who falls between the age group of 18 to 59 years. The government has largely subsumed the older social security benefits into newer schemes like the Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY).

        Category Details
        Launched October 2007
        Coverage Amount ₹30,000 (natural death), ₹75,000 (accidental death)
        Eligibility Rural/landless earning members, 18–59 years
        Key Benefit Scholarships for insured's children
        Premium ₹200/year, shared by centre and state
      4. Central Government Health Scheme (CGHS)

        The CGHS scheme is considered one of the earliest forms of health insurance offered by the Government, which offers full health care services to central government employees and retirees in 80+ cities. The scheme offers services like OPD services, hospitalization, reimbursement of Ayush medicines, and free diagnostic tests like X-ray and MRI.

        Category Details
        Started In 1954
        Coverage Amount Reimbursement-based, no fixed cap
        Eligibility Central govt employees and pensioners
        Key Benefit Free OPD, diagnostics, and AYUSH coverage
        Cities Covered 80+ cities
        Key Beneficiaries  Central government employees, pensioners and their dependants 
      5. Employees' State Insurance Scheme (ESIC)

        ESIC is a multi-dimensional government healthcare insurance program that provides medical, maternity, sickness, and disability cover to organised sector workers. The ESIC scheme applies to units having at least 10 workers and also gives a monthly pension to the dependents in the event of occupational death.

        Category Details
        For Factory and establishment workers
        Coverage Amount Full medical cover + cash benefits
        Eligibility Establishments with 10+ employees
        Key Benefit Dependent pension on occupational death
        Extended To Shops, restaurants, transport (20+ employees)
        Key Beneficiaries  Factory and organised sector workers and their families
      6. Universal Health Insurance Scheme (UHIS) (Currently Inactive)

        UHIS was a mediclaim scheme implemented by the government for those living below the poverty line, but is now inactive for new applicants. The scheme was conducted by four insurers from the public sector. This included hospitalization up to ₹30,000 and accidental death/disability coverage for the earning member of the family.

        Category Details
        Run By Four public sector general insurers
        Coverage Amount ₹30,000 (hospitalisation), ₹25,000 (accidental death)
        Eligibility Below Poverty Line (BPL) families
        Key Benefit Disability compensation of ₹50/day
        Duration Up to 15 days disability cover
      7. Rashtriya Swasthya Bima Yojana (RSBY) (Currently Inactive)

        RSBY was an insurance initiative taken up by the Government of India’s Ministry of Labour and Employment for BPL families. It provided health insurance coverage for families, including a provision for travel expenses for reaching the hospital.

        Category Details
        Launched By Ministry of Labour and Employment
        Coverage Amount ₹30,000 family floater
        Eligibility BPL families
        Key Benefit Travel allowance of ₹100/day (up to ₹1,000)
        Type In-patient treatment coverage
      8. Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)

        PMSMA provides free and good-quality prenatal checks to all pregnant women every 9th of each month, which will help to detect any high-risk pregnancies early and decrease the mortality rate among pregnant women in India.

        Category Details
        Launched By Ministry of Health and Family Welfare
        Coverage Amount Free antenatal services (no cap)
        Eligibility All pregnant women (2nd/3rd trimester)
        Key Benefit Monthly free check-up on the 9th
        Includes Blood tests, ultrasound, BP monitoring
        Key Beneficiaries  All pregnant women in second and third trimester
      9. Surakshit Matritva Aashwasan Yojana (SUMAN)

        PMSMA provides free and good-quality prenatal checks to all pregnant women every 9th of each month, which will help to detect any high-risk pregnancies early and decrease the mortality rate among pregnant women in India.

        Category Details
        Launched October 10, 2019
        Coverage Amount Free services (no cap)
        Eligibility All women, no income restriction
        Key Benefit Free transport and newborn vaccination
        Duration Up to 6 months post-delivery
        Key Beneficiaries  All pregnant women, mothers up to 6 months post-delivery and newborns
      10. Pradhan Mantri Matru Vandana Yojana (PMMVY)

        PMMVY provides cash benefits to pregnant and breastfeeding women as compensation for lost income and proper nourishment, with a payment of ₹5,000 for the first child and an extra ₹6,000 if the second child is a girl.

