Here is a list of health insurance schemes in India by 2022 offered by various state governments. This list also includes the Indian government schemes which cover the below poverty line families.
What’s on this page?
Almost all the government health insurance schemes mentioned below are free health insurance schemes where the premium is borne by the state and central governments:
Delhi Arogya Kosh:
It is a registered society that provides financial assistance to the extent of Rs.5 Lakhs to the needy and eligible patients for treatment of any illness/ disease in Government hospitals. There is another free accidental insurance by the Delhi government that provides relief to accident victims.
Eligibility: A person with an annual family sum insured up to Rs.3 Lakhs is eligible for this cover and should be a bonafide resident of Delhi for the last 3 years.
Sum Insured: A maximum sum insured of Rs. 5 Lakhs would be provided under this scheme
Family Size: All the members of the family can be covered under the scheme
Contribution: The entire premium would be contributed by the state government.
West Bengal Swasthya Sathi Health insurance scheme:
Sum Insured: A maximum sum insured of Rs. 5 Lakhs would be provided under this scheme per family which includes secondary and tertiary care.
Family Size: There is no capping on the number of members included in the policy or the family members to be included. Parents from both the spouse sides are included. All dependent physically challenged persons in the family are also covered.
Contribution: The entire premium would be contributed by the state government and no contribution is required from the beneficiary.
Pre-existing disease: All the pre-existing diseases are covered under the scheme
Pre Authorization: All the medical procedures/ treatments are 100% pre-authorized within 24 hours TAT.
Employee State Insurance (ESI):
Sum Insured: There is no ceiling on the sum insured provided to the members under this scheme. Full medical care is provided to the insured person and his/her family members from the day he/she enters insurable employment. Medical care is also provided to retired and permanently disabled insured persons and their spouses.
Medical benefit: The ESI scheme provides medical benefits to the employee and his/her family members from the day of the individual’s employment.
Disability benefit: In the case of temporary disability, 90% of the wage is payable as long as the disability continues. In case of permanent disability, 90% of the wage in the form of monthly payment depending on the extent of loss of earning capacity as certified by the Medical Board would be paid.
Death Benefit: In case of death of the employee, 90% of the wage in the form of monthly payments would be paid to the dependents in the case where the death occurs due to employment injury or occupational hazards.
Funeral expenses: An amount of Rs.15,000 would be paid to the dependents or the person who performs the last rites from the day of entering insurable employment.
Sickness Benefit: Sickness benefit in the form of cash would be paid at the rate of 70% of the wages during the period of certified sickness for a maximum of 90 days in a year.
Maternity Benefit: Maternity benefit for confinement or pregnancy would be paid for 26 weeks which can be further extended for one month. 100% of the wages are paid as a benefit for 12 weeks.
Telangana Aarogyasri Health Insurance:
Sum Insured: A maximum sum insured of Rs.5 lakhs would be provided to the families enrolled under the scheme. All the eligible BPL families would come under the scheme.
Pre-existing disease: All the pre-existing diseases are covered under the scheme
Pre Authorization & Cashless: All the medical procedures/ treatments are 100% pre-authorized within 24 hours of TAT. All the treatments are on a cashless basis, a beneficiary can go to any of the hospitals and avail of the services under the Arogyasri scheme.
Contribution: The entire premium would be contributed by the state government and no contribution is required from the beneficiary.
Family Size: There is no capping on the number of members included in the policy or the family members to be included. All the members in the Below poverty line card are automatically covered under the scheme.
Goa Deen Dayal Swasthya Seva Yojana:
Sum Insured: A maximum sum insured of Rs.2.5 lakhs per annum for a family of 3 or less members and up to Rs.4 lakhs for a family of four or more members. The maximum sum insured under the scheme would be Rs.4 lakhs.
Family Size: The insurance benefit can be availed individually or collectively by the members of the family. More than 4 members would also be covered under the policy. Family members include Spouses, Unmarried children, and dependent parents or parents-in-law.
