Understanding universal health insurance

Accessibility to quality healthcare is the legitimate right and elemental need of every individual. Sadly, such is not the scenario in most of the third world countries. Universal Health Insurance Scheme (UHIS) is a means of providing healthcare services at a nominal rate. The aim of the plan is that financial impediment should never deprive people of treatment.

The insurance plan was brought into effect in 2003 by the Indian Government. It serves the objective of medical coverage for the entire cross-section of society. It is replete with medical advantages for people below poverty line (BPL). The universal health coverage also comes with medical compensation for well-to-do families. Let us glance over the following features to get a holistic understanding of this scheme.


• HOSPITALIZATION REIMBURSEMENTS: Universal health insurance schemes give extended financial and medical assistance to individuals. These range from ambulance costs to medicinal requirements to diagnostics and discharge bills. The limit of hospitalization reimbursement for one family per policy is INR 30,000. For ICU patients, up to 1% of the sum insured per day can be claimed.

• WIDE COVERAGE: The universal health insurance scheme applies both to an individual as well as groups. The individual policy is named after the earning head of the family. Details of other family members are also included.

• APL & BPL: Proper documentation must be submitted by BPL candidates about their income. There are extensive benefits for the most downtrodden sections of society. Even people above the poverty line are not deprived of the medical perks. Universal Health Insurance is a government scheme aimed at improved wellness of all.

• ELIGIBILITY: There is a slight difference in the age criteria for eligibility for the plan. In the case of BPL, people aged between 5 and 70 can apply for the plan. In the case of APL, it is 5 and 65 years of age. For children of both strata of society, the age bar is 3 months and 5 years. However, one or both parents must be covered at that point in time.


PERSONAL ACCIDENT: Death and debility are never under our control. Thus, the company supports insured individuals who happen to be earning member of the family. It occurs if they face an accident due to outward, violent and visible means. If they die within 6 months post the incident, then the insurance company pays INR 25000.

SUPPORT FOR DISABILITY: The universal health coverage plan is applicable for long-term treatments too. It applies when an earning head of the family is hospitalized due to some disease or accident. The company pays INR 50 per day from the fourth day of admission. Payments are covered until the successive 15 days.

MATERNITY BENEFITS: The universal health insurance plan also provides coverage for maternity. A compensation of INR 2500 is given for normal delivery and INR 5000 for C-section. This cost is covered for BPL families and for one child only. There is a waiting period of one year before one can avail the maternity benefit. The waiting period is taken to be from the date of commencement of the policy.


ManipalCigna Health Insurance Company Ltd (Formerly known as CignaTTK Health Insurance Company Limited) | CIN U66000MH2012PLC227948 | IRDAI Reg. No. 151 
Reg. Office: 401/402, 4th Floor, Raheja Titanium, off. Western Express Highway, Goregaon (East), Mumbai- 400 063 | Toll free number – 1800-102-4462 | Website address –
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