A government health insurance program called Rashtriya Swasthya Bima Yojana (RSBY) aims to protect vulnerable families and individuals below the poverty line (BPL) financially. Since its launch in 2008, this program has helped millions of Indians nationwide have better access to healthcare.
Rashtriya Swasthya Bima Yojana Objective
The health insurance scheme aims to facilitate the phased launch of health insurance projects for BPL workers in all State districts, taking into account the diversity of public health infrastructure, socio-economic conditions, and administrative networks.
Rashtriya Swasthya Bima Yojana Insurance Coverage
Up to five members of the BPL household may be covered by the sum insured, which on a family floater basis has a maximum amount of Rs. 30,000. In addition, this medical insurance plan covers hospital transportation costs up to a maximum of Rs. 1000 per visit or Rs. 100 per visit. The following month after the enrollment date is when the program starts.
Benefits
- Cashless services for all illnesses covered
- Every pre-existing condition will be covered
- Coverage will be provided for the unorganised sector worker and his family (a unit of five).
- On a family floater basis, the total sum insured would be Rs. 30,000 per family annually.
- hospitalisation costs, treating the majority of common illnesses with the fewest possible exclusions
- Actual transportation expenses, up to a maximum of Rs. 100 per visit, is allowed within a Rs. 1000 overall cap.
Eligibility Criteria
- The person must be employed in the unorganised sector and be a member of a BPL household. The program is also open to those who are registered with welfare boards.
- The RSBY scheme has no upper application limit. It is appropriate for every family member, regardless of age.
- Because this scheme is accessible to everyone who qualifies to purchase it, it can help almost one-third of our population.
How is the Selection of the Health Insurance Provider Done?
The state governments choose a public or private insurance provider with an IRDA licence to offer health insurance in India through a competitive public bidding process. The state’s or the group of districts’ health insurers is then determined by selecting the insurance provider that made the lowest financial offer. The annual premium for each registered household is represented by this financial bid.
The health insurance provider must accept the coverage benefit determined by the Indian government through the use of smart cards to facilitate cashless hospitalisation. In a given district, only one insurance company may operate. Nonetheless, a state may allow more than one insurer to operate there.
Smart Card
A smart card can be used for many different things, such as patient information and beneficiary identification using their photo and fingerprints. The ability to conduct cashless transactions at the hospital under contract and to transport benefits across the nation is the smart card’s primary feature. The beneficiary will receive the verified smart card right there at the enrollment station. If biometric data is not successful, the family head’s picture on the smart card can be used for identification.
How is the BPL Data Prepared?
RSBY obtains data from the Union Planning Commission for every state. Every district’s enrolled BPL households are covered by insurance through RSBY. The State Government is required by the Government of India to prepare and submit the BPL data in a particular electronic format.
It contains every detail about the family members, including their names, ages, information about the head of the household, and their relationship to him or her. For the plan to be implemented in the district, the BPL data must be prepared in the required format.
Ministry to Implement RSBY Scheme from April 1, 2015
The Ministry of Health and Family Welfare will carry out the Labour and Employment Ministry’s Rashtriya Swasthya Bima Yojana (RSBY). With effect from April 1, 2015, the Labour and Employment Ministry is transferring the RSBY program to the Ministry of Health and Family Welfare by a recent policy decision made by the government.
Launched for workers in the unorganised sector in the fiscal year 2007–08, the RSBY is a health insurance program for families living below the poverty line. It became fully operational on April 1, 2008. It offers cashless health insurance that is enabled by IT and based on smart cards. It also covers maternity benefit coverage up to Rs. 30,000 annually on a family floater basis for BPL families, which consists of five members, and 11 occupational groups in the unorganised sector. With effect from December 31, 2008, the “Unorganized Workers Social Security Act, 2008” included ten social security programs, including the RSBY, that catered to unorganised workers.
Conclusion
Rashtriya Swasthya Bima Yojana (RSBY) offers vital healthcare coverage to millions of impoverished families in India, acting as a ray of hope for them. Since its founding in 2008, RSBY has played a significant role in providing cashless services, covering pre-existing conditions, and guaranteeing that individuals living below the poverty line have access to high-quality healthcare.