Health Coverage: In a country as big as India, providing equal healthcare to all is a big task. But the government has made significant progress in the last few years to bridge this gap through various health insurance schemes. These schemes aim to cover the masses, especially the economically weaker sections of the society, at zero or minimal cost to the beneficiary. नीचे अपना ऑनलाइन फॉर्म भरे 👇👇
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Ayushman Bharat PM Jan Arogya Health Coverage
Launched in 2018, AB-PMJAY is the flagship health insurance scheme of Government of India. It aims to provide a health cover of Rs 5 lakhs per family per year for secondary and tertiary care hospitalization to 10.74 crore poor and vulnerable families (around 50 crore beneficiaries). The scheme covers 1393 procedures across 25 specialties, including pre-existing conditions and cashless treatment at empaneled public and private hospitals.
Eligibility: Beneficiaries are identified based on the deprivation and occupational criteria of the Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas respectively.
Key Features:
- Portable across the country
- No cap on family size and age
- Covers pre-existing diseases
- Covers all pre and post-hospitalization expenses
- Covers 3 days of pre-hospitalization and 15 days post-hospitalization expenses
- Beneficiaries can avail of services across public and private empaneled hospitals.
Central Government Health Coverage (CGHS)
CGHS is a comprehensive health scheme that provides healthcare facilities to Central Government employees, pensioners, and their dependents in 25 cities across India. It offers both outpatient and inpatient services through a network of allopathic, homeopathic, Ayurvedic, Unani, Siddha, and Yoga & Naturopathy wellness centers and empanelled private hospitals.
Eligibility: Central Government employees, pensioners, and their dependents.
Key Features:
- OPD, diagnostics and hospitalization
- Medicines at wellness centers
- Cashless at empanelled hospitals
- Pre-existing diseases
- COVID-19
Employee’s State Insurance (ESI) Scheme
ESI is a self financing social security and health insurance scheme for Indian workers. It is managed by Employees’ State Insurance Corporation (ESIC) under Ministry of Labour and Employment. It provides medical care, financial assistance for treatment in case of sickness, maternity, employment injury and monthly unemployment allowance in some cases.
Eligibility: Employees earning Rs. 21,000 or less per month, working in factories and establishments with 10 or more employees.
Key Features:
- Medical expenses for self and dependents
- Cash benefits for sickness, maternity and employment injury
- OPD, diagnostic services and hospitalization
- Medicines through ESI dispensaries and hospitals
- Pre-existing diseases
Diseases Covered in Health Coverage Plan
These government health insurance schemes cover a wide range of medical conditions, including:
- Cardiovascular diseases
- Cancer
- Kidney ailments
- Neurological conditions
- Burn injuries
- Reconstructive surgeries
- Ventilator support
- Dialysis
- Cataract surgery
- Dental treatment
- Mental illness
- COVID-19 treatment
The schemes also cover pre and post-hospitalization expenses, diagnostic tests, and follow-up care, ensuring comprehensive coverage for beneficiaries.
Conclusion
The Indian government’s health insurance schemes are a significant step towards achieving universal health coverage. By providing financial protection and access to quality healthcare, these schemes aim to alleviate the burden of medical expenses on the vulnerable sections of society. As these schemes continue to evolve and expand their reach, they hold the promise of a healthier and more equitable future for all Indians.