Government Health Insurance Schemes in India

What is a Government Health Insurance Scheme?

A government health insurance scheme is a central or state government-powered policy designed to provide adequate medical insurance coverage at an affordable price. Such health insurance policies are usually offered on a yearly basis.

Regular Health Insurance Plans vs Government Health Insurance Scheme

List of Central Government Health Insurance Schemes

Take a look at the various central government health insurance schemes introduced by the Government of India:

1. Ayushman Bharat Yojana

   Ayushman Bharat Yojana, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a universal health insurance scheme of the Ministry of Health and Family Welfare, Government of India. The PMJAY provides free healthcare services of up to ₹5 lakh for secondary and tertiary care hospitalization. This health insurance for poor in India aims to make healthcare affordable and accessible for over 10 crore families, especially those who are economically weaker and vulnerable..

   The PMJAY scheme provides coverage for medicines, diagnostic expenses, medical treatment, and pre-hospitalisation costs. The poor or low-income families of India can benefit from this Ayushman Bharat health insurance scheme. The insured can also link the PMJAY benefit to their ABHA ID Card for storing digital medical records and quick access to services.

2. Pradhan Mantri Suraksha Bima Yojana (PMSBY)

   Pradhan Mantri Suraksha Bima Yojana aims to provide accident insurance cover to the people of India. People in the age group of 18 years to 70 years who have an account in a bank or post office can avail benefits from this scheme.

   This personal accident insurance policy provides an annual cover of ₹2 lakh for total disability and death cover and ₹1 lakh for partial disability. The premium for this scheme gets automatically debited from the policyholder's bank account.

3. Aam Aadmi Bima Yojana (AABY)

   The Aam Aadmi Bima Yojana is a National Health Insurance Scheme introduced in October 2007 to provide compensation for accidental death and disability. It covers the earning member or the head of the family between the age group of 18 to 59 years. The AABY insurance scheme is tailored for people living in the upcountry and rural areas as well as landless citizens or tenants living in both urban and rural areas. It also provides scholarships to underprivileged children.

   Under the AABY scheme, the family of the insured is compensated with ₹30,000 in case of natural death and ₹75,000 in case of accidental death. Besides, ₹37,500 is paid as compensation in case of accidental disability. Moreover, the annual ₹200 premium for this scheme is shared equally by the state and the central government.

4. Central Government Health Scheme (CGHS)

   The Central Government Health Scheme was started in 1954 to provide comprehensive healthcare facilities to central government officials and pensioners residing in the country. This government insurance scheme is operational in 80 cities, including Kolkata, Mumbai, Lucknow, Delhi, Nagpur, and Pune.

   The CGHS scheme has the following main components:

   • OPD treatments availed at wellness centres as well as government and empanelled hospitals.
   • Reimbursement of hospitalisation expenses for treatments availed at government or private hospitals.
   • All dispensary-related services, including AYUSH medicines.
   • Investigations, like X-rays, MRIs, etc. or laboratory examination services will be provided free of cost at government and CGHS-empanelled diagnostic centres.
   • Free specialist consultations at polyclinics, government, and empanelled hospitals.
   • Reimbursement of medical expenses incurred on artificial limbs, hearing aids, etc.

5. Employees' State Insurance Scheme (ESIC)

   Employees' State Insurance Scheme is a multidimensional National Health Insurance Scheme that provides medical coverage, maternity insurance, sickness benefit, disablement benefit and dependents benefits to all workers in India. It provides full medical insurance to the workers and their families and pays cash benefits in times of sickness or temporary/permanent disability. In addition, dependents of workers injured in occupational accidents are eligible for a monthly pension known as dependent benefits.

   The ESIC scheme is applicable to all permanent factories and establishments employing more than 10 employees. However, some states have extended this scheme to various establishments and businesses, including shops, restaurants, road and motor transport and newspaper entities that employ 20 or more people.

6. Universal Health Insurance Scheme (UHIS)

   Universal Health Insurance Scheme was implemented to provide medical and personal accident cover to families living below the poverty line. While this mediclaim policy covers the hospitalisation expenses of every family member, it provides accidental death and disability benefit to the earning member or head of the family.

   The main drivers of the Universal Health Insurance Scheme are the four public sector general insurance companies that offer health insurance for below poverty line citizens, especially economically disabled citizens. They cover hospitalisation expenses of up to ₹30,000, accidental death benefit of ₹25,000 and a disability compensation of ₹50 daily for a maximum of 15 days.