        Category Details
        Launched January 1, 2017
        Coverage Amount ₹5,000 (1st child), ₹6,000 (2nd child, girl)
        Eligibility Pregnant/lactating women above 18 years
        Key Benefit Direct cash transfer in instalments
        Launched By Ministry of Women and Child Development
        Key Beneficiaries  Pregnant and lactating women aged 18 years and above
      11. Mission Vatsalya

        Mission Vatsalya caters to the care, rehabilitation, and protection of needy children by providing financial assistance to families adopting, sponsoring, and fostering children at the rate of ₹4,000 per month up to adulthood.

        Category Details
        Launched 2021
        Coverage Amount ₹4,000/month per child
        Eligibility Orphaned, abandoned, or vulnerable children
        Key Benefit Aftercare support beyond age 18
        Launched By Ministry of Women and Child Development
        Key Beneficiaries  Orphaned, abandoned, surrendered and vulnerable children
      12. Niramaya Health Insurance Scheme

        Niramaya is an initiative that provides health insurance to citizens of India who suffer from Autism, Cerebral Palsy, Mental Retardation, and Multiple Disabilities, with a limit of ₹1 lakh without any age bar and without any pre-medical examination.

        Category Details
        Run By National Trust, Ministry of Social Justice
        Coverage Amount Up to ₹1 lakh (reimbursement)
        Eligibility Persons with specified disabilities, any age
        Key Benefit Same premium across all age groups
        Special Feature No pre-medical check-up needed
        Key Beneficiaries  Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities
      13. Janani Suraksha Yojana (JSY)

        JSY aims to promote institutional delivery amongst poor pregnant mothers through cash incentives of up to ₹1,400 in rural areas and ₹1,000 in urban areas in order to minimise maternal and child mortality.

        Category Details
        Launched 2005, under National Rural Health Mission
        Coverage Amount ₹1,400 (rural), ₹1,000 (urban)
        Eligibility BPL women, aged 19+, up to 2 live births
        Key Benefit Encourages institutional deliveries
        Limit Up to two live births
        Key Beneficiaries  BPL pregnant women aged 19 and above, up to two live births
      14. Rashtriya Arogya Nidhi (RAN)

        RAN is a financial assistance program for BPL patients suffering from terminal illnesses such as cancer and kidney failure being treated in super-speciality government hospitals, with financial support of up to ₹20 lakh for each individual.

        Category Details
        Launched 1997
        Coverage Amount Up to ₹20 lakh per patient
        Eligibility BPL patients with life-threatening diseases
        Key Benefit Direct hospital-level fund approval up to ₹2 lakh
        Fund per Hospital ₹50 lakh (₹90 lakh for AIIMS Delhi)
        Key Beneficiaries  BPL patients with life-threatening diseases at government super-specialty hospitals
      15. Scheme for Adolescent Girls (SAG) (Integrated With Saksham Anganwadi & Poshan 2.0)

        Nutrition and Life Skills Programme is being provided to girls aged 11-14 years who are not enrolled in schools through Anganwadi Centres by SAG for providing nutrition support, health care and menstrual hygiene awareness. But, this earlier scheme has been stopped from 31st March, 2022 and this new scheme has been brought into existence as part of Saksham Anganwadi & Poshan 2.0.

        Category Details
        Launched 2010
        Coverage Amount 600 calories, 18-20g protein daily
        Eligibility Out-of-school girls, 11–14 years
        Key Benefit 300 days of nutritional support annually
        Earlier Known As SABLA / RGSEAG
      16. Nikshay Poshan Yojana (NPY)

        Nutritional support for the Treatment (NPT) program is provided to TB patients on a monthly basis through financial assistance for fulfilling their nutritional requirements.

        Category Details
        Launched 2018, under NTEP
        Coverage Amount ₹1,000/month
        Eligibility Registered TB patients
        Key Benefit Direct benefit transfer throughout treatment
        Goal Improve nutrition and treatment success
        Key Beneficiaries  All registered TB patients throughout treatment

      State Government Health Insurance Schemes

      1. West Bengal Health Scheme (WBHS)

        The WBHS scheme offers individuals and their families up to ₹2 lakh per indoor treatment for government employees and pensioners of the West Bengal state government, with cashless treatment being provided since 2014.

