Low-income individuals, at times, cannot afford medical care, particularly those involving highly specialised treatments. The situation for those living below the poverty line (BPL) in India is further complicated by the high cost of medical bills that they must pay as a result. To address the financial demands of the underprivileged and address their need for medical treatment, the government has introduced several health insurance schemes. These schemes are designed to give those who may otherwise find it difficult to get timely, high-quality healthcare access a lifeline by delivering comprehensive, reasonably priced medical coverage. Let us explore the health insurance for below-poverty-line schemes created to promote the well-being of the underprivileged.
Health insurance plans for people below the poverty line
Following are the major below-poverty-level health insurance schemes —
With the goal of the universal health coverage (UHC) project in mind, the government introduced the Ayushman Bharat Yojana based on the National Health Policy's guidelines. The Pradhan Mantri Jan Arogya Yojana (PMJAY) is a healthcare plan that targets the underprivileged and marginalised segments of society. The plan, which has an annual fee of INR 30, provides coverage of up to INR 5 lakh per family each year. Additionally, coverage for pre-existing conditions begins from day one.
Individuals below the poverty line, particularly those employed in the unorganised sector, are the main target of the Rashtriya Swasthya Bima Yojana (RSBY). Up to INR 30,000 in annual coverage is provided under this initiative for workers and their families. Pre-existing conditions are covered from day one for policyholders, who can also take advantage of cashless hospitalisation. The central government contributes 75% of the yearly premium rate, while the state government pays the remaining 25%; those eligible for this scheme pay an annual renewal or registration charge of INR 30. The respective State Governments are responsible for covering the cost of the smart card as well as any associated program administration costs.
Employers in non-seasonal enterprises with ten or more employees are covered by the Employment State Insurance Scheme (ESIS). In addition to financial benefits for illness or disability, it covers hospitalisation costs for the employee and any dependents. Family members get benefits, including a monthly pension, in the tragic event that an employee passes away from accidents linked to their job.
To give farmers and those living in poverty access to healthcare, the maharashtra government launched the Mahatma Jyotiba Phule Jan Arogya Yojana. It pays for hospital stays related to medical and surgical treatments falling within 34 specialities. It has a floater sum insured of INR 1,50,000 per family, which can be increased to INR 2,50,000 per family in the event of a kidney transplant. There is no waiting period associated with this health insurance scheme. Furthermore, the Maharashtra government bears the whole cost of the premium for this policy.
For migrant workers employed in the State, the Kerala government implemented the Awaz Health Insurance Scheme. Hospitalisation coverage against accidental death and disability is offered. This scheme is open to anybody between the ages of 18 and 60. Up to INR 15,000 in hospitalisation costs, INR 1 lakh in accidental permanent disability, and INR 2 lakh in accidental death are covered.
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