India is a populous nation. Many people in India are struggling when it comes to affording necessities. Healthcare is essential for all, but due to the rising healthcare costs, affording essential treatments has become difficult for those with the lowest income. The Universal Health Insurance Scheme (UHIS scheme) is necessary. The Universal Health Insurance Scheme (UHIS scheme) aims to assist the primary breadwinner of the families that belong to underprivileged sections of society in India so that they may struggle less when dealing with health issues. Since its inception two decades ago, this scheme has been crucial in uplifting persons with lesser incomes. This improved the lives of the less financially able population, ensuring that they may be able to have their basic needs met.

Benefits Of Universal Health Insurance

When looking up and trying to understand what scheme is the most suitable for a person, the central area concerning the scheme that they will be interested in would be the benefits offered through that particular scheme; There are different kinds of Universal Health Insurance Scheme benefits. Firstly, each family covered by the Universal Health Insurance Scheme (UHIS scheme) may avail of hospitalization-related benefits. These hospitalization benefits would amount to Rs.30,000. Maternity benefits are also included when it comes to hospitalization benefits. A cap on the number of expenses that can be claimed is Rs.15,000. This does not include maternity benefits. There is also compensation that is afforded for the disability of a person. There is a waiting period that lasts three days, after which the insurer will start paying Rs. 50 per day starting on the fourth day of hospitalization if the primary policyholder or spouse is admitted for some particular reason. These reasons may comprise an illness, disease, or accident. There is a limit of 15 days, according to the policy period. A personal accident cover will also be there for the beneficiary, which serves the fundamental purpose of offering financing in case they go through some accident and need urgent medical attention, which can often be very expensive. The insured person will receive Rs.25,000 if the primary policyholder of the plan, who is assumed to be the family’s head, passes away or loses their life. This applies when an accident causes harm to the insured or the family’s primary breadwinner and if the injury results in death within six months of the accident.

Do Universal Health Insurance Scheme Benefits Comprise Maternity Benefits?

Maternity benefits are an important area covered under several medical or healthcare-related schemes, significantly impacting women and their children. There are also several schemes primarily focusing on just maternity benefits alone. A person may use the scheme for medical services related to their first child. One may also want to know if the maternity benefits offered under Universal Health Insurance Scheme (UHIS scheme) are used for a second child. While the maternal benefits through the Universal Health Insurance Scheme (UHIS scheme) may be used for the first child, the Universal Health Insurance Scheme only extends its benefit to one child. Also, in addition to this, there is a 12-month waiting period which starts on the insurance policy’s start date.

Universal Health Insurance Scheme Eligibility

There are different eligibility criteria for schemes. This is because all schemes made in a populous country like India cannot serve everyone, so the administration has chosen some groups to target for specific schemes. This group focussed on when a scheme is made called the eligible group, and the criteria to belong to this eligible group is the eligibility criteria. It is essential to understand the eligibility criteria, especially when understanding if the Universal Health Insurance Scheme (UHIS scheme) suits one. The insured’s eligibility for the UHIS depends on whether they fall within the BPL or APL category. The complete form of BPL is Below the Poverty Line, and the complete form of APL is Above The Poverty Line. The insured’s eligibility for the Universal Health Insurance Scheme (UHIS scheme) depends on different factors. If the persons are below the poverty line and the parents are enrolled in the program, children between the ages of 3 months and five will also be covered. It shall be noted that when it comes to the scheme, the insurance will only be provided to those families whose income does not exceed the amount of the insurance.

There must be evidence of a certificate stating that the household is considered below the poverty line (BPL) from the local Tehsildar or BDO of the Revenue Department. The beneficiary’s Universal Health Insurance Scheme (UHIS scheme) age should be between 5 and 70 years old. For those above the poverty line, the family’s income must be more than the amount insured. The beneficiary’s age of the Universal Health Insurance Scheme (UHIS scheme) should fall between 5 and 65 years old if the policy ensures that parents and their children between the ages of three months and five years will also be covered by the Universal Health Insurance Scheme (UHIS scheme) and receive the scheme’s benefits.

Documents Required For Universal Health Insurance

When availing of a scheme, there are different kinds of information and proof about one’s identity that a person may have to provide. Usually, these rules are in place to avoid malpractice, fraud, or any other issue, such as identity theft, profiting off the benefits of a scheme, etc. Certain documents will be needed from the beneficiary’s side to access the different kinds of Universal Health Insurance Scheme benefits. These documents include a certificate attesting to your BPL status from a revenue department employee with a minimum rank of Tehsildar or BDO from the relevant state government.

Features Of The Universal Health Insurance Scheme

Every scheme has some feature that is distinctive from that particular scheme. While assessing and choosing between different schemes, it is a good idea to understand the different features of the scheme, trying to make sure that if any of these features affect the person, they are okay with it. This is especially important if the person takes up the scheme for serious medical issues or complications. Firstly, the policy may be taken up by individuals and groups. If a group has taken up the policy, the members cannot benefit from more than 1 group health insurance scheme. The scheme will be taken up in the name of the family’s primary earner. Still, it will also benefit and include the names of the direct family members of the family’s primary earner or the family head. If a group policy has been availed, it will be in the name of that particular group, institution, or association. The policy will contain the name of the members as well as their family members concerning the Universal Health Scheme eligibility.

Are There Any Exceptions To The UHI Scheme

One can avail of the different benefits that may be afforded through the Universal Health Scheme on meeting eligibility conditions. However, there are some exclusions that one may want to consider before taking up the scheme. Firstly while the scheme covers maternity benefits relating to one child of a person, it will only cover that and is limited in this sense. One may want to know if the plan can treat patients using drug experimental therapy. Anyone looking to take up this scheme to cover treatments using this kind of therapy through this program may note that it does not cover experimental drug therapy that is not based on recognized medical standards in India. Additionally, the scheme does not cover naturopathy treatment.