        Category Details
        State West Bengal
        Launched 2008
        Coverage Amount Up to ₹2 lakh/indoor treatment
        Eligibility State employees and pensioners
        Key Benefit OPD cover for 18 diseases
        Key Beneficiaries  State government employees, pensioners and their dependants
      2. Yeshasvini Health Insurance Scheme

        The Yeshasvini scheme covers 2,128 procedures performed in hospitals in the network hospitals for heart, orthopedic, and women's ailments of farmers and co-operative societies of Karnataka.

        Category Details
        State Karnataka
        Procedures Covered 2,128
        Coverage Amount 1,650 medical + 478 ICU procedures
        Eligibility Farmers and co-op society members
        Key Benefit Extendable to family members
      3. Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) (Integrated with AB-PMJAY)

        The MJP JAY scheme offers family health insurance of up to ₹5 lakh to BPL families and farmers in Maharashtra without any waiting period for pre-existing conditions. It has now been integrated with Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY). 

        Category Details
        State Maharashtra
        Coverage Amount Up to ₹5 lakh/family
        Eligibility BPL families and farmers
        Key Benefit 1,209 treatments, PED covered from day 1
        Waiting Period None for pre-existing diseases
        Key Beneficiaries  BPL families and farmers in Maharashtra
      4. Mukhyamantri Amrutum (MA) Yojana (Integrated with AB-PMJAY)

        The MA Yojana scheme covers the health of poor families in Gujarat through floater insurance of up to ₹3 lakh per annum for major ailments, including heart ailments, cancer, and kidney problems, along with organ transplant costs up to ₹5 lakh.

        Category Details
        State Gujarat
        Launched 2012
        Coverage Amount Up to ₹3 lakh/year (₹5 lakh for transplants)
        Eligibility Below poverty line families
        Key Benefit 698 procedures including transplants
        Key Beneficiaries  BPL families in Gujarat
      5. Telangana Employees and Journalists Health Scheme

        This scheme offers cashless treatment for government employees, journalists, and pensioners of the Telangana government in the Rajiv Aarogyasri Trust hospitals for chronic ailments in OPD and inpatient settings.

        Category Details
        State Telangana
        Coverage Amount Cashless, no fixed cap
        Eligibility Govt employees, journalists, pensioners
        Key Benefit OPD cover for chronic illnesses
        Network Rajiv Aarogyasri Health Care Trust hospitals
        Key Beneficiaries  State government employees, journalists and pensioners in Telangana
      6. Dr YSR Aarogyasri Health Scheme (Integrated with AB-PMJAY)

        The insurance scheme has been completely operationalized through AB-PMJAY in the state of Andhra Pradesh. The name of the insurance scheme had been changed in 2024, in which end-to-end cashless insurance had been made available for the BPL families in Andhra Pradesh costing ₹5 lakh for 31 headings and 3,257 treatments.

        Category Details
        State Andhra Pradesh
        Launched 2007
        Coverage Amount Up to ₹5 lakh
        Eligibility BPL families
        Key Benefit Free screening and OPD consultations
        Key Beneficiaries  BPL families with white ration card in Andhra Pradesh
      7. Awaz Health Insurance Scheme

        Awaz insures migrant workers in Kerala between 18 and 60 years of age against their medical and accident needs, offering them ₹25,000 towards medical assistance and ₹2 lakh in case of an accident.

        Category Details
        State Kerala
        Launched 2017
        Coverage Amount ₹25,000 (medical), ₹2 lakh (accidental death)
        Eligibility Migrant workers, 18–60 years
        Key Benefit Disability compensation up to ₹1 lakh
        Key Beneficiaries  Migrant workers aged 18-60 years in Kerala
      8. Bhamashah Swasthya Bima Yojana (BSBY) (Currently Inactive)

        Ayushman Bharat: Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Bhamashah Swasthya Bima Yojana (BSBY) were integrated to form the AB-MGRSBY. BSBY provided the general and critical health insurance cover for NFSA and RSBY families in Rajasthan with pre-hospitalisation cover of 7 days and post-hospitalisation cover of 15 days.