7. Rashtriya Swasthya Bima Yojana (RSBY)

   Rashtriya Swasthya Bima Yojana was launched by the Ministry of Labour and Employment to provide medical insurance coverage to families living below the poverty line. It provides family floater coverage for in-patient treatment expenses of up to ₹30,000. The scheme also covers travel expenses of ₹100 per day up to a limit of ₹1000.

8. Pradhan Mantri Surakshit Matritva Abhiyan

   Launched by the Ministry of Health and Family Welfare (MoHFW), the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) aims to provide guaranteed and quality antenatal services to pregnant women for free. The purpose is to identify high-risk pregnancies at an early stage and thus reduce the maternal mortality rate.

   On the 9th day of every month, a pregnant woman can visit any designated government health facility to get a routine antenatal check-up, including blood tests, ultrasound, blood pressure monitoring and nutritional counselling.

   The benefits can be availed by any pregnant woman in her second or third trimester, regardless of her economic or religious background or past pregnancies.

9. Surakshit Matritva Aashwasan Yojana

   The Surakshit Matritva Aashwasan Yojana (SUMAN) was introduced on October 10, 2019 by the Ministry of Health and Family Welfare (MoHFW). It aims to provide free and quality healthcare services to all pregnant women, new mothers (up to 6 months after delivery) and sick newborns (up to 6 months old).

   The benefits include free antenatal check-ups, free delivery and C-section facilities, free transport to and from the healthcare facility centres, maternity care, and free vaccination services for the newborn.

   All women, irrespective of their financial or social background, are eligible to avail themselves of the benefits of SUMAN.

10. Pradhan Mantri Matru Vandana Yojana

    The Ministry of Women and Child Development launched Pradhan Mantri Matru Vandana Yojana (PMMVY) on January 1, 2017. This maternity benefit scheme offers direct cash benefits to pregnant and lactating women to compensate for loss of wages, support nutrition during pregnancy and after childbirth.

    A maternity benefit of ₹5,000 is provided for the first child's birth. It is paid in two installments, ₹3,000 after the antenatal check-up and ₹2,000 after childbirth and the newborn's immunisation within 14 weeks. Eligible women also receive a cash benefit of ₹6,000 if their second child is a girl.

    It is aimed at women aged above 18, especially from socially and economically weaker sections, to encourage institutional deliveries and health-seeking behaviour.

11. Mission Vatsalya

    Mission Vatsalya was launched in 2021 by the Ministry of Women and Child Development to ensure care, rehabilitation, welfare and protection of vulnerable children. It is specially designed for orphaned and abandoned children, children in need of care and protection and children with special needs.

    The government provides monthly ₹4,000 to children for family-based care (through adoption, sponsorship, foster care and kinship care), their medical, educational and developmental needs, and for aftercare of children who leave institutional care after 18 years of age.

12. Niramaya Health Insurance Scheme

    Implemented by the National Trust under the Ministry of Social Justice and Empowerment, the Niramaya Health Insurance Scheme provides coverage of up to ₹1 lakh on a reimbursement basis for people with Autism, Cerebral Palsy, Mental Retardation, and Multiple Disabilities. All individuals with the mentioned four conditions and holding a valid disability certificate are eligible for this scheme, without any upper age limit.

    It covers the cost of in-patient hospitalisation, OPD consultations, physiotherapy, medicines, AYUSH treatments, speech therapy, preventive dental care, occupational therapy and transport allowance.

    It does not require any pre-medical check-up. All disabilities have the same coverage, and treatment can be availed at any hospital. Moreover, the premium charged is very affordable and the same across all age groups, implying it does not increase with age.

13. Janani Suraksha Yojana

    The Janani Suraksha Yojna (JSY) was launched by the Government of India under the National Rural Health Mission (NRHM) in 2005 to reduce maternal and infant mortality by encouraging institutional deliveries among pregnant women from economically weaker sections.

    The government provides eligible women with cash assistance of up to ₹1,400 in rural areas and up to ₹1,000 in urban areas. All pregnant women aged 19 and above from the BPL (Below Poverty Line) households are eligible for JSY benefits for up to two live births.

14. Rashtriya Arogya Nidhi

    The Government of India launched the Rashtriya Arogya Nidhi (RAN) through the Ministry of Health and Family Welfare (MoHFW) in 1997 to provide financial assistance to poor people suffering from life-threatening diseases.

    Under the RAN scheme, BPL (Below Poverty Line) patients who cannot otherwise afford expensive treatment are provided financial support for the treatment of serious diseases, such as cancer, kidney failure, cardiac problems, brain surgery, etc., at super-speciality government hospitals.

