3 Best Government Health Insurance Schemes for Families in India

Medical treatment is expensive. A single surgery or hospital stay can cost lakhs of rupees. Because of this, choosing the right government health insurance scheme is very important for Indian families.

The good news? India offers several reliable options under different government health insurance schemes in India. These plans help families reduce hospital expenses and access quality healthcare without financial stress.

This guide explains the best government health insurance schemes available, who can apply, what benefits you get and how to choose the right plan

Top Government Health Insurance Schemes in India for Families

Government schemes aim to make healthcare:

• More affordable
• Easier to access
• Less stressful financially

They help families by covering:

• Hospitalization
• Surgeries
• ICU charges
• Medicines during admission

Most importantly, many treatments are cashless.

1 Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Ayushman Bharat (PM-JAY) is India’s largest government health insurance scheme.

Key Benefits

• Coverage up to ₹5 lakh per family per year
• Cashless treatment at empaneled hospitals
• No limit on family size
• Covers many serious illnesses

Who Can Apply: Families listed in the SECC database

What’s Covered?

• Hospitalization
• Surgeries
• Day-care procedures
• Pre- and post-hospitalization expenses

Read: Pradhan Mantri Jan Arogya Yojana (PMJAY)

2 Central Government Health Scheme (CGHS)

CGHS provides healthcare services along with insurance benefits.

Key Benefits

• Covers family members and dependents
• OPD and hospitalization support
• Access to government and private hospitals

Who Can Apply: Central government employees and Pensioners

3 Employees’ State Insurance Scheme (ESIC)

Key Benefits

• Covers employee and family
• Hospitalization and maternity care
• Low salary contribution

Who Can Apply: Employees working in ESIC-registered organizations

Top State Government Health Insurance Schemes

Many Indian states run excellent health insurance programs for families.

Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) – Maharashtra

Best for: Economically weaker families

• Covers major surgeries
• Cashless treatment

Dr. YSR Aarogyasri – Andhra Pradesh

Best for: Low-income families

• Covers expensive medical procedures
• Strong hospital network

Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) – Tamil Nadu

Best for: Low and middle-income families

• Covers hospitalization and critical care
• Good family coverage

Karunya Health Scheme – Kerala

Best for: Critical illnesses

• Focus on serious diseases

Ayushman Bharat Sarbat Sehat Bima Yojana – Punjab

Best for: Eligible families in Punjab

Punjab’s version strengthens the national government health insurance scheme in India.

Key Benefits

• Coverage up to ₹5 lakh per family per year
• Cashless hospitalization
• Covers surgeries and critical illnesses

Who Can Apply?

• SECC beneficiaries
• Smart ration card holders
• Eligible Punjab residents

FeaturePM-JAY (Ayushman Bharat)Sarbat Sehat Bima (Punjab)CMCHIS (Tamil Nadu)
Coverage Amount₹5 lakh per family/year₹5 lakh per family/year~₹5 lakh per family/year*
Cashless TreatmentYesYesYes
Family Size LimitNo strict limitGenerally flexibleBased on scheme rules
Hospital NetworkLarge nationwidePunjab govt + private hospitalsTN govt + private hospitals
EligibilitySECC database familiesSECC + ration card holdersIncome-based eligibility
Pre-existing DiseasesCoveredCoveredCovered (as per policy)
Best ForLow-income families across IndiaPunjab residentsTN low/middle income families

*Coverage limits may vary by treatment category.

Government Health Insurance Schemes – FAQs

How do government health insurance programs benefit low-income families?

Government health insurance programs help low-income families by reducing the financial burden of medical expenses. These schemes typically offer:

• Free or low-cost treatment
• Cashless hospitalization
• Coverage for surgeries and critical illnesses
• Access to empaneled government and private hospitals

This protection prevents families from falling into debt due to unexpected health emergencies.

How can I apply online for government health insurance schemes?

Most government schemes provide online application or eligibility check options. The general process includes:

• Visit the official scheme website (for example, PM-JAY or state portals)
• Enter Aadhaar number, mobile number, or ration card details
• Check eligibility status
• Complete eKYC if required
• Download or print the health card

Always use official government portals to avoid fraud.

What are the eligibility criteria for state-sponsored medical coverage plans?

Eligibility varies by state, but common criteria include:

• Family income limits
• Inclusion in SECC database
• Ration card category (BPL / priority households)
• State residency proof
• Specific occupational categories (in some schemes)

Each state government health insurance scheme defines its own rules.

Which government health insurance plans cover pre-existing conditions?

Many major schemes cover pre-existing diseases, especially:

• Ayushman Bharat (PM-JAY)
• State-expanded Ayushman schemes (such as Punjab’s Sarbat Sehat Bima Yojana)
• Several state health insurance programs

Coverage terms may vary, so checking the official policy guidelines is important.

Where can I find the nearest enrollment center for public health subsidies?

You can locate enrollment centers by:

• Visiting the official scheme website
• Using the “Find Hospital” or “Locate Center” feature
• Contacting local government health offices
• Visiting Common Service Centers (CSCs)

Many districts also offer help desks at government hospitals.

What are the list government health insurance schemes that provide family coverage?

Popular family-focused schemes include:

• Ayushman Bharat – PM-JAY
• Central Government Health Scheme (CGHS)
• Employees’ State Insurance Scheme (ESIC)
• Chief Minister’s Comprehensive Health Insurance Scheme (Tamil Nadu)
• Sarbat Sehat Bima Yojana (Punjab)
• Aarogyasri (Andhra Pradesh / Telangana)

Family coverage rules differ by scheme.

What documents are required to apply for a national health protection scheme?

Commonly required documents:

Aadhaar Card
• Ration Card / Family ID
• Income Certificate (if applicable)
• Residence Proof
• Mobile number

Document requirements may vary by scheme.

Read: How to Link Mobile Number with Aadhaar Card – A Step-by-Step Guide 

What Do the Government Health Insurance Schemes in India Usually Cover?

Most government health insurance schemes in India include:

• Hospitalization
• Surgeries
• ICU expenses
• Medicines during hospital stay
• Day-care treatments

Some schemes also cover:

• Maternity care
• Follow-up treatment

Can I include my whole family in a government health insurance scheme in India?

Usually yes.
• PM-JAY – No family size restriction
• Punjab Scheme – Flexible coverage
• CMCHIS – As per eligibility rules

Final Thoughts

Healthcare emergencies can happen anytime. Government health insurance schemes can protect your savings and gives peace of mind.

Government health insurance schemes like Ayushman Bharat (PM-JAY), Sarbat Sehat Bima Yojana (Punjab), and CMCHIS (Tamil Nadu) have already helped millions of families across India.

If you qualify, enrolling in a government health insurance scheme in India is one of the smartest decisions for your family’s future.

Editor’s Note: This article uses publicly available official procedures and reflects information reviewed for accuracy to the best of our knowledge. Aadhaar update rules may change over time, so users should verify details at authorized Aadhaar centers before proceeding.

Interesting Reads

A I

I am a Bangalore-based entrepreneur and contributor to The Current India. I write research-based articles on governance, regulations, and public affairs, with an emphasis on clarity and accuracy.

Leave a Reply

Your email address will not be published. Required fields are marked *

Back to top button

Adblock Detected

Please consider supporting us by disabling your ad blocker