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Government Health Insurance Schemes In India Research Team | Posted On Saturday, December 29,2018, 05:47 PM

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Government Health Insurance Schemes In India



Government Health Insurance Schemes In India

Rashtiya Swasthiya Bima Yojana (RSBY):

This scheme has been implemented by the government recognizing the need for providing social security to workers in the unorganized sectors. The Rashtiya Swasthiya Bima Yojana had been launched by the Ministry of Labour and Employment to provide health insurance coverage to families living below the poverty line (BPL). The RSBY is a family floater policy that provides coverage to the BPL households for almost all diseases that requires hospitalization. The beneficiaries of the RSBY scheme are required to submit proper documents for identification and soon after they are issued smart cards, so that they can avail the benefits of the scheme.

Features of Rashtiya Swasthiya Bima Yojana (RSBY):

The RSBY scheme differs from other health insurance schemes for BPL households in several ways. The main features of this scheme are listed below:

  • This scheme provides the beneficiary with the option of choosing between public and private hospitals
  • The insurer is paid a certain amount of money for each enrolment. This motivates the insurer to include more and more households under this scheme
  • This scheme issues biometric smart cards to the beneficiaries, making the scheme safe and corruption free as the benefits only reach deserving BPL families
  • One of the main features of this scheme is portability where the migrant workers can carry their cards across the country and can use them in any RSBY enlisted hospital in any state.
  • The beneficiaries of this scheme can avail cashless facility in RSBY enrolled hospitals.

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Benefits of Rashtiya Swasthiya Bima Yojana:

The benefits of the RSBY scheme are designed by the State Government considering the requirement and geography of the state. However, they must integrate the following minimum benefits in their scheme:

  •  A unit of 5 members in a family must be covered
  • Sum assured would be Rs 30,000 per family per annum
  • Coverage on all pre existing diseases
  • Provide Cashless medical insurance facility
  • Cover Transportation costs

Employment State Insurance Scheme (ESIC):

The ESIC scheme is one of the oldest government insurance schemes launched on 24th February by Prime Minister Jawaharlal Nehru with the aim of providing health coverage to workers in case of ailments, maternity, injury, death during employment or partial/ permanent disability. This is an employee insurance scheme that applies to workers working in an organization where 10 or more employees are employed.

Benefits of Employment state insurance scheme:

Mentioned below are the benefits of employment state insurance scheme:

  • The scheme not only provides health cover for the insured, but also the dependents of the family.
  • This scheme offers benefits in case of unemployment after being insured for 3 or more years.
  • The insurance comes into force from the beginning of employment and takes care of the medical needs of the insured
  • The scheme also encompasses benefits for partial/ permanent disability.

Documents required for registration:

Given below is the list of documents that needs to be submitted to enroll for the ESIC scheme:

  • PAN card
  • Compensation details of the employee
  • Registration certificate
  • Memorandum of the organization
  • Form 1 to be downloaded and duly filled
  • Company registration certificate/ partnership deed

Aam Aadmi Bima Yojana (AABY):

Aam Aadmi Bima Yojana is an initiative taken by the Government to provide financial aid and social security to rural households and is a part of rural development schemes in India. The scheme is designed to encompass the rural landless households where access to healthcare facilities like hospitals and pharmacies are limited.

The scheme provides coverage to only the earning member/ head of the family. Any individual falling in the age bracket of 18- 59 years, can enroll in the AABY scheme. The contribution is made by both the central and the state governments to make sure the insured does not have to pay any premiums.

Benefits of Aam Aadmi Bima Yojana:

  • In case of natural death the family/ nominee is liable to receive a death benefit of Rs 30,000.
  • In case of accidental death of the insured the amount received by the nominee/family of the insured is Rs 75,000.
  • In case of partial/ permanent disability of the policy holder, the family/ nominee is liable to receive Rs 37,000.
  • The policy holder is given scholarship benefits for a maximum of two children. This is a free add-on benefit given on half yearly basis.

SEE ALSO: Before Purchasing Health Insurance, Read This Review By

Documents required for AABY Yojana :

To apply for this scheme you must submit the following documents:

Janashree Bima Yojana (JBY):

The Janashree Bima Yojana was launched on 10th of August 2000 to provide life insurance cover to people in rural and urban areas, who are below and marginally above poverty line. This scheme is a joint venture by the government of India and the life insurance corporation (LIC) which includes a total of 45 occupational groups.  Any individual of age 18-59 years can enroll in this scheme. However, the policy holder must be a member of the vocational group/ occupation approved by the nodal agency.

SEE ALSO: Things To Consider While Availing Health Insurance Plans

Documents required for JBY Yojana:

  • Proof of identity
  • Proof of address
  • BPL cards
  • Documents that serves as proof of occupation
  • Income certificate

SEE ALSO: How to Buy health insurance policy?

Features of Janashree Bima Yojana:

  • Woman self help groups: JBY provides a special scheme to woman SHG members to help them avail education for their children. It provides these women with term insurance coverage of Rs 30,000 for a premium of Rs 200 a year. The other half of the premium is paid by the LIC Corporation.
  • Shiksha Sahyog Yojana: this is an added benefit offered by the scheme where the children of the policy holder are also included in the scheme. The benefits are given out to a maximum of 2 children. A scholarship amount of R 600 is paid every 6 months to students pursuing higher secondary and ITI.

SEE ALSO: Family Health Insurance Plan

Benefits of the Janashree Bima Yojana:

The benefits of this scheme are the compensation given under the insurance plan. These are outlined below:

  • The nominee will receive Rs 30,000 as death benefit in case of natural death of the policy holder.
  • On permanent disability due to accident, the policy holder receives a sum of Rs 75,000.
  • On partial disability the insured is liable to receive Rs 37,000.

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