Personal health insurance for Government Employees: Things you should know!

Government schemes provide health insurance coverage to government employees, which can be claimed in a medical emergency. Employees must understand whether they need to purchase personal health insurance or not.

Personal health insurance for Government Employees

The Government of India provides health insurance coverage to employees at different levels. Health insurance coverage provides financial protection to employees and their families in a medical emergency. The schemes under which the employee is covered depend upon the government entity in which the employee works. 

What are the health insurance schemes launched by the government for employees?

Depending upon the job of the employee and the entity under which the job is covered, there are various health insurance schemes launched by the state and central government. Some of those health insurance schemes are:

  • Central Government Health Scheme (CGHS) 
    For central government employees

  • Pandit Deendayal Upadhyay State Employees Cashless Medical Scheme 
    For state government employees in Uttar Pradesh.

  • Punjab Government Employees and Pensioners Health Insurance Scheme (PGEPHIS)
    For state government employees and pensioners of Punjab.

  • West Bengal Health Scheme
    For state government employees of West Bengal

  • Telangana State Government Employees and Journalists Health Scheme
    Employees working for the State government and Journalists working in the state.

  • The State Government Employee Insurance Scheme 
    Employees working for different entities under the Government of Maharashtra

What facilities are provided under health insurance coverage for government employees?

The facilities provided under the health insurance coverage depend upon the scheme by the state or central government. However, the facilities which are covered under all of the health insurance schemes are:

  1. Medical treatment at government hospitals and other private hospitals is covered under the scheme.

  2. Medical tests that are to be conducted for the employee’s treatment.

  3. Medicines which are necessary for the employee’s treatment.

  4. Consultations with Doctor for treatment.

  5. Cashless facility

  6. Reimbursement of medical expenses covered under the scheme.

  7. Reimbursement of medical devices such as hearing aids.

  8. Services for family welfare, maternity, and child health.

Note: There is no limit for the government schemes introduced to provide health insurance coverage to government employees. 

Why does a government employee need to buy personal health insurance?

The health insurance schemes provided by the state or central government can be utilized if the patient undergoes treatment at a medical centre covered under the scheme. If the patient undergoes treatment at a medical centre which is not covered, no coverage will be provided, and the money will come out of the employee’s pocket. Therefore, a government employee should purchase personal health insurance to cover medical expenses if an emergency occurs at a location where no designated medical centres are nearby.

Also, watch: Importance of personal health insurance.

Purchasing personal health insurance is not compulsory but a necessary addition to their government health insurance coverage. An emergency can occur at a place not having a designated medical centre where the coverage can be availed. A personal health insurance plan would protect the employee from any risks associated with this uncertainty.

Disclaimer: This article is intended for general information purposes only and should not be construed as investment or legal advice. You should separately obtain independent advice when making decisions in these areas.



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