Healthcare costs are steadily rising in India. This is making access to quality treatment a concern for many, including low and middle-income families. In response, the Government of India has launched several government health insurance schemes to protect financially and provide access to medical services to its citizens.
These govt health insurance schemes are aimed at reducing your medical burden whether you are a daily wage worker, a senior citizen, or a low income family. Yet, even with these good plans, many still believe that private health insurance provides the complete coverage required in long run.
In this blog, we will discuss the most popular government health insurance schemes in India, their benefits, and why it is still the best decision to go for additional health insurance.
What is a Government Health Insurance?
India’s public health system has gradually strengthened in terms of providing preventive and accessible healthcare. For the very same reason, the government has launched several government health insurance schemes in India to protect vulnerable sections at a very low or no cost.
These schemes are primarily designed to:
- Promote inclusive healthcare.
- Reduce out-of-pocket expenditure.
- Encourage people to seek medical help when required.
- Provide financial assistance during hospitalisation and treatment.
Let’s now dive into the best government health insurance schemes currently available.
Best Government Health Insurance Schemes & Their Benefits
Here are some of the most well-known and impactful government health insurance schemes in India:
- Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)
PM-JAY is one of the world’s largest govt health insurance programmes. It provides coverage of up to ₹5 lakh per family per year for secondary and tertiary hospitalisation.
Key Features:
- Covers over 10 crore poor and vulnerable families.
- No premium, no age restriction, and no limitation on family size.
- Services available at public and empanelled private hospitals.
- Cashless and paperless claim process.
This scheme is particularly useful for families below the poverty line or working in the unorganised sector.
- Employees’ State Insurance Scheme (ESI)
Managed by the Employees’ State Insurance Corporation (ESIC), this scheme is a social security programme for employees earning ₹21,000 or less per month.
Key Features:
- Includes medical, maternity, disability, and dependent benefits.
- Access to ESI hospitals and dispensaries across India.
- Employers and employees both contribute to the scheme.
- Coverage extends to family members too.
- Central Government Health Scheme (CGHS)
CGHS is a health insurance programme for central government employees and pensioners.
Key Features:
- Comprehensive medical cover including outpatient care, medicines, diagnostics, and specialist consultation.
- Available in select cities through CGHS wellness centres.
- Beneficiaries include government employees, MPs, judges, and more.
- Rashtriya Swasthya Bima Yojana (RSBY)
RSBY is meant for Below Poverty Line (BPL) families and provides health insurance coverage for hospitalisation expenses.
Key Features:
- Offers ₹30,000 coverage per family annually.
- Covers five members per family.
- Cashless facility available at empanelled hospitals.
- Minimal premium with a biometric smart card.
- Aam Aadmi Bima Yojana (AABY)
AABY is aimed at rural landless households and workers in informal sectors.
Key Features:
- Covers natural and accidental death.
- Offers scholarships for children of insured families.
- Funded jointly by the central government and LIC.
- Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) – Tamil Nadu
This state-level government health insurance scheme offers comprehensive cover for economically weaker sections.
Key Features:
- Coverage of up to ₹5 lakh per family per year.
- Includes treatment for 1000+ procedures.
- Access to government and empanelled private hospitals.
Why Private Health Insurance is Still Necessary?
While government health insurance schemes provide crucial support, they may not always be enough. Here’s why you should consider complementing them with private health insurance:
- Wider Hospital Network
Private medical insurance often includes a broader list of hospitals, including high-end private healthcare institutions. This means faster access to specialised care and reduced waiting times.
- Higher Sum Insured
Many government schemes come with a capped limit (₹30,000 to ₹5 lakh). If a major surgery or long-term treatment is required, these limits may fall short. Health insurance from private providers offers higher sum insured options—ideal for urban, nuclear families.
- Coverage for OPD & Diagnostics
Outpatient consultations, diagnostics, and day-care procedures are often excluded or limited in govt health insurance. With private online health insurance, these are more frequently included.
- Customisation & Add-Ons
Private insurers allow you to tailor your plan with maternity cover, critical illness, top-up covers, and more. You can easily buy health insurance online that suits your family’s needs.
- Ease of Access & Claim Support
With digital platforms, you can now compare health insurance plans in India, read reviews, and buy health insurance online instantly. Many private players also offer dedicated 24×7 claim support and hassle-free cashless hospitalisation.
Government or Private: Which One Should You Choose?
Ideally, you don’t have to choose between them — you can combine both. Government schemes act as a basic safety net, particularly helpful for those with limited income.
But for better hospitals, more coverage, and smoother claims, buying additional health insurance online makes a big difference.
By combining both types of insurance, you can get peace of mind, extensive coverage, and financial stability in the face of rising healthcare costs.
Final Thoughts
India offers some of the best government health insurance schemes to support its citizens. These initiatives have changed the way many families access medical care. However, relying solely on them may not be sufficient, especially during emergencies or critical illnesses.
Investing in a medical health insurance plan alongside government schemes ensures you’re truly covered — no matter what life throws at you.
Take time to explore the best health insurance plans in India, and don’t hesitate to buy health insurance online after comparing policies and features.
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Source:https://www.insightssuccess.in/top-government-health-insurance-schemes-in-india/