National Health Insurance Schemes are the health insurance policies that are designed by the Indian government to cater to the enhancement of healthcare services to its citizens.
The Government of India with the help of the Ministry of Health & Family Welfare and the National Knowledge Commission has set up the National Health Portal to offer valid and right information regarding healthcare to its citizens. Multiple health insurance schemes are there to serve the various needs of the different sections of Indian society.
Let us learn more about National Health Insurance Schemes in detail.
Rashtriya Swasthiya Bima Yojana (RSBY) is launched by the Ministry of Labour and Employment, Government of India to offer health insurance coverage and to provide financial protection against the medical expenses raised due to hospitalization to the Below Poverty Line (BPL) families. Even the beneficiaries under this scheme are given the privilege of hospitalization coverage (up to Rs.30,000) for most of the diseases that require hospitalization.
Employees' State Insurance Scheme (ESIS) is a multidimensional social security system of the Government of India, specially designed for the working-class people and their dependents to provide them with socio-economic protection. This scheme not only provides the full medical care to the insured and his/her dependants (from day one of insurable employment) but also the insured can avail of various cash benefits in times of physical distress due to temporary/permanent disablement, sickness, and many more.
The Central Government Health Scheme started in New Delhi in 1954, is a comprehensive healthcare scheme that is specially tailored for the Central Government employees and their dependents, who reside in CGHS covered cities. The medical services are offered through Wellness Centers (previously known as CGHS Dispensaries) or polyclinics under Allopathic, Yoga, Ayurveda, Sidha, Unani, and Homeopathic methods of treatment.
The Main Components of This Scheme:
Aam Admi Bima Yojana started on 2nd October 2007, is a scheme for social security for rural landless households that aims to give coverage to the head of the family or one earning member of the family, aged between 18 to 59 years. The premium of Rs.200 per person per annum is shared equally by the State and the Central Government of India.
Janashree Bima Yojana (JBY) came into the limelight on 10th August 2000, replacing the Social Security Group Insurance Scheme (SSGIS) and Rural Group Life Insurance Scheme (RGLIS). A total of 45 occupational groups are covered under this scheme.
JBY is designed to provide life insurance protection to the people, aged between 18 to 59 years, who belong from Below Poverty Line (BPL) families or from marginally above poverty line families and are the members of the 45 recognized occupational groups.
Note: Janashree Bima Yojana and Aam Admi Bima Yojana have been merged into one scheme, namely Aam Admi Bima Yojana, and have come into force from 1st January 2013.
Four public sector general health insurance companies are managing and implementing this scheme that aims to compensate the poor families for their medical expenses.
The insured, under this scheme, can get the compensation of Rs.30,000 for the hospitalization that is floated among the entire family. Rs.25,000 is reimbursed to the earning head of the family in case of accidental death. Also, compensation of Rs.50 per day (up to 15 days) is provided to the earning head of the family (due to loss of his/her earning).
The premium value varies according to the size (numbers of family members) of the family. The premium rate of this scheme is Rs.200 for an individual, Rs.300 for a family of five, and Rs.400 for a family of seven.
As recommended by the National Health Policy 2017, Ayushman Bharat, a flagship scheme of the Government of India, was launched to achieve the vision of Universal Health Coverage (UHC). This scheme is designed to meet Sustainable Development Goals (SDGs) and its underlying commitment, which is to "leave no one behind."
It provides need-based, comprehensive healthcare services and consists of two interrelated components - Health and Wellness Centres (HWCs) and Pradhan Mantri Jan Arogya Yojana (PM-JAY).
The Government of India announced the formation of 1,50,000 Health and Wellness Centres (HWCs) by modifying the existing sub-centers and Primary Health Centres (in February 2018) to provide Comprehensive Primary Health Care (CPHC), bridging healthcare services and the households.
Benefits of HWCs:
Launched in September 2018, Ayushman Bharat PM-JAY (previously known as National Health Protection Scheme) is the largest health assurance scheme in the world that is developed to provide a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to cover 10.74 crore poor families (approximately 50 crore beneficiaries) that form the bottom 40% of the Indian population. PM-JAY is fully funded by the Government and the implementation cost is shared between the Central and State Governments.
Key benefits of PM-JAY:
The scheme covers the following expenses-
The above are the 7 National Health Insurance Schemes that the Indian government has laid out for the betterment of the citizens of our society. The concerned individual can choose the best among them to suit his/her family's healthcare needs.
Written By : Naval Goel
Last Updated : January, 2021
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