    13 central government hospitals (like AIIMS, PGIMER, etc.) are given a revolving fund of ₹50 lakh (₹90 lakh for AIIMS, Delhi). Each hospital can approve an amount of up to ₹2 lakh per eligible case from the fund. Cases requiring a higher amount for treatment are referred directly to the MoHFW for sanction of further funds. The maximum amount sanctioned per patient is ₹20 lakh, depending on the patient's disease type (core life-threatening, cancer or rare disease).

15. Scheme for Adolescent Girls

    The Scheme for Adolescent Girls (SAG) was introduced by the Ministry of Women and Child Development in 2010 to provide nutritional support, health services and life skills education to out-of-school girls aged 11 to 14 years.

    The scheme is implemented through the Anganwadi Centres under the Integrated Child Development Services (ICDS) framework. It was earlier known as SABLA or the Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG).

    Under SAG, the government provides micronutrient-rich nutritional support of 600 calories with 18–20 grams of protein daily for 300 days in a year, along with Iron and Folic Acid (IFA) supplementation.

    As part of non-nutritional support, the girls are provided with services like health check-ups, BMI monitoring, menstrual hygiene awareness, life skills development, and education on public services (such as banks, PHCs, and police stations).

16. Nikshay Poshan Yojana

    Introduced by the Ministry of Health and Family Welfare, the Nikshay Poshan Yojana (NPY) provides financial support to tuberculosis (TB) patients to meet their nutritional needs during treatment. The scheme was launched under the National Tuberculosis Elimination Programme (NTEP) in 2018.

    Under the NPY scheme, all eligible, registered TB patients receive a direct benefit transfer of ₹1,000 per month for the entire treatment period. It aims to improve treatment success rates by ensuring that poor nutrition does not delay recovery and by encouraging patients to complete their full TB treatment course.

List of State Government Health Insurance Schemes

Take a look at the various state government health insurance schemes:

1. West Bengal Health Scheme (WBHS)

   The Government of West Bengal launched the West Bengal Health Scheme to provide better medical facilities to its employees in the year 2008. Gradually, the scheme was made available to superannuated and family pensioners, IAS, IFS and IPS employees and retired AIS officers.

   Under the WBHS scheme, both individual and family floater coverage is available for up to ₹2 lakh per indoor treatment. The scheme covers all indoor medical treatments and OPD treatment for 18 diseases. Moreover, cashless health insurance was introduced in 2014, leading to the renaming of the scheme to 'West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme 2014'.

2. Yeshasvini Health Insurance Scheme

   The Karnataka State Government introduced the Yeshasvini Health Insurance Scheme for peasants, farmers and members of any co-operative society. The beneficiaries can avail medical treatments at identified Yeshasvini network hospitals across the state. Moreover, coverage benefits can be extended to the beneficiary's family members.

   This government health insurance scheme covers 2128 procedures, including 1650 medical procedures and 478 ICUs. However, it mainly offers coverage for heart diseases, orthopaedic diseases, nerve-related diseases, women-related diseases, intestinal diseases, ENT and ophthalmology diseases.

3. Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY)

   The Government of Maharashtra introduced the Mahatma Jyotirao Phule Jan Arogya Yojana to provide medical insurance coverage to all families in the states. This health insurance for low-income individuals is especially helpful for people living below the poverty line and farmers in Maharashtra.

   The MJPJAY scheme offers a family health cover of up to ₹5 lakh for 1209 treatments under 34 specialities. The best part about this policy is that there is no waiting period for pre-existing diseases, and it is claimable from the first day itself.

4. Mukhyamantri Amrutum (MA) Yojana

   Mukhyamantri Amrutam Yojana was initiated by the Gujarat government in the year 2012 to provide quality medical and surgical care for major illnesses to poor people living in the state. People belonging to lower-income groups and living below the poverty line are eligible to enrol in this scheme.

   The MA Yojana provides family floater health insurance coverage of up to ₹3 lakh per annum. Under this health insurance for poor people, policyholders can avail of cashless medical treatments for heart diseases, cancer, neurosurgery, kidney diseases, burns and neonatal or newborn baby diseases, covering 698 procedures at private, government and trust-run hospitals. Moreover, transplants of kidney, liver and kidney + pancreas are covered up to ₹5 lakh.

5. Karunya Arogya Suraksha Padhathi (KASP)

   The Kerala Government launched the Karunya Arogya Suraksha Padhathi to provide secondary and tertiary care hospitalisation to the poor and vulnerable families in the state. It provides health insurance coverage of ₹5 lakh for 1573 medical procedures. Moreover, it covers pre-hospitalisation expenses of up to 3 days and post-hospitalisation expenses of up to 15 days.

