header Health Insurance

Central Government Health Insurance Schemes are the Real Game-changer

By Vikas Chandra Das
14 November 2022, 5:08 PM

As tragic as it may sound, not even half of the 1.3 billion people in our country have any medical insurance. Talk about the actual poverty rates, and you'll realise that a significant portion of our society cannot afford quality healthcare services. That's where the efforts of the Government of India are highly commendable. They have created various health insurance programmes to make primary medical services more widely available to Indian citizens.

Here are some of the most effective central government programmes to consider, which have made it possible for millions of Indians to pay for high-quality medical procedures and treatments when required.

The Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY)

The PM-JAY is a government health insurance programme that offers medical insurance coverage of INR 5 lakhs to the poor and the vulnerable. It was created to meet the health insurance needs of the bottom 40% of the country's population in terms of income levels.

These are some of the health insurance benefits offered by the yojana:

  1. A hospital stay can last up to three days
  2. A maximum 15-day post-hospitalisation period of coverage
  3. A pre-existing condition policy that does not require a waiting time
  4. There are no limitations on how many family members the programme will cover
  5. The programme provides cashless treatment at all public and private hospitals nationwide
  6. 1393 procedures are covered
  7. Coverage for the costs of medication, treatment, a doctor's visit, tests, ICU fees, etc.
  8. INR 30 yearly premium

Aam Aadmi Bima Yojana

The Aam Aadmi Bima Yojana is one of India's numerous government health insurance programmes. After paying a premium of INR 200 annually, individuals who practise one of the 48 vocations mentioned in the programme are eligible to become beneficiaries. In addition, members of this programme are provided with life and accidental death insurance.

The Aam Aadmi Bima Yojana's coverage is as follows:

  1. INR 30,000 insurance payout in case of the beneficiary's untimely death
  2. INR 75,000 insurance payout if the beneficiary passes away accidentally
  3. Coverage that only applies to the family's head or earner

Central Government Health Scheme

It is a central government-sponsored health insurance programme to give workers medical coverage. Employees in the judiciary, executive, legislative, and press departments are included in this group. In addition, it is accessible to the workers and retirees from the many central government ministries that are mainly included in the plan.

The following health insurance benefits are included in this programme:

  1. Providing medication and PPF treatment coverage
  2. Coverage for expert consultations in public hospitals 
  3. Indoor treatment at government hospitals and accredited hospitals
  4. Services for family welfare are covered
  5. Pay for maternity costs
  6. Includes AYUSH treatment (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy)

Employees' State Insurance Scheme

It is primarily intended to assist industrial workers in managing the costs associated with mishaps and occupational dangers and is accessible to those employed in various factories around India. Employees who earn little more than INR 21,000 per month can join this programme. The limit for people with impairments is INR 25,000.

The cost of joining this health insurance programme is split between the employees and the employers. Nevertheless, workers who make less than INR 137 per day are excused from paying their portion of the premium.

Here's the coverage provided by the Employee State Insurance Scheme (ESIS):

  1. Health insurance for the insured and their family
  2. Sickness benefits for a total of 91 sick days each year
  3. Extended sickness benefit for up to two years in cases of 34 malignant diseases and chronic illnesses
  4. Enhanced sickness benefit for up to 7 days for beneficiaries who are male and up to 14 days for beneficiaries who are female in the event of sterilisation
  5. 26-week maternity leave with a four-week extension
  6. Benefits for dependents in the event of the insured's death due to an injury caused by their work or occupational hazard 
  7. Disablement benefit

Pradhan Mantri Suraksha Bima Yojana

The Indian government introduced this yojana to increase the penetration of health insurance within the country. In addition, this programme provides accidental death and disability insurance coverage.

You can take advantage of the following coverages for a yearly cost of INR 12:

  1. INR 2 lakh insurance payout in the event of accidental death or total incapacity.
  2. INR 1 lakh in insurance coverage for partial disability. The beneficiaries' bank accounts are automatically deducted each year for the premium. You must have a bank account and an Aadhar card to enrol in this programme.

Rashtriya Swasthya Bima Yojana

Workers in the unorganised sector and labourers frequently do not have health insurance. However, these people experience illness and accidents just like everyone else. As a result, their need for medical insurance is just as urgent as that of others.

Offering such coverage to employees in the unorganised sector and their families (up to 5 people) is the responsibility of the Ministry of Labour and Employment.

Universal Health Insurance Scheme

One of the most cost-effective government health insurance programmes supported by the Indian government. Any applicant between the ages of 5 and 70 may choose this coverage. Additionally, after providing the required documentation, anyone who fulfils the definition of someone living below the poverty line can benefit from it. This policy includes coverage for hospitalisation, accidental disability, and other things. The insurance cost, however, is based on the size of your family and the number of people insured.

Janshree Bima Yojana

It is intended for people who fall into the poverty category and are between 18 and 59. Unique elements of the programme include Women SHG Groups and Shiksha Sahyog Yojana. There are 45 occupational groups now included in this programme.


These programmes attempt to provide health insurance coverage to all Indian people through comprehensive coverage and affordable premiums. You can determine your eligibility for any such programme if you enrol.


1. Do all government initiatives come from the Central Government?

Not all initiatives come from the Central Government. For example, state governments also create specialised government plans for health insurance. 

2. Can you purchase government health insurance plans online in India?

Even though some government health plans in India allow for direct bank debit, not all of them can be bought online.

3. Do all people have access to government health insurance plans?

Different plans have various requirements for eligibility. You can review the conditions for the plan, including the documentation needed, and then decide.

4. What are the Central Government Health Insurance Plans' exclusions?

In general, government insurance plans do not cover cosmetic operations.Gender change surgery. It would be wise to thoroughly examine the relevant policy wordings to understand the benefits and exclusions of the health insurance plan.

5. How are the costs of government-sponsored health insurance determined?

Depending on how many people are insured, these plans' rates vary. In some situations, beneficiaries of schemes must pay an annual premium in an amount that has been predetermined.

Health Insurance banner
Health Insurance

Plans starting at only ₹7/day*

Enter your details to buy Health Insurance
By proceeding, I agree to the Terms & Conditions