A diagnosis for a life-threatening disease can shake us mentally, physically, emotionally and most of all, financially. To ease your financial burden, there are many government schemes that provide assistance based on ad hoc basis, that we have outlined below:
Rashtriya Arogya Nidhi (RAN)
Since 1997, the Ministry of Health and Family Welfare has been providing financial assistance to patients living below poverty line and suffering from major life-threatening diseases, to receive medical treatment at any super specialty government hospital or institute under the umbrella scheme of Rashtriya Arogya Nidhi (RAN).The scheme provides financial assistance under these respective components:
- Rashtriya Arogya Nidhi (RAN) for patients suffering from life-threatening diseases other than cancer
- Health Minister’s Cancer Patients Fund (HMCPF) for patients suffering from cancer
- Scheme for patients suffering from specified rare diseases
Find the complete list of disease/treatments, hospitals and cancer centres where revolving funds are set up under the umbrella scheme of RAN, here.
Key features:
- Revolving funds have been set up in 13 Central Government hospitals/institutes.
- Funds up to INR 50 lakhs are placed at their disposal for providing treatment up to INR 2 lakhs per patient.
- Financial assistance is eligible to patients as a one-time grant, and is released to the medical superintendent of the hospital where treatment is being received.
- Cases of financial assistance beyond INR 5 lakhs have to be referred to the Ministry of Health and Family Welfare.
- For hospitals not having revolving funds, financial assistance for a patient will only be provided on approval by the Ministry of Health and Family Welfare along with a sanction letter.
- Families covered under Ayusman Bharat - Pradhan Mantri Jan Arogya Yojana (PMJAY) will not be eligible for financial assistance under the umbrella scheme of RAN.
- Financial assistance received by the patient for the purpose of treatment, under the Prime Minister's National Relief Fund (PMNRF) or from any other source, will be deducted from the admissible amount of financial assistance under the umbrella scheme of RAN.
- Government servants and their families are not eligible under this scheme.
- There is no reimbursement for expenditure already incurred.
- The application complete in all respects is processed within a period of one month.
Requirements to avail financial assistance:
- Application form, signed by the treating doctor and the medical superintendent of the government hospital/institute where treatment is being received.
- Copy of income certificate
- Copy of ration card
Health Minister’s Cancer Patients Fund (HMCPF)
The Health Minister’s Cancer Patients Fund is a component of the umbrella scheme of Rashtriya Arogya Nidhi (RAN), providing financial assistance to patients below poverty line suffering from cancer and undergoing treatment in any of the 27 empanelled regional cancer centres.
Key features:
- Revolving funds of up to INR 50 lakhs have been set up in 27 regional cancer centres, tertiary care centres and state cancer institutes.
- Under HMCPF, each cancer patient can receive financial assistance of up to INR 5 lakh
- Cases involving treatment beyond the set limit have to be referred to the Ministry of Health & Family Welfare, for fund disbursement.
Requirements to avail financial assistance:
- Application form, signed by the treating doctor and the medical superintendent of the government hospital/institute where treatment is being received.
- Copy of income certificate
- Copy of ration card
Health Minister’s Discretionary Grant (HMDG)
Introduced in 2013, the Health Minister’s Discretionary Grant is another component of the umbrella scheme of Rashtriya Arogya Nidhi (RAN), providing up to INR 1.25 lakhs to poor indigent patients suffering from major illnesses, whose annual income is INR 1.25 lakhs or less, to settle a part of the medical expenditure incurred in government hospitals or institutes.
Read more, here.
Key features:
- Under this scheme, the patient will be provided financial assistance of
- INR 50,000 if the estimated cost of treatment is up to INR 1 lakh
- INR 75,000 if the estimated cost of treatment is between INR 1 lakh and INR 1.5 lakhs
- INR 1 lakh is the estimated cost of treatment is above INR 1.5 lakhs
- Patients receiving treatment in private hospitals cannot avail the grant.
- Government employees are not eligible for the grant.
- Financial assistance will not be provided for diseases of common nature with inexpensive treatments.
- Reimbursement of expenditure already incurred is not permissible
Requirements to avail financial assistance:
- Application form, signed by the treating doctor and the medical superintendent of the government hospital/institute where treatment is being received.
- Copy of income certificate
- Copy of ration card
Prime Minister’s National Relief Fund
Although the Prime Minister's National Relief Fund (PMNRF) primarily renders immediate relief to bereaved families of those killed in natural calamities, it also provides financial assistance to indigent patients suffering from major life-threatening diseases to receive treatment at government/PMNRF enlisted hospitals to partially cover the medical expenditure. Funds are allocated on the approval of the Prime Minister.
