17 Types of Government Health Insurance Schemes in India

What is a Government Health Insurance Scheme?

A government health insurance scheme is a central or state government-powered policy designed to provide adequate medical insurance coverage at an affordable price. Such health insurance policies are usually offered on a yearly basis.

Regular Health Insurance Plans vs Government Health Insurance Scheme

Types of Government Health Insurance Schemes

Take a look at the various types of government health insurance plans introduced by the Government of India:

1. Ayushman Bharat Yojana

   Ayushman Bharat Yojana, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a universal health insurance scheme of the Ministry of Health and Family Welfare, Government of India. The PMJAY was launched to provide free healthcare services to more than 40% population of the country. This health insurance for poor in India offers a health cover of ₹5 lakh.

   The PMJAY scheme provides coverage for medicines, diagnostic expenses, medical treatment, and pre-hospitalisation costs. The poor or low-income families of India can benefit from this Ayushman Bharat health insurance scheme.

2. Pradhan Mantri Suraksha Bima Yojana (PMSBY)

   Pradhan Mantri Suraksha Bima Yojana aims to provide accident insurance cover to the people of India. People in the age group of 18 years to 70 years who have an account in a bank or post office can avail benefits from this scheme.

   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 for this scheme gets automatically debited from the policyholder's bank account.

3. Aam Aadmi Bima Yojana (AABY)

   The Aam Aadmi Bima Yojana is a National Health Insurance Scheme introduced in October 2007 to provide compensation for accidental death and disability. It covers the earning member or the head of the family between the age group of 18 to 59 years. The AABY insurance scheme is tailored for people living in the upcountry 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 compensated with ₹30,000 in case of natural death and ₹75,000 in case of accidental death. Besides, ₹37,500 is paid as compensation in case of accidental disability. Moreover, the annual ₹200 premium for this scheme is shared equally by the state and the central government.

4. Central Government Health Scheme (CGHS)

   The Central Government Health Scheme was started in 1954 to provide comprehensive healthcare 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 treatments availed at wellness centres as well as government and empanelled hospitals.
   • Reimbursement of hospitalisation expenses for treatments availed at government or private hospitals.
   • All dispensary-related services, including AYUSH medicines.
   • Investigations, like X-rays, MRIs, etc. or laboratory examination services will be provided free of cost at government and CGHS-empanelled diagnostic centres.
   • Free specialist consultations at polyclinics, government, and empanelled hospitals.
   • Reimbursement of medical expenses incurred on artificial limbs, hearing aids, etc.

5. Employees' State Insurance Scheme (ESIC)

   Employees' State Insurance Scheme is a multidimensional National Health Insurance Scheme that provides medical coverage, maternity insurance, sickness benefit, disablement benefit and dependents benefits to all workers in India. It provides full medical insurance to the 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 benefits.

   The ESIC scheme is applicable to all permanent factories and establishments employing more than 10 employees. However, some states have extended this scheme to various establishments and businesses, including shops, restaurants, road and motor transport and newspaper entities that employ 20 or more people.

6. Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS)

   Chief Minister's Comprehensive Health Insurance Scheme is a Tamil Nadu state government scheme that works in association with the United India Insurance Company Ltd. It is a family floater health insurance policy designed to provide quality healthcare services to economically weak 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 hospitalisation expenses up to ₹5 lakh at both private and government hospitals. Tamil Nadu residents with an annual family income of less than ₹1.2 lakh per year are eligible to enrol under this scheme.

7. Universal Health Insurance Scheme (UHIS)

   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 the hospitalisation expenses of every family member, it provides accidental death and disability benefit to the earning member or head of the family.

   The main drivers of the Universal Health Insurance Scheme are the four public sector general insurance companies that offer health insurance for below poverty line citizens, especially economically disabled citizens. They cover hospitalisation expenses of up to ₹30,000, accidental death benefit of ₹25,000 and a disability compensation of ₹50 daily for a maximum of 15 days.

8. West Bengal Health Scheme (WBHS)

   The Government of West Bengal launched the West Bengal Health Scheme to provide better medical facilities to its employees in the year 2008. Gradually, the scheme was made available to superannuated and family pensioners, IAS, IFS and IPS employees and retired AIS officers.

