Articles 8846 views July 2, 2019

What are the National Health Insurance Schemes in India

About National Health Insurance

Healthy citizens are a priority for every government. This explains why the Indian government has multiple schemes in place to ensure adequate medical facilities and a nominal health insurance cover for most people including those belonging to the marginalized sections of the society.

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The Government of India has initiated a number of national health insurance scheme including the Rashtriya Swasthya Bima Yojana, Central Government Health Scheme, Employment State Insurance Scheme, Universal Health Insurance Scheme, Aam Aadmi Bima Yojana, Janashree Bima Yojana, etc. Each of these schemes has its own benefits and caters to a particular section of society.

List of Best National Health Insurance Scheme

Listed following are the details of these schemes and their associated benefits.

1. Rashtriya Swasthiya Bima Yojana (RSBY)

This health insurance plan was first launched by the Ministry of Labour & Employment in 2008 to cater to families with minimal income and absolutely no savings to take care of possible medical expenses in the future. Also, deemed as a blessing for Indian families living below the poverty line (BPL), this health insurance cover was created to cover all the BPL families effectively, thus, availing the necessary medical treatment at nominal costs.

Under the Rashtriya Swasthya Bima Yojana scheme, the government has fixed the hospital package rates and limited the hospitalization cover to Rs. 30,000. As opposed to health insurance plans sold by insurance companies in India, the policyholders can avail cover for pre-existing disorders sans the mandatory waiting period criterion. A maximum of five members inclusive of the policyholder, spouse and dependents are covered under this health insurance scheme. Policyholders in a bid to be covered under this scheme need to register themselves by paying Rs. 30 only. The premiums towards health insurance coverage would be paid regularly by the government.

The beneficiaries under the RSBY scheme can avail cashless treatment benefits in any of the hospitals within its network. Since this scheme is a part of the National Health Insurance Scheme, policyholders can avail treatment at any of the network hospitals across the country. The policyholder has to just submit the admit card issued under the policy and verify the details using the fingerprint. The payments are made electronically to the hospital or treatment center.

2. Employment State Insurance Scheme (ESIS)

This is a government scheme that ensures a cover customized according to the needs of the workers and policyholders covered under this health insurance policy. Policyholders and their dependents covered under the employment state insurance scheme policy not only avail full medical cover but are also entitled to additional cover in case of any emergencies owing to permanent or total disability. Factories involved in creating non-seasonal products or services and employing more than 10 people can cover their employees under this scheme. In addition, hotels, restaurants, newspaper agencies and transport companies employing more than 20 people can cover their employees by choosing to pay premiums on their behalf. Indian citizens excluding those belonging to Assam, Mizoram, Manipur, Arunachal Pradesh, and the Union Territories can benefit from this government health insurance scheme.

3. Central Government Health Scheme (CGHS)

This scheme is nothing short of a boon to all those employees employed with the Central Government. The central government health scheme applies to pensioners and their dependents too. Under this health insurance scheme, central government employees and their family dependents can avail benefits including:-

  1. Free medical treatment from government dispensaries;
  2. Domiciliary care;
  3. Free consultancy from hospitals or medical treatment centers within the government network;
  4. Part-payment on medical tests inclusive of ECG, X-Ray and laboratory tests;
  5. Free hospitalization cover;
  6. Free medicines from CGHS dispensaries;
  7. Regular seminars on health education.

4. Aam Aadmi Bima Yojana (AABY)

Dubbed as the scheme that introduced the concept of health insurance in 2007 to the landless and rural Indian population, the Aam Aadmi Bima Yojana (AABY) covers people aged between 10 and 59 years. Those insured under this scheme avail benefits including:-

  1. Compensation to the tune of Rs. 30, 000 to the policyholders’ dependents;
  2. Compensation not exceeding Rs. 75,000 in case of death by accident, temporary or permanent disability of the policyholders;
  3. Compensation not more than Rs. 37,500 in case of partial, permanent disability owing to the accident of the policyholder.

5. Universal Health Insurance Scheme (UHIS)

Universal Health Insurance Scheme came in the wake of rising hospitalization expenses and reports of poor families’ inability to afford medical treatment at hospitals or medical treatment centers. This scheme implemented by four public insurance companies ensures adequate coverage for poor families or those who are economically deprived.

Hospitalization schemes not exceeding Rs. 30,000 are covered under this scheme. Accidental death cover and daily compensation are also added benefits that the insured can avail under this scheme.

6. Ayushman Bharat

Implemented by the National Health Authority (NHA) in 2018, Ayushman Bharat scheme is currently being touted as the world’s largest health scheme. During the establishment of the NHA, J. P. Nadda, Union Minister for Health and Family Welfare had elucidated, “Ayushman Bharat has stabilized as the largest health scheme in the world, benefiting over 10 lakh patients since its launch, and created an atmosphere of positivity.”

This scheme introduced under the National Health Protection Mission aims to provide coverage to more than 10 crore vulnerable families by offering coverage up to Rs. 5 lakhs to every policyholder and dependents in the event of primary, secondary or tertiary hospitalization. Moreover, this cover can also be availed by policyholders while seeking preventive health care measures through an app available on the Google Play Store.

Health insurance policies introduced and implemented under the National Health Insurance Schemes are meant to serve and help those belonging to the financially weaker sections. These innovative schemes designed after keeping in mind the growing hospitalization costs and the need to secure an insurance cover to the most vulnerable sections of the society.

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