        Category Details
        State Rajasthan
        Coverage Amount ₹30,000 (general), ₹3 lakh (critical illness)
        Eligibility NFSA and RSBY-listed families
        Key Benefit 1,715 treatment packages
        Pre/Post Hospitalisation 7 days / 15 days
      9. Chirayu Ayushman Haryana

        The Chirayu Ayushman Haryana Scheme is completely integrated with the national scheme known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Under this scheme in Haryana, Chirayu Scheme is offering additional features of Ayushman Bharat to offer cashless hospitalization cover of ₹5 lakh to families earning up to ₹1.8 lakh for free and to those earning ₹6 lakh at nominal premium rates.

        Category Details
        State Haryana
        Launched 2022
        Coverage Amount Up to ₹5 lakh
        Eligibility Families earning up to ₹6 lakh/year
        Key Benefit Free for income up to ₹1.8 lakh
        Key Beneficiaries  Families with annual income up to ₹6 lakh in Haryana
      10. Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS)

        CMCHIS provides cashless medical cover up to ₹5 lakh along with neo-natal and maternity benefits, without any waiting period to claim the benefits, for poor families in Tamil Nadu.

        Category Details
        State Tamil Nadu
        Launched 2009
        Coverage Amount Up to ₹5 lakh
        Eligibility Income below ₹1,20,000/year
        Key Benefit 1,090+ procedures, maternity cover included
        Key Beneficiaries  Families with annual income below ₹1,20,000 in Tamil Nadu
      11. Aarogyasri

        Aarogyasri provides Rs. 5,00,000/- per year for medical expenditure, such as day care, out-of-door and in-patient benefits to BPL families in Andhra Pradesh from day one.

        Category Details
        State Andhra Pradesh
        Launched 2007
        Coverage Amount ₹5 lakh/family/year
        Eligibility White ration card holders, land under 35 acres
        Key Benefit PED covered from day 1
        Key Beneficiaries  BPL families with white ration card in Andhra Pradesh
      12. HIMCARE

        The scheme of HIMCARE offers a benefit of ₹5 lakhs to the BPL families of Himachal Pradesh, which is not covered under the Ayushman Bharat scheme, who can avail cashless hospitalization within and outside HP at the empanelled hospital without any hassle.

        Category Details
        State Himachal Pradesh
        Launched 2019
        Coverage Amount ₹5 lakh/family
        Eligibility Non-BPL families needing financial support
        Key Benefit Coverage extends to a few hospitals outside HP
        Key Beneficiaries  Himachal Pradesh residents not covered under Ayushman Bharat
      13. Rajiv Aarogyasri Scheme, Telangana

        The scheme provides free cashless treatment for up to ₹10 lakhs per BPL family in Telangana State for critical illnesses, with a specific cover of ₹6.5 lakhs for cochlear implants.

        Category Details
        State Telangana
        Launched 2007
        Coverage Amount Up to ₹10 lakh/family/year
        Eligibility BPL families, resident 18+ months
        Key Benefit 1,835 treatments, cochlear implant cover
        Key Beneficiaries  BPL families resident in Telangana for 18+ months
      14. Karunya Arogya Suraksha Padhathi (Integrated With AB-PMJAY)

        The KASP scheme was introduced by the Government of Kerala, providing health insurance cover for critical illnesses to poor families with cashless treatment cover in empanelled hospitals, whether private or government. It has now been integrated with the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

        Category Details
        State Kerala
        Launched 2019
        Coverage Amount Up to ₹5 lakh/family
        Eligibility Economically vulnerable families
        Key Benefit Secondary and tertiary medical care covered
      15. Arogya Karnataka Scheme (Integrated with AB-PMJAY)

        This scheme of the state of Karnataka, now it has been officially merged with the central government’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The integrated scheme is referred to as Ayushman Bharat - Arogya Karnataka (AB-ArK). AB-ArK, covers all BPL families with a ₹5 lakh cover and 30% cover (up to ₹1.5 lakhs) for APL families.