   People in Kerala who are living below the poverty line can enrol themselves in this health insurance for poor in India. Besides, it provides coverage to the entire family with no restriction on family size, gender or age.

6. Telangana State Government - Employees and Journalists Health Scheme

   Telangana Government launched the Employees and Journalist Health Scheme for its working and retired journalists and employees, including pensioners. In this scheme, beneficiaries and their families can avail of cashless treatment at hospitals registered with Rajiv Aarogyasri Health Care Trust. The coverage includes in-patient treatment, OPD treatment for chronic illnesses and follow-up therapies.

7. Dr YSR Aarogyasri Health Scheme

   The Andhra Pradesh Government launched the Dr YSR Aarogyasri Health Scheme in 2007 to offer universal health coverage to people in the state living below the poverty line. It provides end-to-end cashless coverage of ₹5 lakh for listed diseases at government and private empanelled hospitals. In 2024, the scheme was renamed as Dr. Nandamuri Taraka Rama Rao Vaidya Seva Trust Health Insurance scheme.

   This health insurance for below poverty line citizens covers 3257 listed in-patient treatments across 31 categories, along with free screening and OPD consultations.

8. Awaz Health Insurance Scheme

   The Kerala Government launched the Awaz Health Insurance Scheme in 2017 to provide medical insurance and personal accident insurance coverage to migrants in the state. It provides a sum insured of ₹25,000 to beneficiaries between the age of 18 years and 60 years for medical treatments. Moreover, an accidental death benefit of 2 lakh and a disability compensation of ₹1 lakh are also available for the insured migrants.

9. Bhamashah Swasthya Bima Yojana (BSBY)

   Bhamashah Swasthya Bima Yojana was launched by the Government of Rajasthan to provide cashless hospitalisation facilities to families identified under the National Food Security Act (NFSA) and the Rashtriya Swasthya Bima Yojana in the state. It covers in-patient treatment expenses of up to ₹30,000 for general illnesses across 1715 packages. The scheme also provides critical illness insurance coverage of up to ₹3 lakh.

   Moreover, this government health insurance scheme also provides pre-hospitalisation expenses of up to 7 days and post-hospitalisation expenses of up to 15 days.

10. Chirayu Ayushman Haryana

    An initiative by the Government of Haryana, the Chirayu Ayushman Haryana scheme was launched in 2022 to expand Ayushman Bharat's coverage and cover more families in the state.

    CHIRAYU, which stands for Comprehensive Health Insurance of Antyodaya Units, provides cashless hospitalisation of up to ₹5 lakh to eligible patients. It covers the cost of in-patient hospitalisation, surgery, daycare treatment, medicines, diagnostics, 3-day pre-hospitalisation and 15-day post-hospitalisation.

    The scheme benefits are extended to families earning up to ₹6 lakh. While families earning up to ₹1.8 lakh can avail the benefits for free of cost, those earning above can get the benefits by paying a nominal annual premium.

11. Chief Minister's Comprehensive Health Insurance Scheme

    The Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS) was launched in 2009 by the Government of Tamil Nadu to provide health insurance coverage to economically weaker families in the state.

    Under the CMCHIS scheme, Tamil Nadu residents with an annual family income below ₹1,20,000 can avail a cashless medical coverage of up to ₹5 lakh at both government and private hospitals in the state. It covers over 1,090 medical procedures along with maternity and newborn care benefits. There is no waiting period for pre-existing diseases, implying the insured can avail of health insurance coverage for pre-existing conditions from Day 1.

12. Aarogyasri

    The Aarogyasri scheme was launched by the Government of Andhra Pradesh in 2007 to provide financial assistance for medical treatment to people from BPL families or low-income families requiring secondary and tertiary care.

    It provides ₹5 lakh coverage per family per year for various medical care benefits, including in-patient hospitalisation, cashless OPD benefit, PED coverage from day 1, and patient's transport and food expenses. It also covers cashless treatment for 10 days after hospital discharge in case of general treatment and up to 30 days for therapy-based treatments.

    People holding a white ration card (signifying BPL status) and with an annual family income of below ₹5 lakh are eligible to avail benefits under this scheme. They should not own more than 35 acres of agricultural land, and if living in a city, their household must be under 3,000 sq.ft.

13. HIMCARE

    Launched by the Government of Himachal Pradesh in 2019, HIMCARE provides support to families who are not covered under major central government healthcare schemes (like Ayushman Bharat) but still require financial aid to cover major medical expenses.

