Rashtriya Swasthya Bima Yojana is a health insurance programme launched for the economically weak people of the nation. This Central Government scheme is known for providing health insurance coverage to non-recognized sector workers. The workers who fall under the BPL line are treated eligible to avail of the benefits, and their family members are also considered beneficiaries under this scheme. Under the Rashtriya Swasthya Bima Yojana, the beneficiaries are offered Cashless Health Insurance for their hospitalization and treatment in both private as-well-as public hospitals.
Introduction of the Rashtriya Swasthya Bima Yojana
Entailing nearly about 93% of the total workforce in India, the workers in the unorganized sectors have been struggling continuously to face health issues and other health-related problems. The government has been executing social security measures for these occupational groups, but the coverage is quite minute. Many small-scale workers have been struggling without any health insurance coverage.
Intending to overcome this insecurity of the workers of unorganized sectors, the Rashtriya Swasthya Bima Yojana has been launched. The motive behind the launch of this scheme is to provide aid and protection to economically weak people or poor households living with reduced circumstances.
Aim of this Scheme
- The Rashtriya Swasthya Bima Yojana (RSBY) has been introduced with the aim of granting cashless health insurance coverage to the needy and indigent people of the weaker and unrecognized sectors of our country. But, due to the elevated prices of the health insurances and the treatments covered, the workers either fail or hold back to take the health insurances.
- Regulating and conducting health insurance in rural areas is also a big challenge and fails to generate and achieve a good success rate.
- Acknowledging the requirement and soaring need for providing health insurance coverage to these workers, Rashtriya Swasthya Bima Yojana (RSBY) has been brought into existence.
Rashtriya Swasthya Bima Yojana: Eligibility Criteria
To avail of the benefits of health insurance coverage provided under this yojana, given below is the eligibility criteria:-
- The workers belonging to the BPL and EWS category, along with their family members, are being considered beneficiaries under this scheme.
- The agencies providing cashless health insurance coverage to needy people will be held responsible for verifying the eligibility of the workers and their family members.
- Benefits under this scheme will be offered only to the people who will satisfy the eligibility criteria.
- All the beneficiaries of this scheme will be issued smart cards for their identification purpose.
Benefits Offered
The beneficiaries of this scheme will be eligible for the following:-
- Both the smart cardholders or the unrecognized sector workers and their families (5 family members) will be covered.
- The total sum of the health insurance coverage given will be ₹30,000. This amount will be given on an annual basis.
- Cashless treatments will be granted to all the beneficiaries.
- Hospitalization and other treatment charges will be taken care of by the Central government.
- All the pre-existing conditions of the patient will be addressed and covered free of cost
- The transportation charges will be covered with a maximum limit of – 100 patients per visit and 1000 patients for overall visits.
Below given infographic shows the benefits of this yojana:-
Funding under this Rashtriya Swasthya Bima Scheme
Given below is the funding pattern of the RSBY, which shows the contribution of both the Government of India as well as the State government:-
- Contribution by the Government of India: – Subjected to a maximum of ₹565 per family per annum, an estimated annual premium of 75% of ₹750 is being contributed. But, the cost of the smart cards will be taken care of by the Central government.
- Contribution by the State government: – Along with the additional premium plans, an annual premium of 25% is being contributed by the respective State governments. The expenses related to the administration and other related costs are also being taken care of by the state government.
Enrollment Process
Under the enrollment process of this scheme, the following steps are being followed:-
- An electronic list is prepared. This is a list that carries the details of all the eligible applicants belonging to the BPL and EWS households.
- Using a pre-specified data format, this list is handed over to the insurer of the policy.
- With the assistance of the district level officials, the enrollment schedule for each village is prepared. This schedule also carries the dates shared by the insurance company.
- Prior to the enrollment process, date announcement and the allocation of location, the BPL list is circulated and posted in each of the targeted villages at the enrollment station.
- This is achieved on the basis of the schedule list, and the targeted village areas are publicized in advance.
- In each of the targeted village, these enrollment stations are set up at the local centres like the public schools of the village.
- All of these stations are equipped with biometric machines, which help in collecting and maintaining the data record of all the patients through their fingerprints.
- Not only the biometric information (fingerprints) but also the photographs of all the members of a household are covered.
- These stations always have printers that are used to print the smart cards with the respective photographs.
- The beneficiaries associated with the Rashtriya Swasthya Bima Yojana are provided with the smart card, which carries all the demographic details, scheme details, list of eligible hospitals registered under this scheme.
- This smart card is handed over to the beneficiaries in less than 10 minutes.
- The concerned government official authenticates this smart card.
Role of Smart Card under this Scheme
The Smart card issued under this yojana is used for various activities like the following:-
- Verification of the beneficiary.
- Checking the demographic details of the candidate.
- Ensuring all the details of the insured and the insurer.
- The smart card is also used to enable cashless transactions at the hospitals, which fall under the panel of this yojana.
- This smart card is provided to the beneficiary at the enrollment station.
- Another important feature of the smart card is that in case the biometric identification fails, the photograph of the head of the family is considered as the identification proof.
Features of RSBY
The RSBY has the following features:-
- Empowerment of the Beneficiary– The RSBY grants aid to its active beneficiaries of the BPL or EWS household by giving them the authority of choosing between private and public hospitals.
- Paneled Hospitals– The hospitals under this scheme are provided with incentives to treat patients in a large number. Also, the public hospitals which are covered under this scheme are provided with incentives to grant medical treatment to the beneficiaries. Under this process, the money is disbursed directly to the concerned public hospitals.
Conclusion
Introduced by the Ministry of Labour & Employment[1], Rashtriya Swasthya Bima Yojana revolves around providing health insurance coverage to people belonging to the BPL and EWS category. This scheme focuses on to provide protection to the poor and needy people from their financial liabilities. Aatmnirbhar Sena being a supportive pillar for the government never steps back from creating awareness of the schemes formulated by the government. The vision of Aatmnirbhar Sena is to make the picture of our country progressive, and hence we work for the indigent people with all our resources.