Other exclusions when it comes to the Universal Health Insurance Scheme (UHIS scheme) and the Universal Health Insurance Scheme benefits are disease or injury due to war, an act of terrorism, or invasion, and circumcision is included only in the case if a person requires necessary treatment or disease or case of an accident. There may be expenses related to spectacles, hearing aids, and contact lenses. These kinds of expenses are generally not covered under the Universal Health Scheme. If a person may need dental surgery or treatment for corrective, cosmetic, or aesthetic purposes, they must finance this privately because the scheme will not cover these. Some further exclusions include venereal or congenital diseases, the cost of vitamins or tonics unless required for medication purposes, HIV/AIDS, any death or injuries caused due to nuclear weapons, injuries that may be caused due to self-inflictions, 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 some kind of criminal intent.

Universal Health Insurance Scheme Hospital List

One may want more details about accessing the Universal Health Insurance Scheme benefits. One must know what hospitals offer these Universal Health Insurance Scheme benefits to avail and access these benefits. To access the exclusive list of hospitals that can offer medical services to patients under the Universal Health Insurance Scheme (UHIS scheme), the person interested in obtaining these details must speak with the insurance provider. The GST rate of 18% has applied to all financial services since July 1, 2017. Disclaimer: One must note that the premiums may vary depending on factors like age, location, and prevailing taxes/GST.

Need For The Universal Health Insurance Scheme In India

Schemes started by the government focus on areas that are key to the development and progress of our country. There is a great need for a scheme like the Universal Health Insurance Scheme (UHIS scheme) in India. It has served an important purpose and continues to do so. Understanding the need for the Universal Health Insurance Scheme (UHIS scheme) will help us understand why the government initiated this scheme. Many people in India are in need and hold less privilege than most. These persons usually struggle financially and socially. As a result, they may struggle to pay for healthcare. These groups are also riddled with misinformation and a need to understand how they must finance their healthcare. Financial literacy is hugely important when it comes to paying medical bills because of the rising and confusing costs related to receiving many treatments that could be life-saving. Different medicines, procedures, and healthcare consultants may have different and separate costs, which may be considerable. When persons belong to the BPL or Below the Poverty Line group in the country or even if they do not belong to this group and may be struggling financially, many times take on huge loans so that they may be able to afford the treatments which may be life-saving and cause even further problems such as domestic abuse, drinking, etc. to deal with the stress of raising money to pay back the entities that the loans have been taken from. When it comes to Universal Health Insurance Scheme eligibility, it consists of the struggling classes in India and benefits them.

Universal Healthcare & The UHI Scheme

Universal healthcare means everyone can access healthcare and medical services when and where needed. The concept of universal health care is ideal, but many countries have been able to ensure their citizens with universal health care. In India, universal healthcare is daunting due to the population’s colossal size and focus on good quality medical services in urban regions. Since there is a massive deficiency of the necessary medical and financial resources in rural regions, considering that there are many more rural regions in India as compared to urban, the idea of being able to provide everyone with healthcare becomes difficult. However, the government has taken some approaches which may help them to aid specific groups of people in the country that may need assistance when it comes to the issue of access to some kinds of basic needs and in the case of the Universal Health Insurance Scheme (UHIS scheme), this is healthcare. The scheme targets people who may be in need and ensures that they can receive necessary treatments. In this way, while universal healthcare may not yet be a reality in India, schemes ensure access to healthcare for groups that would be most difficult for, therefore ensuring that most people at the very least can attain good quality, professional medical resources when they need them and the rest of the population that may have the means to afford necessary health services can do so themselves. In such a way, ideally, everyone should have access to health care, so schemes like this one indirectly ensure universal healthcare.

Can A Person Cancel Universal Health Insurance Scheme For Free At Any Time?

Once a scheme like Universal Health Scheme is taken up, they may endlessly want to avail of its benefits and keep using it with no limit. However, there may be different reasons one may want to end using a scheme after a certain point. There could be another scheme that suits the beneficiary of the current scheme better, but they may only be able to take that more suitable scheme up once they opt out of the other scheme. A person’s financial situation may improve, and they do not qualify for that particular scheme anymore or may not need it. It would suit a person to opt out of that particular scheme in such situations. Yes, one can cancel for free after taking up the scheme. One must note that there is a 15-day free look period from the policy’s start date to evaluate the terms and conditions for all individual policies, save for those with less than a year of tenure.

Conclusion

People must be allowed healthcare and good quality medical services simply because they have fewer financial means. Good quality healthcare is a basic need. The government of India has recognized this and implemented schemes to ensure that the health and medical needs of people in the country are met regardless of where the person may come from, their social status, and their amount of income, among other factors. The Universal Health Insurance Scheme (UHIS scheme) has been a positive step forward by India’s government since July 2003, making healthcare accessible to both BPL or Below The Poverty Line families and APL or Above Poverty Line families. This will impact the families in the lower income strata and push forth the country’s development. If we can meet the needs of everyone in the country, the overall lifestyle, community development, and life satisfaction, among several other factors, will improve. In this way, the Universal Health Insurance Scheme (UHIS scheme) has played a crucial role in the country’s development and has proven to be a significant scheme for all.

If you aren’t eligible for the scheme and are looking for funds for medical treatment or expenses, you should check out Impact Guru. Fundraising in India has been a growing preference to raise funds for medical emergencies, and Impact Guru is one of the best crowdfunding platforms to raise medical funds online.