Find the complete list of enlisted hospitals under PMNRF, here.
Read more, here.
Key features:
- PMNRF runs on public contributions and does not receive any budgetary support.
- PMNRF accepts voluntary contributions from individuals, organisations, trusts, companies, institutions, etc.
- All contributions towards PMNRF are eligible for tax exemption under Section 80G.
Requirements to avail financial assistance:
- Application form addressed to the Prime Minister, signed by the treating doctor and the medical superintendent of the government hospital/institute where treatment is being received.
- Copy of income certificate
- Copy of ration card
- Two photographs of the patient in passport size
- Original medical certificate clearly stating the type of disease and cost estimate of treatment
Janani Shishu Suraksha Karyakram (JSSK)
In 2011, the Ministry of Health And Family Welfare launched the Janani Shishu Suraksha Karyakram (JSSK) in every state and union territory, whereby expecting mothers and sick newborns have access to better facilities in women and child health services. The objective of the scheme was to do away with any barriers for needy mothers and newborns to seek institutional care.
Read more, here.
Beneficiaries are entitled to:
- Free and cashless delivery
- Free c-section
- Free and zero expense treatment
- Free drugs and consumables
- Free diagnostics and diet
- Free provision of blood
- Free transport from home to health institutions
- Free transport between facilities in case of referral
- Drop back from institutions to home
- Exemption from all kinds of user charges
Ayushman Bharat (Pradhan Mantri Jan Arogya Yojana)
Popularly known as the Pradhan Mantri Jan Arogya Yojana (PM-JAY), Ayushman Bharat is a national public insurance fund that aims to provide free access to health insurance for low-income earners in the country, in both public and enlisted private healthcare facilities. It was launched by the Ministry of Health and Family Welfare in 2018, and caters to nearly 50 crore people, making it the world’s largest government-sponsored health coverage program.Find the complete list of enlisted hospitals under PM-JAY, here.
Read more, here.
Key features:
- When anyone needs additional care, beyond the primary care services from their family doctor, then under PM-JAY, they can avail free secondary health care for specialist treatment and tertiary health care for hospitalisation.
- PM-JAY aims to secure the lives of poor families in both rural and urban areas.
- A defined benefit cover of INR 5 lakhs is provided per family, per year.
- The primary objective is to increase access to quality and affordable healthcare and medication.
Eligibility to avail financial assistance:
- To claim benefits under the scheme you can get yourself identified at the nearest PM-JAY enlisted hospital or Community Service Centre (CSC)
- To check if your name is on the beneficiary list or that you are eligible for PM-JAY, click here
Pradhan Mantri Suraksha Bhima Yojana (PMSBY)
Launched in 2015, Pradhan Mantri Suraksha Bima Yojana (PMSBY) is a social security scheme that provides a renewable annual coverage for disabilities caused by accidents. It is administered through both public and private sector insurance companies in collaboration with enlisted commercial banks, regional rural banks and cooperative banks. The benefits of this insurance coverage can be availed by partially disabled and permanently disabled citizens.
Read more, here.
Key Features:
- PMSBY provides a one-year cover of INR 2 lakhs for permanent disability, and INR 1 lakh for partial disability
- People aged between 18 and 70 years, who have an account in a PMSBY-enlisted bank, can avail the benefits. Application for the same can be found here
Requirements to claim financial assistance for disability of insured member:
- Completed claim form with the following documentation enclosed:
- Aadhaar and PAN number of the insured member and claimant
- KYC document in respect of the insured member/claimant
- First two pages of passbook, or bank/post office account statement showing account details
- Proof of claimant being legal heir, in case they are not the insured member
- Advance receipt for discharge of claim, duly filled in and signed
Aam Admi Bima Yojana (AABY)
Aam Aadmi Bima Yojana is a social security scheme approved by the Department of Financial Services, and has been in operation since 2007. Aimed at low-income families and rural landless households where the head of the family is not on a payroll, it provides them with financial assistance to deal with unfortunate circumstances that could lead to a disability.
Find the complete list of insurance companies and occupations/vocations covered under AABY, here.
