Considering the impecunious state of healthcare infrastructure, health insurance is a product that each and every Indian must acquire. A remarkable section of the Indian population came into poverty because of health ailments that necessitate high costs. Rather than spend all their hard-earned income on treatment it becomes imperative for households to buy health insurance.
Compared to other countries that have either Universal Health Coverage or moving towards it, India’s per capita public spending on health is low. Around 35 crore individuals were covered under any insurance in 2015-16. This amounts to 27% of the total population of India. 77% of them were covered by public insurance companies. Overall 80% of all persons covered by insurance fall under government-sponsored schemes.
Main health schemes provided by the Government is as follow-
Employment state insurance scheme-
The ESI Act encompasses health-related eventualities which workers are exposed to on a daily basis. This could include any type of sickness, temporary or permanent disability, maternity, diseases contracted from a workplace, death due to employment, and any type of injury that results in the loss of wages or earning capacity.
Eligibility for ESI
- To come under the vast umbrella of benefits offered by the Employee State Insurance Corporation (ESIC), an individual should meet certain criteria that have been set by the committee. The ESI scheme is applicable to
- An individual who is employed in a non-seasonal factory that has more than 10 employees. This criterion applies under Section 2 (12) of the Act.
- With effect from 1 January 2017, the wage limit of an employee is set at Rs.21,000 per month for him/her to come under the coverage of the ESI scheme.
Central government health scheme-
This scheme offers comprehensive medical treatment for pensioners and employees of the Central Government. To avail, this scheme one should have enrolled in this scheme.
Eligibility Criteria for CGHS
- Members of parliament, both ex- and sitting
- Ex-vice presidents
- Retired judges of high courts
- Freedom fighters
- All employees of the Central Government who draw their salary from central civil estimates
- The dependent family members of the Central Government employees who draw their salary from Central Civil Estimates and reside in areas covered under the CGHS
- Retired as well as sitting judges of Supreme Court
- Journalists accredited with Press Information Bureau
- Employees of the Railway Board
- Delhi Police Personnel
- Pensioners and employees of certain statutory/autonomous bodies that have been extended CGHS facilities in Delhi
- Pensioners and family pensioners of the Central Government, who receive a pension from central civil estimates
- The eligible dependent family members of pensioners and family pensioners of the Central Government who receive a pension from central civil estimates.
Rajiv Arogya Bhagya Scheme
RAB is a Health Assurance Scheme of Govt. of Karnataka to make super speciality quality tertiary healthcare treatment accessible and affordable to Above Poverty Line (APL) population of Karnataka.
You can get specialized care for procedures under 7 broad super specialities of Cardiology, Cancer, Urology, Neurosurgery, Pediatric surgery including Neonatal Surgery, Burns and Polytrauma, in best public and private hospitals at a subsidized cost. The cost includes surgery, ICU and hospital stay including medicines.
Meghalaya Health Insurance Scheme
All citizens of the state, except Central or State government employees, are eligible for this scheme with a maximum of five family members. Beneficiaries of MHIS have to pay only Rs 30 at the moment of enrolment. The government will pay the premium for beneficiaries.
Deen Dayal Swastha Seva Yojna, Goa
Anyone who has resided for a period of more than five years in Goa is eligible for this scheme. It provides insurance coverage up to Rs 2.5 lakh a year for a family of three or less, and Rs 4 lakhs for families with 4 or more members.