What is Rashtriya Swasthya Bima Yojana?
Who should buy Rashtriya Swasthya Bima Yojana?
Features and Benefits of Rashtriya Swasthya Bima Yojana
1) Options in the selection of the provider:
The Rashtriya Swasthya Bima Yojana provides various options to the policyholder to set one’s sight on the healthcare options, thus providing the opportunity to get the best treatment in either private or public sector in RSBY as per their choices.
2) Security and Safety:
With the advancement in technology, the RSBY scheme is issued with a biometric-enabled smart card. This would make sure that no unauthorized person can claim the amount.
3) Network hospitals:
The smart card issued to the policyholder can be claimed in any empanelled hospital, which is not restricted to a particular district or state. It also provides split for workers who are migrating for their work.
4) Cashless Claim facility:
Because of smart card facility, one doesn’t have to worry about reimbursement. Just by showing the smart card, one can avail for cashless claim facility, then it would be verified with their fingerprints.
All the process takes place electronically. There is no paperwork involved.
How does Rashtriya Swasthya Bima Yojana work?
Eligibility Criteria for Rashtriya Swasthya Bima Yojana
i) People working in an unorganized sector or BPL household
ii) People who register for welfare bound
iii) People of any age, with no age barrier
This covers up to 5 family members with sum assured of INR 30000.
How does Beneficiary utilize services in Rashtriya Swasthya Bima Yojana?
How to enrol for Rashtriya Swasthya Bima Yojana
What is Covered and Not Covered in Rashtriya Swasthya Bima Yojana?
i) Welfare boards building and constructions workers
ii) Street sellers
iii) Railway Porters ( Licensed )
iv) MNREGA ( worked for more than 15 days during the foregoing financial year)
v) Beedi/ Domestic/ Sanitation/ Mine Workers
vii) Rickshaw pullers
viii) Auto or Taxi Driver
However, there are certain things which are not covered under Rashtriya Swasthya Bima Yojana:
i) Outpatient Expenses
ii) Diagnosis Charge
iii) Co-payment or doctor’s consulting charges
Rashtriya Swasthya Bima Yojana Claim settlement process
What are the documents required for Rashtriya Swasthya Bima Yojana?
Families who are under the poverty line can opt for Rashtriya Swasthya Bima Yojana.
The policyholder will have to bear the registration cost of INR 30 and the premium amount would be paid by the Central and the State government based on competitive bidding. The government pays 75 percentage and 25 percentage is paid by the state government whereas in J&K and north-eastern states, 90 percentage is borne by the government of India and remaining 10 percentage is paid by the State government.
After receiving the policy, the policyholder receives a smart card which is biometrics enabled and it can be availed in any of the network hospitals which are RSBY enabled. They offer cashless hospitalization within the network hospitals under this scheme which is verified with the help of their fingerprints.
Rashtriya Swasthya Bima Yojana was designed for BPL population of India. This scheme is sponsored by the government of India. Upto 75 percentage of financing Rashtriya Swasthya Bima Yojana is done by the government of India and the rest amount is paid by the state government. While in Jammu and Kashmir and in the north-eastern states of India, the government contributes 90 percentage and the state government pays 10 percentage of the premium amount. The policyholder must pay a registration amount of INR 30 which is used for administrative purposes.