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Government Health Insurance scheme in India

 Government Health Insurance Scheme in India As we know that the government gives healthy facilities to the general public and government em...

 Government Health Insurance Scheme in India

As we know that the government gives healthy facilities to the general public and government employees, which can be available at very low prices and with good quality, but they will know how and how they can get this facility. The health facilities that the government provides are available from the state government and the central government. Let us know what criteria are needed to get healthy facilities and what is the eligibility. Type of Government Health Insurance:-

1. Ayushman Bharat Yojana (PMJAY Scheme):-

Ayushman Bharat is a government-funded health scheme for those who are below the poverty line (BPL & APL). Scheme cover all over India in rural and urban cities. Under this scheme, no family size limit, and coverage of insurance amount per family is Rs 5 Lakh per year. It covers your hospitalization indoor treatment and post-treatment medication as per the list of diseases given by Govt. of India.

    Benefits under PMJAY Scheme:-

    • Indoor treatment and Post Hospitalization facilities across India under PMJAY scheme.
    • Ayushman Bharat offers more than 30+ specialties and list of Diseases cover under 1554 medical and surgical packages. 
    • Post of medicine expenses are covered for 15 days excluding protein supplements, Medical devices, syrup, Vitamins medicine, etc. 
    • Under Indoor treatment, room rent surgical/Medical package, doctor visit, medicine, diet, etc, will be covered by PMJAY scheme. 
    • All Diagnostic and Histopathy investigation.
    • If list of surgery does not come under PMJAY scheme package that also covers as per unlist package guideline. 

    Who are comes under PMJAY scheme:-

    • Beggar, Ragpicker, Domestic worker
    • All street workers.
    • Plumbr, security guard, co0lie, or the head-loaded worker.
    • Sweeper, conductor, Helper, Driver.
    • No adult member between ages of 16-59
    • SC/ST householder.
    • Landless workers and a major part of the income from casual labor work.
    • Not having income more than 10000 -15000. 
    • Unemployed and non-governmental not having own land.  

    2. Central Government Health Scheme (CGHS)  

    CGHS is to provide affordable health care services to the Central Government Pensioner and Serving employees at a low cost. Those government employees residing in India will become under the CGHS Beneficiary scheme. CGHS facilities come under 74 cities and Presently 39 Lakh approximately all over India. What is the contribution amount have to pay CGHS employees and What are the entitlement will get in a private hospital under CGHS and Based on the Basic Pay band.

    Corresponding levels in Pay Matrix as per 7th CPC Contribution per month 
                       Level 1-5 Rs. 250                Level 6 Rs. 450
                       Level 7-11 Rs. 650              Level 12 and above Rs. 1000 

    Ward Entitlement Corresponding Basic pay is drawn by the officer in 7th CPC per month 
                          1 General Ward Upto Rs. 47,600/- 
                          2 Semi-Private Ward Rs. 47,601 to 63100/-
                          3 Private Ward Rs. 63101 and above 

    Facilities under CGHS  for Working Employee/Pensioner/Family 

    • OPD Consultation with medicine.
    • Indoor Treatment under at Private Empanelled Hospital and Govt. Hospital.
    • All Investigation at Empanelled Diagnostic center/Hospital and Govt. Hospital.
    • All the Identified Cghs Beneficiary and their family can avail cashless facilities to the Panel hospital and Diagnostic center.
    • In case of emergency CGHS beneficiaries directly can avail cashless facilities in Govt. and Private Hospitals or Reimbursement of expenses in case of Nonempempanelled hospital & Diagnostic Centre. 
    • In the case of outside, Hospital and diagnostic center services and medical devices and appliances will be reimbursed from the CGHS dispensary. 

    Who are they come under the cghs?

    • Minister of Home Affairs; and Minister of Cooperation.
    • Minister of Health and Family Welfare; and Minister of Chemicals and Fertilizers.
    • Minister of State in the Ministry of Parliamentary Affairs; and Minister of State in the Ministry of Culture.
    • Minister of State in the Ministry of Agriculture and Farmers Welfare
    • Minister of Road Transport and Highways
    • Minister of Finance; and Minister of Corporate Affairs
    • Minister of Agriculture and Farmers Welfare
    • Minister of External Affairs
    • Minister of Tribal Affairs
    • Minister of State in the Ministry of Textiles; and Minister of State in the Ministry of Railways
    • Minister of Women and Child Development.
    • Minister of Parliamentary Affairs; Minister of Coal; and Minister of Mines.
    • Minister of Commerce and Industry; Minister of Consumer Affairs, Food, and Public Distribution; and Minister of Textiles
    • Minister of Communications; and Minister of Electronics and Information Technology.
    • Minister of Jal Shakti.
    • Minister of Petroleum and Natural Gas; and Minister of Housing and Urban Affairs.
    All ministry and Govt. Autonomous bodies can avail of CGHS benefits.  

    Like.:-ITBP,NSG.CRPF,CISF,Delhi Police,Assam Rifles,BSF,Home Guard, Indian Cost Guard,Intelligence Bureau, CBI,NCRB,ETC.

    3. Ex-Serviceman Contributory Health Scheme (ECHS) 

    • All defense forces personnel and their family members could avail facilities of medical/surgical/emergency benefit with specific cost and surgery as per listed under ECHS guideline.
    • The beneficiary of ECHS and their dependents who are eligible for treatment in Armed Hospital and Private/Civil Hospital as per panel ethics. 

    Benefits of ECHS Beneficiary 

    • ECHS members could avail facilities with No age Limit.
    • As per Grade pay Lifetime contribution required 
    • Provision for reimbursement at CGHS rate in case of treatment not covered under emergency in non-empanelled Hospital.
    •  The beneficiary can avail of hospitalization expenses with no caping amount.
    • Treatment of Hospitalization /Outdoor medical expenses/Medicines and all types of investigation related to disease will be cover under ECHS. 
    • ECHS Cover beneficiary, Spouse, Son at age limit of 25 years, Daughter till marriage and in case of Dependent physically challenged then will be a cover the lifetime of health service. 

    Who are they come under the ECHS?

    • Retire armed forces like Army, Navy, Airforce, & other Defence forces.

    4. Employee's State Insurance Corporation (ESIC)

    ESIC act is applicable to all Non-seasonal Factories employing 10 or more person will cover under the ESIC scheme. If existing wages of employee is Rs-21000 /-Per month as per govt. rule than can be under schemes and Disable employee wages is Rs- 25000/- Per month will be cover under ESIC act.

    Benefits of ESIC Beneficiary

    • Free medical & surgical treatment in ESIC Hospital & Tie-up Hospital for Indoor treatment to Insure employee and his family.
    • Diagnostic and radiology investigation & laboratory test facilities are free provided to Insure persons at ESIC hospital and Tie-up other private hospitals.
    • Maternity Benefit for confinement/pregnancy is payable for 26 weeks and 70 days contribution of wages in the preceding Two contribution periods.
    • Disablement Benefit (Temporary and Permanent).
    • Dependants and family benefit.
    • Rehabilitation allowance and vocational & Unemployment allowance under Rajiv Gandhi sharmik Kalyan Yojana.

    Who are they come under the ESIC.?

    • All private and Govt employees whose wages are under Rs-21000 /- can avail themselves of medical facilities under ESIC Empanelled hospital. 
    • All contract employees and non-contractual employees also can avail esic benefits.

    About Post:-

    Through this article, I have shared with you all, Government Health Insurance schemes in India. I hope all of you guys would like the article, then definitely share it with your family & friends apart from this if you have any suggestions and doubts related to my post please let me know below the comment section. 

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