Rashtriya Swasthya Bima Yojana
Rashtriya Swasthya Bima Yojana, (राष्ट्रीय स्वास्थ्य बीमा योजना) : RSBY Complete Details, RSBY Benefits, Rashtriya Swasthya Bima Yojana Charges, RSBY Smart Card Use,Rashtriya Swasthya Bima Yojana
Rashtriya Swasthya Bima Yojana RSBY has been launched by the Ministry of Labor & Employment, Government of India to provide health insurance coverage to the Below Poverty Line (BPL) families. The objective of RSBY is to provide protection to BPL families from financial liabilities arising out of health shocks, which include hospitalization.
Workers in the unorganized sector constitute about 93 percent of the total workforce in the country. The government has implemented some social security measures for some occupational groups but their coverage is still very low. Most workers still have no social security coverage. A major vulnerability for workers in the unorganized sector is their frequent falling ill and the need for medical care and hospitalization of the said workers and their family members. Despite the expansion of health facilities, their disease remains one of the biggest causes of human deprivation in India.
It is clearly recognized that health insurance is a means of providing protection to poor families due to health risks, which lead to poverty due to high expenditure. Poor people are unwilling or unable to afford health insurance because of its cost or lack of desired benefits. Providing and implementing health insurance, especially in rural areas, is very difficult. Recognizing the need to provide social security to these workers, the Central Government has launched the Rashtriya Swasthya Bima Yojana (RSBY). As of 25 March 2013, the scheme has covered 34,285,737 smart cards and 5,097,128 hospitalizations.
Who is Eligible for RSBY?
- Unorganized sector workers who come under the BPL category and their family members (a family unit of five members) will get benefits under the scheme.
- It will be the responsibility of the implementing agencies to verify the eligibility of the unorganized sector workers and their family members, who are proposed to get the benefits under the scheme.
- Smart cards will be issued to the beneficiaries for the purpose of identification.
RSBY Benefits: राष्ट्रीय स्वास्थ्य बीमा योजना लाभ
- Workers in the unorganized sector and their families (a unit of five) will be included.
- The total sum insured per family per year on a family floater basis will be Rs.30,000/-.
- Cashless attendance for all covered illnesses.
- Certain exclusions are possible including hospitalization expenses and care for all common ailments.
- All pre-existing diseases should be included.
- 1000 with an overall limit of Rs.1000 plus transportation cost (actual subject to a maximum of Rs.100 per visit).
Rashtriya Swasthya Bima Yojana Charges
- Contribution by the Government of India: 75% of the estimated annual premium of Rs.750 subject to a maximum of Rs.565 per family per year. The cost of the smart card will be borne by the Central Government.
- Contribution by the respective State Governments: 25% of the annual premium plus any additional premium.
The beneficiary will be paid Rs.30 as an annual registration/renewal fee.
- The administrative and other related costs for implementing the scheme will be borne by the respective State Governments.
RSBY Smart Card Use
A list of hospitals (both public and private) will be provided at the time of enrollment (External website that opens in a new window). A helpline number will also be given along with the smart card. Hospitals, both public and private, will be empaneled by the insurance company based on the qualifying criteria. The beneficiary will have the option of visiting the hospital as per his/her wish.
The hospital will not have to pay anything for treatment up to Rs.30000/-.
In the case of cashless service, the patient will not have to spend any amount for treatment and hospitalization. It is the responsibility of the hospital to claim the same from the insurer.
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