Higher cover: An individual can take a higher sum insured from the insurance company by paying an additional premium.
Registration/ Annual renewal fee: A registration or annual renewal fee of Rs. 200 for a family of 3 or fewer members. Concession of 50% would be considered subject to appropriate documents towards the reserved communities.
Kerala Arogya Suraksha Padhathi:
Sum Insured: A maximum sum insured of Rs.5 lakhs per year per family would be provided to the families enrolled under the scheme for secondary and tertiary care hospitalization across public and private empanelled hospitals.
Contribution: The entire premium would be contributed by the state government and no contribution is required from the beneficiary.
Pre & Post Hospitalization: The scheme covers up to 3 days of pre hospitalization and 15 days of post hospitalization expenses such as diagnostics and medicines.
Pre existing disease: All the pre-existing diseases are covered from day one under the scheme.
Karnataka- Arogya Karnataka Scheme:
Sum Insured: A maximum sum insured of Rs.5 lakhs per year per family would be provided to the families enrolled under the scheme for secondary and tertiary care hospitalization across public and private empanelled hospitals.
Benefit Limit: The benefit limit for General Patients shall be 30% of Government package rates, with an overall annual limit of INR 1.50 lakh per family per year on a copayment basis.
Eligible Patient: A patient who is a resident of Karnataka state and belongs to “Eligible household” as defined under the National food security act, 2013 shall be eligible for the scheme.
Pre Authorization & Cashless: All the medical procedures/ treatments are 100% pre authorized within 24 hours TAT. All the treatments are on a cashless basis, a beneficiary can go to any of the hospitals and avail the services under Arogyasri scheme.
Registration fee: A one time registration fee of Rs. 10 has to be paid for the Arogya karnataka card.
Andhra Pradesh- Arogya Raksha:
Sum Insured: A maximum of Rs.2 lakhs per annum for individuals for catastrophic needs would be provided under the scheme. The aim of the scheme is to provide quality healthcare to the above poverty line families.
Contribution: The Above poverty line and below poverty line families can enroll under the scheme by paying Rs.1200 per person. The new born can be registered under the scheme by paying Rs.100 per month for the remaining tenure of the policy.
Pre existing disease: All the pre-existing diseases are not covered from day one under the scheme
Family members: The newly married couple either the wife or the husband belonging to another state, can register under this scheme as one family by paying the entire annual premium.
Tamilnadu- CM Comprehensive health insurance scheme (AB-PMJAY)
Sum Insured: A maximum sum insured of Rs.5 lakhs per year per family on a floater basis would be provided to the families enrolled under the scheme for secondary and tertiary care.
Family members: The family definition under this scheme is a legally wedded spouse, dependent children, and dependent parents of the eligible person.
Eligibility: He/she should be a resident of Tamil Nadu with his/her name on the family card and the annual income of the family should not exceed Rs.1.2 Lakhs per annum.
Maharashtra- Mahatma Jyotirao Phule Jan Arogya Yojana:
Sum Insured: A sum insured of Rs.1.5 lakh or 2.5 lakh as the case may be is available to each and every member of the family on a floater basis. The sum insured can be availed collectively or individually by any family member.
Contribution: The scheme is fully funded by the state government with the premium being paid by the state government. Pradhan Mantri Jan Arogya Yojana is jointly funded by the Government of India and the Government of Maharashtra in a ratio of 60:40.
Beneficiaries: The beneficiaries under the scheme are the families holding yellow ration card, Antyodaya Anna Yojana ration card (AAY), Annapurna ration card, Orange ration card (annual income up to INR 1 lakh) issued by Civil Supplies Department, Government of Maharashtra for 36 districts of Maharashtra.
Pre Authorization & Cashless: All the medical procedures/ treatments are 100% pre-authorized within 24 hours of TAT. All the treatments are on a cashless basis, a beneficiary can go to any of the hospitals and avail of the services under Arogyasri scheme.