   Under the WBHS scheme, both individual and family floater coverage is available for up to ₹2 lakh per indoor treatment. The scheme covers all indoor medical treatments and OPD treatment for 18 diseases. Moreover, cashless health insurance was introduced in 2014, leading to the renaming of the scheme to 'West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme 2014'.

9. Yeshasvini Health Insurance Scheme

   The Karnataka State Government introduced the Yeshasvini Health Insurance Scheme for peasants, farmers and members of any co-operative society. The beneficiaries can avail medical treatments at identified Yeshasvini network hospitals across the state. Moreover, 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 offers coverage for heart diseases, orthopaedic diseases, nerve-related diseases, women-related diseases, intestinal diseases, ENT and ophthalmology diseases.

10. Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY)

    The Government of Maharashtra introduced 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 scheme offers a family health cover of up to ₹5 lakh for 1209 treatments under 34 specialities. The best part about this policy is that there is no waiting period for pre-existing diseases, and it is claimable from the first day itself.

11. Mukhyamantri Amrutum (MA) Yojana

    Mukhyamantri Amrutam Yojana was initiated by the Gujarat government in the year 2012 to provide quality medical and surgical care for major illnesses to poor people living in the state. People belonging to lower-income groups and living below the poverty line are eligible to enrol in this scheme.

    The MA Yojana provides family floater health insurance coverage of up to ₹3 lakh per annum. Under this health insurance for poor people, policyholders can avail of cashless medical treatments for heart diseases, cancer, neurosurgery, kidney diseases, burns and neonatal or newborn baby diseases, covering 698 procedures at private, government and trust-run hospitals. Moreover, transplants of kidney, liver and kidney + pancreas are covered up to ₹5 lakh.

12. Karunya Arogya Suraksha Padhathi (KASP)

    The Kerala Government launched the Karunya Arogya Suraksha Padhathi to provide secondary and tertiary care hospitalisation to the poor and vulnerable families in the state. It provides health insurance coverage of ₹5 lakh for 1573 medical procedures. Moreover, it covers pre-hospitalisation expenses of up to 3 days and post-hospitalisation expenses of up to 15 days.

    People in Kerala who are living below the poverty line can enrol themselves in this health insurance for poor in India. Besides, it provides coverage to the entire family with no restriction on family size, gender or age.

13. Telangana State Government - Employees and Journalists Health Scheme

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

14. Dr YSR Aarogyasri Health Scheme

    The Andhra Pradesh Government launched the Dr YSR Aarogyasri Health Scheme in 2007 to offer universal health coverage to people in the state living below the poverty line. 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 below poverty line citizens covers 3257 listed in-patient treatments across 31 categories, along with free screening and OPD consultations.

15. Awaz Health Insurance Scheme

    The Kerala Government launched the Awaz 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 to beneficiaries between the age of 18 years and 60 years for medical treatments. Moreover, an accidental death benefit of 2 lakh and a disability compensation of ₹1 lakh are also available for the insured migrants.

16. Bhamashah Swasthya Bima Yojana (BSBY)

    Bhamashah Swasthya Bima Yojana was launched by the Government of Rajasthan to provide cashless hospitalisation facilities to families identified under the National Food Security Act (NFSA) and the Rashtriya Swasthya Bima Yojana in the state. It covers in-patient treatment expenses of up to ₹30,000 for general illnesses across 1715 packages. The scheme also provides critical illness insurance coverage of up to ₹3 lakh.

    Moreover, this government health insurance scheme also provides pre-hospitalisation expenses of up to 7 days and post-hospitalisation expenses of up to 15 days.

17. Rashtriya Swasthya Bima Yojana (RSBY)

    Rashtriya Swasthya Bima Yojana was launched by the Ministry of Labour and Employment to provide medical insurance coverage to families living below the poverty line. It provides family floater coverage for in-patient treatment expenses of 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

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

• Government health insurance schemes are offered at a low price.
• With medical insurance for low-income people, BPL families can also avail of insurance benefits.
• These schemes cover both in-patient and OPD treatments.
• Government mediclaim policies ensure coverage for poor people.
• The scheme provides treatment at both private empanelled and government hospitals for better healthcare.
• Government health insurance plans cover pre-existing diseases (PED) from day 1.
• Beneficiaries of these schemes can avail cashless medical treatments at empanelled hospitals.
• Government health plans offer standardized but comprehensive medical coverage.

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