Top Government Health Insurance Schemes in India (2025)
Updated: October 30, 2025 | By: ClaimWeb Editorial Team
India mein health insurance ab ek zarurat ban chuka hai, khaas kar un logon ke liye jo private plans afford nahi kar sakte. Sarkar ne kuch affordable aur accessible government health insurance schemes launch ki hain — jisse har citizen apne aur apne parivaar ke liye financial protection le sake.
1. Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)
Coverage: ₹5 lakh per family per year
Beneficiaries: 10+ crore poor and vulnerable families
Benefits: Cashless treatment at empanelled hospitals across India.
Claim Process: Show Ayushman card at hospital desk → Aadhaar verification → Free treatment.
2. Central Government Health Scheme (CGHS)
For: Central Government Employees, Pensioners, MPs, etc.
Benefits: Outpatient & inpatient treatment, specialist consultation, diagnostics.
Claim Process: Cashless at CGHS empanelled hospitals or reimbursement post-treatment.
3. Employees’ State Insurance Scheme (ESIS)
For: Salaried employees earning under ₹21,000/month.
Benefits: Medical care, maternity, disability, and dependents’ benefits.
Claim Process: Use ESIC card → visit ESI hospital → treatment and claims as per rules.
4. State-Specific Health Schemes
- Bhamashah Swasthya Bima Yojana (Rajasthan)
- Aarogyasri Scheme (Telangana)
- Kutumba Health Insurance (Karnataka)
- Karunya Health Scheme (Kerala)
In schemes ke eligibility aur claim process alag-alag states me vary karte hain. Lekin har program ka main goal — affordable healthcare sab tak pahunchana.
Eligibility & Documents Required
- Aadhaar Card / Ration Card
- Income Certificate / BPL Card
- State Residency Proof
How to Apply for Government Health Insurance
- Visit the official website of the scheme (e.g., pmjay.gov.in)
- Enter Aadhaar number or ration card details
- Check eligibility and submit application online/offline
- Once approved, download your scheme health card
Claim Process (Step-by-Step)
- Go to an empanelled hospital under the scheme
- Show your scheme card + Aadhaar for verification
- Hospital initiates pre-authorization
- Get cashless treatment — no out-of-pocket cost
- Collect discharge summary after treatment
FAQs — Government Health Insurance Schemes 2025
Q1: Are pre-existing diseases covered?
Yes, most schemes like PM-JAY cover pre-existing diseases from day one.
Q2: Is there an age limit?
No strict limit, but depends on the scheme (PM-JAY: all age groups).
Q3: Can I have both government and private insurance?
Yes, but government scheme benefits apply first in case of hospitalization.
