Private vs. Public Health Insurance: Everything You Need to Know

With the increasing cost of medical treatment, individuals need additional financial support. Thus, it would help if you choose the right medical health insurance to overcome financial strain.

The Government of India and private companies offer health insurance, and all these plans incorporate several features and benefits for policy buyers. So, here is a comparative study of private vs. public healthcare insurance that helps you understand them well.

What is Private Health Insurance?

Organisations outside of the government fund private health insurance. You must pay the premiums regularly; the insurance providers will cover the medical expenses in return. These insurance plans come with high premium costs but include additional benefits.

What is Government Health Insurance?

India’s central and state governments offer public or government health insurance plans. These plans are mainly designed for people in economically weaker strata of society. However, they come with considerable coverage and little to no premium, so people from all economic backgrounds can access them.

What is the Difference Between Private and Government Health Insurance?

Private and public health insurance has several distinctions. You will learn these differences from the health insurance comparison table given below–

Private Health Insurance	Public Health Insurance
Private medical insurance plans have comparatively higher premiums. However, they offer access to advanced medical facilities suitable for critical care.	Government health insurance has low to no premiums depending on the insured person’s eligibility. These plans are accessible to everyone regardless of their economic status.
These plans cover a wide range of medical expenses. They include add-on benefits such as home care treatment, dental or vision care, etc.	The government insurance provides the basic coverage. They only include essential healthcare services and no add-ons.
Private health insurance plans in India offer flexibility in choosing treatment options as they cover a diverse network of hospitals and doctors.	However, the public plans incorporate limited options as they have a fixed list of hospitals and doctors.
A significant advantage of private medical insurance is the cashless treatment. So, you don’t need to pay anything and focus on recovery.	There are no such options for public health insurance. If you have the policy, you can get treatment at selected government hospitals.
As these plans provide access to high-quality healthcare facilities, you become facilitated by super-speciality hospitals with their top-up and super-top-up plans.	The low-cost policies of the government-backed plans ensure that treatments are affordable for underprivileged people. Thus, these plans allow access only to government or public hospitals.
You will get various options for customised plans according to your healthcare needs.	Public health insurance imposes fewer customisation options. You will only get the necessary treatment options.
The only eligibility criteria for private insurance plans are that you must have the financial means to pay the premiums.	On the other hand, eligibility for government health policies should meet specific age, income, or disability status.

Types of Private and Government Health Insurance in India

There are different types of private and government health insurance in India. You can buy health insurance online and pay the premiums as well. Here are some of the variants of private and public healthcare insurance plans.

Types of Private Insurance:

• Individual Health Insurance: This plan facilitates the individual or insured person. They can spend the entire sum of the insurance for their medical expenses.
• Family Health Insurance: This plan covers every family member under a single plan. The sum insured will be available for all the family members as required.
• Senior Citizen Health Insurance: These medical health insurance plans cover the medical costs of senior citizens 60+. However, they should undergo specific medical check-ups before purchasing these plans.
• Critical Illness Health Insurance: These insurances cover critical diseases such as cancer, heart attack, kidney failure, etc. These plans offer a large amount of compensation to the insured person. You can buy these plans as a standalone or an add-on with a basic health insurance plan.

Types of Public Insurance:

1. The Ayushman Bharat—Pradhan Mantri Jan ArogyaYojna (PM-JAY): This government health insurance scheme is designed for people in the backward economic classes. Under this plan, coverage can be up to ₹5 lakhs.
2. The Employees’ State Insurance Scheme (ESI): This insurance is available for the working personnel of several firms in India. But their salaries shouldn’t exceed ₹21000/month. The upper limit is ₹25000/month for people with disabilities.
3. The Pradhan Mantri Suraksha Bima Yojana (PMSBY): The PMSBY scheme offers coverage for accidental death and disability. The sum insured for accidental death/total disability is ₹2 lakhs, and for partial disability, it is ₹1 lakh.
4. The Rashtriya Swasthya Bima Yojna (RSBY): This scheme was designed for the people working in the unorganised sectors of India. The sum insured under the scheme is ₹30000.

Conclusion:

Health insurance plans provide essential financial support during medical emergencies. Every type of insurance plan has its unique advantages and challenges, whether private or public.

And, what’s more! Most reputable insurers also offer online health insurance options, allowing you to compare and purchase plans conveniently. This flexibility makes securing the right coverage for you and your loved ones easier than ever.