        Category Details
        State Karnataka
        Launched 2018
        Coverage Amount ₹5 lakh (BPL), 30% subsidy (APL)
        Eligibility All Karnataka residents
        Key Benefit Now integrated with Ayushman Bharat
        Key Beneficiaries  BPL families and APL families in Karnataka
      16. Ayushman Bharat Yojana Uttar Pradesh

        It is the UP-specific version of the Ayushman Bharat, providing ₹5 lakhs cashless cover for 1,900+ treatment packages which can be used at any empanelled hospital in India. 

        Category Details
        State Uttar Pradesh
        Coverage Amount ₹5 lakh
        Eligibility Low-income households
        Key Benefit Pan-India hospital portability
        PED Cover From day 1
        Key Beneficiaries  Low-income households in Uttar Pradesh
      17. Atal Amrit Abhiyan (Integrated with AB-PMJAY)

        Atal Amrit Abhiyan helps the poorer families in Assam by providing coverage of ₹2 lakh per person for six costly disease categories, including cardiovascular and renal diseases.

        Category Details
        State Assam
        Launched 2016
        Coverage Amount ₹2 lakh/individual
        Eligibility BPL and low-income APL families
        Key Benefit Covers 6 high-cost disease categories
        Key Beneficiaries  BPL and low-income APL families in Assam
      18. Gopabandhu Jan Arogya Yojana (GJAY) (Integrated with AB-PMJAY) 

        Under the GJAY program, the citizens of Odisha will get free cashless treatment with ₹5 lakh insurance coverage in the rural area and ₹6 lakh insurance coverage in urban areas along with additional ₹5 lakh coverage for female beneficiaries. The Odisha Government Scheme GJAY is completely operational and integrated with the central government’s scheme AB PM-JAY.

        Category Details
        State Odisha
        Coverage Amount ₹5–6 lakh/family
        Eligibility All Odisha residents
        Key Benefit Extra ₹5 lakh cover for women
        Treatment Free, cashless
        Key Beneficiaries  All Odisha residents including rural and urban poor families
      19. Mukh Mantri Sarbat Sehat Bima Yojana (MMSSBY) (Integrated with AB-PMJAY)

        The Mukh Mantri Sarbat Sehat Bima Yojana (earlier known as AB-PMJAY MMSBY) is updated and included in the Mukh Mantri Sehat Yojana (MMSY). It continues to be a very active scheme and is very much linked with AB-PMJAY. The MMSSBY scheme offers cashless treatments for 2,000 packages to economically weaker sections of Punjab. The scheme is combined with the Mukh Matri Sehat Yojna scheme in 2026 with coverage of ₹10 lakhs for each household.

        Category Details
        State Punjab
        Launched 2019 (upgraded 2026)
        Coverage Amount Up to ₹10 lakh
        Eligibility All bonafide Punjab households
        Key Benefit PED covered from day 1
        Key Beneficiaries  All bonafide Punjab households 

      Enrollment and Claim under a Government Health Insurance

      Although there may be slight differences in each state, government health insurance schemes follow an almost identical procedure across the country.

      1. Check Eligibility 

        Depending on the income (BPL/APL), Occupation, residence in the state or Category (senior citizen, pregnant women, migrant laborers, etc.) This can normally be done using the SECC database or ration cards.

        Eligibilities and Government Assistance:

        • Poor economic section based on income
        • Occupations/Employee based on Occupation
        • Senior citizens (Age Based)
        • This will be eligibility based on residence and not for the specific state schemes.
        • Complete or partial government assistance, depending on the scheme
      2. Documents needed

        Aadhaar Card, Ration Card/Income certificate, Family information, photo, bank details, state domicile certificate (specific to the state).

      3. Enrollment Online/Offline

        Online through the official website (pmjay.gov.in) and offline via the CSCs, empanelled hospitals and enrolment camps, etc., post-Aadhaar/OTP verification.

      4. Verification & Card Issuance

        Application is digitally or manually verified, beneficiaries receive a health card and unique ID, typically 2–14 days later.

