Universal Health Insurance Scheme (UHIS) 2024 – Benefits, Coverage, Eligibility

Universal Health Insurance Scheme

The Universal Health Insurance Scheme (UHIS) is considered as one of India’s most comprehensive government health insurance programmes. This insurance scheme provides coverage for those with lesser incomes, particularly the primary breadwinner in the household. The primary breadwinner’s personal accident coverage, hospital expenses, and death benefits are all covered by the health insurance. Read the article below to know more about Universal Health Insurance Scheme

What is Universal Health Insurance Scheme 2024 ?

The Ministry of Health and Family Welfare unveiled the Universal Health Insurance Scheme as a component of its proposed UHAM, or Universal Health Assurance Mission. The Indian government created the Scheme in 2003 with the goal of giving the underprivileged and needy people access to healthcare. Both Below Poverty Line (BPL) and Non-BPL families are eligible for the programme. Its insurance coverage currently covers over 25% of the population.

Niramaya Health Insurance Scheme

Universal Health Insurance Plan Details in Highlights

Name of the schemeUniversal Health Insurance Scheme
Launched byIndian government
Launched in2003
DepartmentMinistry of Health and Family Welfare
ObjectiveTo give the underprivileged and needy people access to healthcare
Modeonline
BeneficiariesPoor people
BenefitInsurance coverage
Official Website

Features of UHIS Scheme

Some of the key features of Universal Health Insurance Scheme are mentioned below:

  • Both people and groups are eligible for coverage under this plan.
  • All family members’ names are listed on the plan, which is issued in the name of the chief earner in the household.
  • All group insurance shall be issued in the collective name of the group or the purchasing institution acting on behalf of the BPL families.
  • The member and their family will be named on the universal health insurance plan.
  • The participants cannot be covered by more than one group health plan.

Benefits of Universal Health Insurance Scheme

The benefits of Universal Health Insurance Scheme are mentioned below:

  • Every family is eligible for a hospitalisation benefit of Rs. 30,000, which covers the maternity benefit mentioned above.
  • With the exception of maternity benefits, the maximum amount of expenses that can be claimed is Rs. fifteen thousand.
  • Disability compensation: If the primary policyholder or spouse is admitted owing to sickness, disease, or accident, the insurer will begin paying Rs. 50 per day on the fourth day of hospitalization after a three-day waiting period. However, the maximum is limited to 15 days for each policy period.
  • Personal accident cover: If the head of the family, who is the primary policyholder under the plan, passes away, the insured would receive Rs. 25,000. This is applicable if the insured person is harmed in an accident if the insured person is the family’s main provider, and if the injury results in death within six months of the accident.

Central Government Health Scheme

Exclusions In the Universal Health Insurance Scheme:

The health plan’s list of exclusions is as follows:

  • Disease or injury due to war, an act of terrorism, or invasion.
  • Dental surgery or treatment for corrective, cosmetic or aesthetic purposes.
  • Venereal or congenital diseases.
  • Circumcision is included only in the case of necessary treatment or disease or in case of an accident.
  • Death or injuries caused due to nuclear weapons.
  • Expenses related to spectacles, hearing aids, contact lenses are not covered.
  • Injuries due to self-inflictions.
  • Cost of vitamins or tonics unless required for medication purposes.
  • HIV/AIDS
  • Attempted suicide.
  • Suicide.
  • Injuries or death arising out of the influence of alcohol or drugs.
  • Injuries or death while operating an aircraft or taking part in adventure sports.
  • Injuries or death caused due to breaching the law with criminal intent.

Documents Required for UHIS Scheme 2024

Following is the documents required for Universal Health Insurance Scheme

  • A certification from a revenue department staff member holding at least the Tehsildar or B.D.O. rank from the appropriate state government, attesting to your BPL status.

Eligibility Criteria for Universal Health Insurance Scheme 2024

Before applying for Universal Health Insurance Scheme, make sure you fulfil all the eligibility criteria. The insured’s eligibility for the UHIS is contingent upon their classification as either BPL or APL. Here are the specifics:

Eligibility Criteria for BPL Families:

  • A family’s income shouldn’t exceed the total cost of insurance. 
  • Evidence of a certificate from the revenue department’s BDO or local Tehsildar attesting to the family’s BPL status.
  • Applicant should range in age from five to seventy years.
  • If both parents are covered by the system, children under the age of five will also be insured.

Eligibility Criteria for APL Families:

  • The family’s income needs to be more than the total insured.
  • Applicant must be between the ages of five and sixty-five.
  • If both parents are insured by the policy, children between the ages of three months and five years will also be covered.
  • Certain diseases that you may already have had before enrolling may not be covered for the first two years. However, if you enrol in the programme, you can continue to get coverage for additional injuries or illnesses.
  • Avoid being the person who waits to renew their insurance! You can re-enroll at any age as long as you continue before the deadline. If you miss the deadline, though, you may need to go over the qualifying requirements once more. Make a note to ensure that you maintain coverage!

 Employee State Insurance Scheme

Universal Health Insurance Scheme Premium Rates:

The premium rates of Universal Health Insurance are given in the table below.

For families below the poverty line

Coverage Premium Rate (Rs.) Government Subsidy (Rs.) Insured Share (Rs.) 
Individual Rs.300 Rs.200 Rs.100 
For family with up to 5 members Rs.450 Rs.300 Rs.150 
For family up to 7 members Rs.600 Rs.400 Rs.200 

For families above the poverty line

Coverage Premium Rate (Rs.) 
Individual Rs.365 
For family with up to 5 members Rs.548 
For family up to 7 members Rs.730 

Application Process of Universal Health Insurance Scheme 2024

In order to enrol in the UHIS, you must speak with the relevant insurance provider, who will assist you with the application process.

FAQ’s

Is it possible to discontinue the Universal Health Insurance Plan at any time?

Yes, all individual policies, except those having less than a year of tenure, offer a 15-day free look period from the policy’s commencement date to review the terms and conditions.

Is the treatment strategy intended to use experimental drugs to treat patients?

No, drug experimental therapy that is not founded on accepted medical standards in India is not covered by this programme.

Is naturopathy covered by the UHIS?

No, this programme does not cover naturopathy treatment.

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