Universal Health Insurance Scheme

These days there is an increased demand for health insurance policies in our country, due to the rise in inflation in the health sector. The best way to shield the health of yourself and your loved ones is by investing in a suitable health insurance policy. Several companies offer health insurance policies at an affordable price but, people living below the poverty line still cannot manage to afford such plans. BPL families hardly manage to afford a two-course meal for themselves and therefore,  investing in a health insurance policy is not their priority. 

To make a health insurance policy essential for the people living below the poverty line and to give them affordable access to quality healthcare, the government launched a scheme called the Universal Health Insurance Scheme, which offers assistance for medical expenses to the breadwinner of the family. 

About Universal Health Insurance Scheme (UHIS)

Universal Health Insurance Scheme is a widely known scheme by the Government of India, that offers health insurance policies to people from low-income groups. It covers all the medical expenses of an individual or a family, that might incur due to an emergency. Universal Health Insurance Scheme was launched in the year 2003, under the Universal Health Assurance Mission of the government. It is open to below poverty line and above poverty line families.  Let us look at some of the prominent features of the Universal Health Insurance Scheme: 

• This government policy is available for individuals, groups, and families. 
• You cannot be a part of more than one group health insurance policy under this scheme.
• The policy has to be purchased in the name of the breadwinner of the family and the other family members can be added to it.  
• In the case of a group health insurance cover, the policy should be purchased in the name of the group, organization, or institution. 

Eligibility For Universal Health Insurance Scheme 

Universal Health Insurance Scheme is available for individuals and groups that are included below the poverty line or above the poverty line. For people below the poverty line (BPL), the age limit is 5 to 70 years and the family’s income should be less than the sum assured. Necessary documents issued by the Tehsildar/ BDO of the Revenue Department of the respective State Government should be attached along with the insurance-related documents. However, for individuals above the poverty line (APL), the age limit ranges from 5 to 65 years. Children from the age of 3 months to 5 years can also be included in both cases. In the case of APL families, the family income should be more than the sum assured under the policy.  

Inclusions of Universal Health Insurance Scheme 

Following are the inclusions of the Universal Health Insurance Scheme: 

• Room and boarding expenses of up to 0.5% of the sum assured and 1% of sum assured in case of ICU. 
• Up to 15% of the sum assured is for the cost of a nurse, surgeon, or any other doctor.
• Maternity expenses of up to Rs. 5,000 and hospitalization benefit of up to Rs. 30,000 for every family per policy is available under this scheme. 
• Disability compensation and personal accident cover are also a part of the scheme for the breadwinner of the family insured under the plan. 

Exclusions of Universal Health Insurance Scheme 

Following is the list of expenses that are excluded under the Universal Health Insurance Scheme: 

• HIV/ AIDS
• Congenital disorders
• Warlike situations 
• Suicide attempts or suicides 
• Injuries due to consumption of alcohol, drugs, or any other dreadful substances  
• Injuries due to breach of law 
• Dental or cosmetic surgery 
• Medical devices like hearing aids, and a lot more 

Conclusion 

To know the details of the Universal Health Insurance Scheme you must carefully read the policy-related documents, as it avoids any confusion at the time of claim settlement. The rate of premium for this scheme is very much affordable and therefore, it should be bought by the people belonging to a lower income group as it can protect them and their loved ones against any medical expenses in case of an emergency.

Also Read: National Health Insurance Schemes in India

Types of Government Health Insurance Schemes in India

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.