    Under the HIMCARE scheme, ₹5 lakh coverage is provided per family to state residents who may not fall under BPL but for whom handling major medical expenses can be difficult. The scheme provides cashless hospitalisation at government hospitals and empanelled private hospitals in the state, and also a few hospitals outside the state.

14. Rajiv Aarogyasri Scheme Telangana

    Rajiv Aarogyasri Scheme Telangana was launched in 2007 by the Government of Telangana to provide free cashless treatment to the BPL families for serious, complex medical conditions.

    This scheme provides cashless treatment of up to ₹10 lakh per BPL family per year for 1,835 medical treatments covered across 30+ specialities. Moreover, PEDs are covered from day 1, without any waiting period. It also covers Cochlear implant surgery with Auditory Verbal Therapy, which is covered separately for up to ₹6.5 lakh.

    Families who are living in Telangana for more than 18 months and holding a white ration card can avail themselves of the benefits under this scheme.

15. Karunya Arogya Suraksha Padhathi

    Karunya Arogya Suraksha Padhathi (KASP) was launched by the Government of Kerala in 2019 to provide health insurance coverage for serious ailments to economically vulnerable families.

    This scheme provides cashless coverage of up to ₹5 lakh per family for secondary and tertiary medical care at empanelled government and private hospitals.

16. Arogya Karnataka Scheme

    Arogya Karnataka Scheme was launched by the Government of Karnataka in 2018 as a universal healthcare scheme to provide affordable medical care to all state residents.

    Now known as Ayushman Bharat Arogya Karnataka (AB-ArK), it provides cashless health insurance coverage of up to ₹5 lakh to BPL families. For APL families or general patients, a 30% subsidy is provided on the government package rate, capped at a maximum of ₹1.5 lakh per family.

17. Ayushman Bharat Yojana Uttar Pradesh

    The Ayushman Bharat Yojana Uttar Pradesh was introduced by the Government of Uttar Pradesh as part of the Ayushman Bharat Yojana. It provides cashless hospitalisation to the low-income households at government or empanelled private hospitals.

    The scheme provides ₹5 lakh cashless coverage for more than 1,900 treatment packages across 27 specialities. It also covers pre-existing diseases from Day 1. Moreover, the beneficiary can avail health insurance benefits at any empanelled hospital in India, not just state hospitals.

18. Atal Amrit Abhiyan

    The Atal Amrit Abhiyan was launched by the Government of Assam in 2016 to provide financial aid to the state's economically weaker sections for treatment of critical medical care at empanelled hospitals.

    It provides coverage of ₹2 lakh per individual to patients from BPL and low-income APL families for the treatment of six high-cost disease groups, including cardiovascular issues, cancer, kidney diseases, neonatal problems, neurological conditions and burns.

19. Gopabandhu Jan Arogya Yojana

    Launched by the Government of Odisha, Gopabandhu Jan Arogya Yojana (GJAY) provides free, cashless treatment to eligible residents of the state.

    The GJAY scheme provides coverage of up to ₹5 lakh per family in rural areas and up to ₹6 lakh in urban areas for medical treatment at empanelled hospitals. Moreover, women members get an additional ₹5 lakh over and above the family limit.

20. Mukh Mantri Sarbat Sehat Bima Yojana

    The Government of Punjab launched Mukh Mantri Sarbat Sehat Bima Yojana (MMSSBY) in 2019 to offer cashless treatment facilities to economically weaker and socially disadvantaged sections of the state.

    The scheme provides health insurance coverage of up to ₹5 lakh per family per year for treatment at empanelled government and private hospitals. It was integrated into the Mukh Matri Sehat Yojna (MMSY) in January 2026, upgrading the coverage amount to ₹10 lakh and expanding benefits to all bonafide Punjab households, irrespective of their income.

    It covers 2000 treatment packages and also provides pre-existing disease coverage from Day 1, implying the beneficiary can avail coverage for PED without any waiting period.

Features and Benefits of Government Health Insurance Schemes

Some of the key features and benefits of government health insurance schemes are given below:

• Government health insurance schemes are offered at a low price.
• With medical insurance for low-income people, BPL families can also avail of insurance benefits.
• These schemes cover both in-patient and OPD treatments.
• Government mediclaim policies ensure coverage for poor people.
• The scheme provides treatment at both private empanelled and government hospitals for better healthcare.
• Government health insurance plans cover pre-existing diseases (PED) from day 1.
• Beneficiaries of these schemes can avail cashless medical treatments at empanelled hospitals.
• Government health plans offer standardized but comprehensive medical coverage.

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