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RSBY full form is Rashtriya Swasthya Bima Yojana and it was initiated in the year 2008 by the Ministry of Labor and Employment. The scheme was aimed at offering best health facilities as well as social security to people or families living under the line of poverty. The government initiated the scheme to limit the medical expenditure done out-of-the-pocket by the families living under the poverty line as well as to enhance awareness and access to health facilities.
The insured sum available as family floaters under RSBY swasthya bima is Rupees 30,000, which allow coverage for 5 family members of a BPL family. Along with treatment charges, the scheme also allows 100 rupees transportation charges for single trip to the network hospital. Once a BPL family enrolls, they can start getting treatment starting from the following month from the date of enrollment.
Under the Rashtriya Swasthya Bima Yojana Scheme, the members of BPL families and unspecified sector workers’ can choose to get health care facilities either from government hospitals or from a private hospital.
So, this scheme allows the insured to get good access to treatment in good hospitals. This is because the scheme allows significant revenue to healthcare providers or hospitals.
Below are the criteria of eligibility to avail health benefits under Rashtriya Swasthya Bima Yojana Scheme:
Below are the steps to claim Swasthya Bima Yojana:
When an individual under BPL household receives the policy, a smart RSBY card is offered to them, which is used by the insured to avail treatment at any network hospital across India registered under the scheme. All network hospitals under this scheme allow cashless hospitalization and treatment to the beneficiary on getting RSBY card check online.
Also Read: Government Health Insurance Plans and Schemes for Senior Citizens
Since RSBY is a central government sponsored initiative, especially crafted for the BPL families in the country, so 75% of finances are offered by the central government, while the remaining 25% is offered by the state government of the respective states that the insured belongs to.
However, in case of J&K and the North-eastern states, the central govt. contribution is 90%, while only 10% is contributed by the state govt. The insured families are only required to pay Rs. 20 as registration fee, which is used by the government as administrative cost incurred under the Yojana.
It is done through a process of public bidding initiated by state governments. Through this bidding, the government selects IRDA approved insurance providers (both public and private). The bid act as the annual premium to cover BPL families under the scheme.
The Government of India sets coverage benefits for BPL families through cashless treatment at network hospitals by availing smart cards. The insurer has to agree to the cover and benefits fixed by the government. One district has a single insurer who works through the district, while a state can have more than one insurance company.
The government selects the health insurance provider based on the bidding process as mentioned above. Once the selection of the insurer is done, the selection of the network hospitals is also done because all or most of the network hospitals of the insurer come under the RSBY scheme as agreed by the government and the insurer. It is the responsibility of the health insurance company to allow enough government and private network hospitals to Rashtriya Swasthya Bima Yojana hospital list 2022, so that more benefits can be availed by the insured.
All the network hospitals enlisted under this scheme must have a committed RSBY desk with qualified officials. The insurer is also expected to offer a list of network hospitals under RSBY scheme while a BPL family registers for the scheme.
To utilize the services under RSBY, the insured should visit a RSBY help desk in a network hospital. Once the insured reaches the desk, his identity is verified with the help of a smart card via photograph, fingerprints, etc.
If the insured requires hospitalization, the help desk official checks the procedure for ensuring the amount with the price available from the insurer. At the time of the insured getting discharged from the hospital, his/her smart card gets swiped to deduct the cost of treatment from the card.
Now that you have got the Rashtriya Swasthya Bima Yojana name check, you know that RSBY is a suitable scheme that is aimed at helping BPL households. The compensation under RSBY covers transportation cost of Rupees 100 for the patient to reach home after getting discharged. The maximum limit of this cost is up to Rupees 1000/year that is available with a Rupees 30,000 sum insured. Further, there is no requirement of showing proof of availing transportation by the insured.
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