Health Insurance for Individuals Below the Poverty Line

• If you are a working individual, you might have considered health insurance for yourself and your family. Even if you haven’t started earning yet, you might be covered under a health policy provided by your family. But what exactly is health insurance?

• Health insurance is a formal agreement between the policyholder and the insurance company. In this arrangement, the policyholder selects the policy and pays the premium. In exchange, the insurance provider offers health coverage that shields the policyholder from financial challenges during a health crisis.

• If you search for these plans online or consult your insurance agent, you might discover that the premiums for these plans can be quite exorbitant. Therefore, it is likely that most of these plans may be unaffordable for families living below the poverty line.

Health Insurance Policies for Individuals Below the Poverty Line (BPL)

• Individuals below the poverty line may find it difficult to afford standard insurance programs offered by private entities. However, this does not mean that they must go without any type of medical insurance.

• The Government of India has introduced several schemes over the years to enable those living below the poverty line to take advantage of. Here is an overview of some of the policies currently available in India that people below the poverty line might be eligible for themselves and their families.

1. Rashtriya Swasthya Bima Yojana

• Commonly referred to as RSBY, the Rashtriya Swasthya Bima Yojana is an initiative from the Ministry of Labour and Employment, Government of India. It is specifically designed to provide coverage for individuals below the poverty line. The scheme offers cover of up to ₹30,000 for beneficiaries, encompassing a range of illnesses that necessitate hospitalization. This scheme has no age restrictions. Additionally, pre-existing conditions are included in this policy without any waiting period.

2. PM-JAY (Ayushman Bharat)

• The primary objective of launching Ayushman Bharat was to make a significant stride toward the Sustainable Development Goal-3 (SDG-3), which emphasizes the principle of ‘leave no one behind’. It serves as a flagship program of the Government of India as per the recommendations of the National Health Policy 2017, initiated in late 2018.

• Two key components were introduced under the Ayushman Bharat Yojana. The first involves establishing health and wellness centers throughout the country. The second is the Pradhan Mantri Jan Arogya Yojana, commonly known as PM-JAY. This part of the Ayushman Bharat Yojana is designed to provide “Swasthya Suraksha”.

3.Employees’ State Insurance Scheme

• Also referred to as ESIS, this policy is one of the various offerings provided by the Government of India. It offers protection for employees working in non-seasonal factories. To avail of this coverage, the factory must have a workforce of more than 10 employees. The coverage is available for both employees and their dependents. You can receive coverage for hospitalization expenses. Moreover, if you or a dependent were to face disability, you might also be eligible to claim monetary benefits. Coverage also includes death benefits, whereby if a factory employee were to die, a compensation may be provided to their beneficiary in addition to a regular pension.

Universal Health Insurance Scheme

• Under the Universal Health Insurance Scheme (UHIS), which is another medical insurance policy provided by the Government of India, reimbursements of up to ₹30,000 are available in the event of hospitalization. This coverage is shared among the entire family included in the plan. In addition, an accidental death benefit of ₹25,000 is provided for the family provider. The scheme is specifically designed for families living below the poverty line (BPL). The premium for this scheme can vary from ₹100 to ₹400.

Difference Between Health Insurance Plans for People Below the Poverty Line and Regular Health Insurance Plans

• Feature
• Health Insurance Plans for People Below the Poverty Line (BPL)
• Regular Health Insurance Plans
• Premium Cost
• Significantly subsidized or low premiums to ensure affordability for low-income groups.
• Higher premiums that depend on coverage and benefits.
• Coverage Scope
• Basic coverage that includes hospitalization, essential treatments, and occasionally preventive care.
• Extensive coverage that encompasses hospitalization, OPD, diagnostics, and specialized treatments.
• Sum Insured
• Limited sum insured, usually tailored for basic healthcare needs.
• Larger sum insured options that cater to individual needs.
• Eligibility
• Restricted to individuals or families with a BPL card or those who fulfill low-income criteria.
• Accessible to anyone who can afford the premium, subject to underwriting.
• Additional Benefits
• Few or no additional benefits beyond basic health coverage.
• Includes supplementary options such as maternity benefits, wellness rewards, and critical illness riders.
• Network Hospitals
• Restricted to government or certain private hospitals under the scheme.
• Broad network of hospitals, encompassing high-end private facilities.
• Claim Process
• Streamlined with minimal documentation to facilitate easy access.
• Standardized with comprehensive documentation and claim validation.

Conclusion

• These represent some of the health schemes accessible for individuals living below the poverty line. If you search for online health insurance plans from private providers, you may find them to be financially unviable for many BPL families. Therefore, rather than looking for online health insurance plans, they should consider these policies that can aid them in obtaining coverage and safeguarding their families against health crises.

FAQs

What is below poverty line insurance?

• Below poverty line (BPL) insurance offers affordable health coverage to low-income families, ensuring access to essential medical treatments at little or no cost.

Which health insurance is being provided to the poor?

• Programs like Ayushman Bharat provide free or subsidized health insurance to economically disadvantaged sections, covering hospitalization and essential treatments.

Who is eligible for Ayushman Bharat?

• Families classified as below poverty line (BPL) in the SECC database or fulfilling certain government conditions are qualified.

What does BPL mean in health insurance?

• BPL denotes individuals or families residing beneath the poverty line who are eligible for subsidized or complimentary health insurance programs.