The Rashtriya Swasthya Bima Yojana was launched on 1st April, 2008 by the Ministry of Labour and Employment which is a ministry under the Government of India.
The Rashtriya Swasthya Bima Yojana scheme provides health insurance coverage to families Below Poverty Line (BPL) categories. It also includes labourers and workers in the unorganised sector which constitute about 93% of the total workforce of India. The scheme pays for the medical expenses incurred by the covered members so that they can avail quality healthcare easily without having to spend huge amounts of money on illnesses and injuries.
Rashtriya Swasthya Bima Yojana covers the following categories of individuals –
Examples of workers who are eligible to be covered under the scheme include the following –
The Rashtriya Swasthya Bima Yojana covers the following types of healthcare expenses –
Since Rashtriya Swasthya Bima Yojana is a Government sponsored health insurance scheme, the Government of India bears 70% of the cost of the scheme and the remaining 30% is borne by the State Government. In case of North-eastern States and Jammu and Kashmir, the Government of India bears 90% of the cost and the State Governments bear 10%. The beneficiaries who are covered by the scheme have to pay only INR 30 for registering under the scheme and this amount is used to cover the administrative expenses incurred in implementing the scheme.
The following is the step-by-step guide to how the Rashtriya Swasthya Bima Yojana scheme works –
The Rashtriya Swasthya Bima Yojana has various salient features which are as follows –
A claim under the Rashtriya Swasthya Bima Yojana happens when the beneficiary avails treatment at an empanelled hospital. To make a successful claim, the beneficiary should follow the following steps –
The Rashtriya Swasthya Bima Yojana was launched in April 2008 and has been implemented in various phases so far. Here are the milestones in implementation of the scheme –
Grievances relating to the Rashtriya Swasthya Bima Yojana (RSBY) scheme can be longed online using Central Complaint and Grievance Redressal System (CGRS) portal. All the stake holders can file an online complaint about the RSBY Scheme. An Online facility to track the complaint real-time is also available.
The NDA Government has expressed its intention of increasing the coverage available under the scheme. The coverage might increase from the existing INR 30,000 per family to INR 1 lakh. Moreover, the Central Government also aims to make the scheme more widespread in India so that the maximum eligible population can be covered under the benefits provided by the Rashtriya Swasthya Bima Yojana.
A smart card is a card which lets beneficiaries avail cashless treatment at empanelled hospitals. The card contains the biometric details of the beneficiary which enables hospitals to verify the identity of the insured member and provide cashless treatments.
The smart card carries the photograph of the head of the family. The photos of other family members are contained in the chip of the card which can be identified when the card is swiped upon hospitalisation.
The premium for Rashtriya Swasthya Bima Yojana is paid by the Central and the State Governments in the ratio of 75%:25%. In case of north eastern states and Jammu and Kashmir, the ratio changes to 90%:10%.
The beneficiary pays INR 30 for registering himself/herself under the scheme.
The fee is payable both at the time of enrolling into the scheme as well as annually every time the scheme is up for renewal.
If there are more than five family members, besides the head of the family and the spouse, the dependent children who would be covered under the under the Rashtriya Swasthya Bima Yojana scheme will have to be selected by the head of the household. Because, the Rashtriya Swasthya Bima Yojana scheme would cover only a maximum of 5 members.
The smart card is portable and accepted at all empanelled hospitals across India. Even if the beneficiary is travelling to a different district the smart card can be used at a hospital in that district without any limitations even when the beneficiary is not registered in that district.
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