India has several government health insurance schemes providing coverage from ₹50,000 to ₹5 lakh per family. This comprehensive list covers Ayushman Bharat PMJAY, state-specific health schemes, CGHS for government employees, and employer-provided ESI coverage for the organized sector.
Introduction
India has one of the world's largest government-funded health insurance ecosystems, covering over 70 crore beneficiaries across central and state schemes. From Ayushman Bharat PMJAY providing ₹5 lakh cover to state-specific schemes like Swasthya Sathi (West Bengal), Arogyasri (Andhra Pradesh), and Mukhyamantri Amrutam (Gujarat), this guide provides a complete comparison of all major health insurance schemes available in India for 2026.
Major Health Insurance Schemes Compared
| Scheme Name | Coverage Amount | Beneficiaries | Premium/Contribution |
|---|
| Ayushman Bharat PMJAY | ₹5 lakh per family/year | 10.74 crore families | Free (government-funded) |
| CGHS | Unlimited OPD + IPD | 40+ lakh central govt employees | ₹500-₹5,000/month (employee share) |
| ESI Scheme | Medical + cash benefits | 13+ crore workers/families | 0.75% employee + 3.25% employer |
| Swasthya Sathi (WB) | ₹5 lakh per family/year | 7+ crore WB residents | Free for BPL; ₹900/year for APL |
| Dr. YSR Arogyasri (AP) | ₹5 lakh per family/year | 1.5+ crore AP families | Free (state-funded) |
Which is the largest health insurance scheme in India?","answer":"Ayushman Bharat PMJAY is the world's largest government-funded healthcare program, covering over 10.74 crore poor and vulnerable families with a health cover of ₹5 lakh per family per year. It has 25,000+ empanelled hospitals and covers 1,600+ medical procedures across all states except Delhi and West Bengal.
Does ESI cover maternity benefits?","answer":"Yes, ESI provides maternity benefit of 100% of daily wages for 26 weeks (12 weeks in case of miscarriage). The benefit also covers prenatal and postnatal medical care. In addition, ESI provides maternity leave, nursing breaks, and crèche facilities at workplaces with 20+ women employees.
What is the difference between CGHS and Ayushman Bharat?","answer":"CGHS is exclusively for central government employees and pensioners, offering comprehensive OPD and IPD coverage at designated CGHS hospitals and dispensaries. Ayushman Bharat is for BPL families with coverage limited to inpatient care at empanelled hospitals. CGHS has an employee contribution while PMJAY is fully government-funded.
Can foreigners avail Ayushman Bharat?","answer":"No, Ayushman Bharat is specifically for Indian citizens identified through the SECC 2011 database. Foreign nationals are not eligible. However, OCI/PIO cardholders who are Indian residents and meet the SECC criteria may be eligible if their families are enumerated in the database.
What is the process to claim cashless treatment?","answer":"Visit any empanelled hospital with your Ayushman card (e-card or physical) and Aadhaar. The hospital checks eligibility online, submits a pre-authorization request, and after approval (within 8 hours for normal cases, 1 hour for emergencies), provides cashless treatment. You do not pay anything at the hospital.
