A Look at the Features and Benefits of National Health Insurance Schemes/NHIS
A significant number of low-income Indians are covered by national health insurance schemes, which provide them with the financial security they need in the event of a medical emergency.
Due to skyrocketing global medical prices, treating serious illnesses is now challenging. Expenses associated with medical care for a severe illness or accident can devastate a family’s financial stability. Health insurance is vital in these situations.
Having reasonable health insurance is a luxury that not everyone can afford. The Indian government created a number of health insurance plans in response to the urgent need to provide health coverage to all citizens. National Health Insurance Schemes (NHIS) is the collective name for various programmes.
Unfortunately, many individuals may miss out on the various benefits of NHIS insurance coverage because they are unaware of it.
So, we’re writing this blog to inform our readers about the details of the NHIS plan and its most notable perks.
Please explain the National Health Insurance Scheme.
We have already established that the National Health Insurance Scheme is the government’s attempt to ensure that low-income citizens have access to quality healthcare.
The federal government, the Ministry of Health and Family Welfare, and the National Knowledge Commission built the National Health Portal to keep the health insurance schemes running. Through the site, which functions like a single-point access, Indian individuals have access to integrated healthcare information.
In this article, we will go over the characteristics and benefits of the various health insurance plans offered by this platform.
The Ministry of Labour and Employment introduced the Rashtriya Swasthiya Bima Yojana (RSBY) to ensure that individuals living below the poverty line may access health insurance.
The Rashtriya Swasthiya Bima Yojana’s Characteristics and Advantages:
You can get up to ₹30,000 in hospitalisation coverage.
- Rates for hospital packages that are set.
- Pre-existing condition coverage that does not age out of reach.
- Protection for up to five people in the insured’s immediate family: themselves, their spouse, and any three dependents living with them.
The cost to register is a mere thirty rupees.
Coverage is nationwide in India, and the government foots the bill for the NHIS premium.
State Insurance Programme for Employees (ESIS)
The Indian government established Employment State Insurance to safeguard the financial well-being of working citizens and their families. In the event of a medical emergency, participants in this programme are eligible to receive monetary rewards.
Benefits and Characteristics of the Employment State Insurance Programme:
- Pays out in the event of a permanent or temporary impairment that limits the beneficiary’s ability to work.
- In the event of the beneficiary’s death as a result of a work-related accident or occupational hazard, the beneficiary’s dependents will be entitled to a monthly pension.
The ESIS is implemented on an area-by-area basis with the exception of certain states and territories (such as Sikkim, Mizoram, Manipur, Arunachal Pradesh, and the Union Territories). • Any factory that is not seasonal, as well as small businesses (such as shops, movie theatres, restaurants, or workforce employers) with more than 20 employees are eligible to enrol.
Aam Aadmi Bima Yojana
On October 2nd, 2007, the central government launched the Aam Admi Bima Yojana (AABY) initiative to ensure that rural households, including those without land, may participate in social security insurance. Anyone between the ages of 10 and 59 who is the primary earner in their home is eligible to receive this NHIS insurance coverage.
The Aam Aadmi Bima Yojana’s Characteristics and Advantages:
₹30,000 is the death benefit that dependent family members are entitled to in the event that the insured person dies from natural causes prior to reaching the age of 59.
- Dependents can get a death benefit of up to ₹75,000 in the event that the insured person dies in an accident. Permanent disabilities, such as the loss of both eyes or both limbs, are also eligible for this payment.
- If an accident causes partial disability, such as the loss of a limb or an eye, the insured and their dependents will get a monetary reward of up to ₹37,500.
National Health Service (NHS) Programme
Central government personnel and their dependant families are the only ones eligible for the National Health Insurance scheme, which began in 1954. In cities covered by CGHS, the scheme is available through hospitals and polyclinics that practice Allopathy, Yoga, Ayurveda, Unani, Siddha, and Homoeopathy.
What the Central Government Health Scheme Offers and How It Works:
- This National Health Insurance programme provides extensive medical coverage.
- Coverage for hospitalisation
diagnostic procedures (e.g., electrocardiogram, X-ray)
- Coverage for pharmaceuticals
In-home medical treatment: seeing a doctor who specialises in the condition.
Claims that do not involve the use of cash for medical procedures such as surgery
Healthcare Insurance Programme for All (UHIS)
The Universal Health Insurance Scheme is unique among NHI programmes in that individual government agencies do not run it; instead, four public sector general insurance companies run it.
Universal Health Insurance: Its Characteristics and Advantages:
- A subsidised premium is available for the purchase of UHIS. With a ₹ government subsidy of 200, an individual can buy the insurance for ₹100.
- The insured can buy the plan for ₹150, and the subsidy would be ₹300 if he has five dependent family members.
- A family of seven will pay ₹200 for a Universal Health Insurance Scheme premium, with an additional ₹400 subsidy.
Hospitalisation coverage up to ₹30,000 would be provided on a family floater basis.
The accidental death compensation offered by the UHIS plan is ₹25,000.
To make up for the insured’s income loss, it pays ₹50 every day.
The National Health Protection Mission, often known as Ayushman Bharat
More than ten crore low-income families would be covered by the national health protection initiative Ayushman Bharat. More than 50 crore individuals are anticipated to be covered by the NHI system, taking into account that every family will have five members.
Ayushman Bharat features and benefits include:
The Ayushman Bharat programme offers hospitalisation coverage of up to ₹ five lakhs per family per annum, accessible care at both public and private institutions within its network, and coverage for pre-existing conditions starting from the first day.
Covered individuals can get health benefits nationwide.
- The Ayushman Bharat scheme provides coverage for up to three days before hospitalisation and up to fifteen days after hospitalisation.
In summary
These National Health Insurance Schemes benefits profoundly impact both the lives of individuals and the progress of our nation. Because citizens have a fundamental right to health care, nearly all industrialised nations provide medical insurance to their residents. National Health Insurance Schemes were a small but significant step towards India’s goal of becoming a developed nation.
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