Healthcare schemes1 refer to the the various medical expenses (expenses insurance, health insurance, critical illness insurance, other healthcare disability schemes or other medical emergency arrangements) will be provided by the company for the benefit of the executive. Government Healthcare2 schemes are specifically made for the lower section of society, covering a maximum sum insured up to 5 lakhs. It starts with Rs 100 per month or is fully paid by the government, offering a narrow coverage.
The Benefits of Healthcare Schemes are3–
- Coverage against medical expenses- The main purpose of medical schemes is to provide the best medical care in an emergency without causing any financial crisis to the individual. It cares for hospitalization costs, daycare costs, ambulances, and many other related expenses
- Coverage against critical illness- Insurance companies also provide benefits against critical illness. Such insurance policies cover life-threatening diseases related to kidney failure, bone marrow transplantation, stroke, loss of limbs, and others.
- Cashless claim benefits- Many insurance company offer cashless claim benefits. In such cases, the person need not make out-of-pocket payments. To claim this, person needs to get the benefits of any of the insurer’s network hospitals.
- Protection over and against the employer cover- Many insurance companies protect against the group insurance plan. However, such policies are not tailor-made according to the needs of every individual. Besides, you may be left uninsured in case of loss of job or change in employment.
- Tax benefits- Healthcare schemes also provide tax-free benefits.
The Common Government Healthcare Schemes are-
- Reproductive, Maternal, Newborn, Child, and Adolescent Health4 – Ensuring the survival of the mother and child and focusing on their health is the ultimate goal of this scheme. This strategy is holistically planned. It aims to provide complete care for the reproductive health of the women till child is born, also covering the health necessities of the young one till adolescence giving all of them full coverage. The plus point of this scheme is covering the health of adolescents within the overall strategy, giving priority to mother and child health, and linking home and community-based service to facility-based service. The scheme also ensures the linkages, referrals, and counter referrals to create a continuous care pathway.
- Rashtriya Bal Swasthya Karyakram (RBSK) 5 – The Ministry of Health and Family Welfare Plan under the National Health Mission launched the Rashtriya Bal Swasthya Karyakram. It is one of the most innovative and ambitious steps for child health screening and Early Heath Intervention services. It focuses completely on children’s health givig them primary focus. This program covers the health of children from the time of birth up to 18 years of age and focuses on 4-Ds: Defect during the time of birth, Diseases, Deficiencies, and Developmental Delays. This task is huge but its systematic approach has made this mission worthy and successful.
- The Rashtriya Kishor Swasthya Karyakram6 – The Rashtriya Kishor Balya Karyalram was launched on January 7th, 2014. The motive of this program is adolescent participation, leadership, equity and inclusion, and gender equality. The program focuses primarily enabling adolescents all over the country to realize their full potential. To enable the smooth working of this program, MOHFW along with UNFPA has developed a National Adolescent Health Strategy. It realigns its clinic-based curative approach to focus on a more holistic model for caring the adolescent health and developmental needs.
- Rashtriya Swasthya Bima Yojana7 – Unorganised sectors that are below the poverty line are the main target for this scheme. It’s the responsibility of the implementing agencies to verify the unorganized sector workers and their families to be benefited under this scheme. For identification purpose, the beneficiaries are allotted a smart card carrying their identity. The beneficiary is eligible for the patient healthcare insurance whose benefits are designed by the respective state government. The entire family of the unorganized sector family will be covered, including hospitalization charges, pre-existing diseases, and transportation costs.
- Integrated Child Development Service 8 – Children in the age group 0-6 years constitute around 158 million of the population of India. The scheme provides supplementary nutrition, immunization, and pre-school education to the children and is a popular flagship program of the government. This scheme was launched in 1975 and provides the largest program for an integrated package of services. It is a centrally sponsored scheme implemented by the state government and union territories.
A Health Insurance policy equips you to get the best healthcare treatment without worrying about the huge costs payable at the time of discharge. Therefore knowing about the claim process is an essential piece of information that the insured individual should be aware of at all times.