      5. Cashless Treatment

        Present the health card and ID at the help-desk of an empanelled hospital, and the treatment is given without having to pay anything upfront.

      6. Claim Processing (Reimbursement Schemes)

        In these schemes, such as CGHS, submit bills, prescription details and discharge reports for reimbursement and it takes 30-45 days.

        Common Reasons for Rejection:

        • Non-empanelled hospital used
        • Aadhaar/document mismatch
        • Failure to pay bills or discharge summary
        • There is a procedure that is not listed in the covered package list.
        • Late claim submission

      Note: Ensure empanelment with hospitals before admission, update all information like Aadhaar/bank details and keep all original bills/papers.

      Benefits of Government Health Insurance Schemes

      1. Financial Safety in Case of Emergencies

        The primary benefit of government health insurance schemes is financial safety in case of emergency situations. Admission to hospitalisation, surgeries, and other critical procedures can easily cost lakhs of rupees, which no poor family can afford. This scheme covers such expenses, thereby preventing families from going into debt.

      2. Access to High-Quality Health Care Nationwide

        Many of the government health insurance schemes give patients access not only to hospitals in their home state but also throughout the country via an entire network of government and private hospitals.

      3. Insurance of Vulnerable and Marginalised Groups

        It often happens that senior citizens, migrants, differently abled people, and poor families face difficulties when trying to get insured through private health insurance. Govt health insurance schemes are specially tailored to accommodate such people.

      4. Prevention of Disease and Early Diagnostics

        In addition, some health insurance schemes pay particular attention to preventive healthcare – screening, diagnostic tests, and timely detection of diseases.

      5. Easy Registration Online and Offline

        Most health insurance schemes can be registered online, using Aadhar and mobile authentication as well as offline at CSCs, hospitals, and government enrollment camps.

      How Government Health Plans Are Shaping Universal Healthcare Access

      With the cost of healthcare services in India on the rise, government health insurance becomes even more significant. It is believed that in the future, through the development of hospital networks, improved IT infrastructure, and regular improvements to the scheme, existing coverage shortcomings will be addressed. Provided that the appropriate government health insurance scheme is in place, citizens can enjoy adequate healthcare regardless of their financial condition in the future.

      Check Out Other Government Health Insurance Plans

      Frequently Asked Questions (FAQs)

      • Q1. Why do we start government health insurance schemes?

        Ans: To provide access to quality healthcare at affordable costs to economically weaker sections, BPL families, and workers who cannot afford private insurance schemes.
      • Q2. Is there any criteria of eligibility for purchasing public health insurance schemes?

        Ans: Yes, almost all the schemes are for families below the poverty line or with a specified low annual income; however, some schemes like SUMAN or PMSMA have no such restrictions and are available for everyone.
      • Q3. Is there any limitation in the Government Health Insurance Schemes?

        Ans: Yes, there are several limitations, like low sum insured, limited coverage, no tax benefit, and in some cases, a limited hospital network compared to private schemes.
      • Q4. Are all government schemes started by the Central Government?

        Ans: No, there are many schemes that are state-wise, like HIMCARE (Himachal Pradesh), CMCHIS (Tamil Nadu), and Aarogyasri (Andhra Pradesh).
      • Q5. Is it possible to purchase the Government Health Insurance schemes through the internet in India?

        Ans: While there are some Government health insurance schemes that can be purchased through the Internet, most of the schemes require people to verify themselves in designated centres, hence taking more time compared to purchasing private insurance policies.
      • Q6. What is the sum assured in the case of government medical insurance schemes?

        Ans: The sum assured varies between ₹30,000 to ₹10 Lakh in accordance with the particular scheme and State.
      • Q7. Is PMJAY & Ayushman Bharat Yojana the same?

        Ans: Yes, PMJAY (Pradhan Mantri Jan Arogya Yojana) is the official name for Ayushman Bharat Yojana.
      • Q8. Is it possible to purchase a Government health insurance scheme using my Aadhaar card?

        Ans: Yes, you can purchase a Government health insurance scheme using your Aadhaar Card.

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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

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      ##On ground claim assistance is available in 114 cities

      Tax Benefits are subject to changes in tax laws. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

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