Key features:
- The premium cost of AABY is extremely low, making it more affordable
- Under the scheme benefits are provided the following benefits for:
- Partial disability - INR 37,500
- Permanent disability - INR 75,000
- The applicant can enrol for the scheme at an appointed nodal agency. Requirements for application include:
- Application form (can be found on each state government’s official website)
- Identity proof
- Income certificate
- Address proof
- Nominee application form (who will receive the benefits upon death of claimant )
Requirements to claim financial assistance for disability of insured member:
- Documentary proof of accident
- Medical certificate issued by registered medical practitioner, certifying the insured member’s disability
Eligibility to avail financial assistance:
- People aged between 18 and 59 years can avail the benefits of the scheme
- The applicant should belong to a family living Below the Poverty Line (BPL)
- Only one member of the family, the sole breadwinner, will be covered under the scheme
Employees’ State Insurance Scheme (ESI)
Implemented in 1952, under the Employees’ State Insurance Act, the Employee State Insurance Scheme (ESI) is an integrated social security plan tailored to provide workers and their families socio-economic protection. It covers employees in factories and other establishments like road transport, hotels, restaurants, newspapers, shops etc., during certain health-related eventualities by extending medical care for the insured and their dependents.
Find the complete list of enlisted hospitals under ESI, here.
Read more, here.
Key features:
- From day one of employment, the insured person’s medical expenses are covered through affordable healthcare facilities
- Employees can avail medical benefits at any of the ESI-enlisted hospitals
- Employees are eligible for cash benefits in the case of sickness, disability, maternity, physical rehabilitation, etc.
- It provides maternity benefit of 100% of wages for 12 weeks
- In the event of an employee becoming temporarily or permanently disabled, they are supplied a monthly wage of 90%
- The insured can receive 70% of cash benefits during medical leave for a maximum of 91 days.
- ESI ensures that the family of the insured will receive monthly payout after their death
Eligibility to avail financial assistance:
- Employees that draw monthly wages of INR 21,000 are entitled to social security cover under the ESI Act
- The worker must be employed in a non-seasonal factory that has over 10 employees
Janshree Bima Yojana (JBY)
Launched in 2000 by the Government of India, jointly with the Life Insurance Corporation of India, the Janshree Bima Yojana is a social security scheme for people from both urban and rural areas, living Below the Poverty Line (BPL) and marginally Above the Poverty Line (APL). At present, JBY covers 45 occupational groups, encompassing two previously prevalent plans - the Social Security Group Insurance Scheme (SSGIS) and Rural Group Life Insurance Scheme (RGLIS).
Find the complete list of categories of workers covered under JBY, here.
Key features:
- Premium per member is INR 200, of which 50% will be borne by the state government or nodal agency they are registered with, and the other 50% will be paid from the Social Security Fund
- Nodal agencies may refer to self-help groups, NGOs, panchayats and any other institutional agencies
- Under the scheme benefits are provided the following benefits for:
- Partial disability due to accident - INR 37,500
- Permanent disability due to accident - INR 75,000
Eligibility to avail financial assistance:
- People aged between 18 and 59 years can avail the benefits of the scheme.
- The membership size should be a minimum of 25
- Should preferably be a member of any nodal agency or vocational group.
Universal Health Insurance Scheme (UHIS)
The Universal Health Insurance Scheme was launched by the Ministry of Health and Family Welfare in 2003, as part of its Universal Health Assurance Mission (UHAM), and is an insurance plan for lower-income groups, mainly the breadwinner of the family. The scheme offers coverage for all medical expenses for persons falling Below the Poverty Line (BPL) and Above the Poverty Line (APL), as well as personal accident to the primary-earner of the family.
Read more,
here.
Key features:
- Insurance coverage will be in the name of the family’s breadwinner, also containing the names of the family members
- The insured members are reimbursed for medical expenses incurred during hospitalisation for any illness, disease, or injury sustained by them.
- Each family is liable to receive INR 30,000 as hospitalisation benefit, which includes maternity benefit
- Minimum claim expenses are limited to INR 15,000 (excluding maternity benefits)
- The insured member of their spouse may receive INR 50 for a maximum of 15 days, in case they are hospitalised due to illness or an accident. This is provided from the 4th day of hospitalisation.
- Insurance companies will help with enrolling in this scheme
Eligibility to avail financial assistance:
- People aged between 5 and 70 years can avail the benefits of the scheme.
- Children aged between 3 months and 5 years old are covered with their parents under the scheme.
- The family’s income must be lesser than the coverage amount
- Certificate providing proof of BPL status from Tehsildar or Block Development Officer of the State Revenue Department
