Rashtriya Swasthya Bima Yojana:- Rashtriya Swasthya Bima Yojana has been launched by the Central Government to provide social security to the poor citizens of the country. Poor people who are working people in unorganized sectors are covered under the National Health Insurance Scheme. To provide them medical protection, health insurance of Rs. 30000 will be provided by the central government (Health insurance provided by the central government to provide medical protection to them).
With the help of National Health Insurance Scheme, the government will pave the way to provide cashless treatment to the poor citizens of the country in case of hospitalization. Rashtriya Swasthya Bima Yojana (RSBY) is a government-sponsored health insurance scheme in India that aims to provide affordable healthcare to individuals living below the poverty line. Under this scheme, eligible families are provided with a smart card that can be used to avail cashless medical treatment at empanelled hospitals and healthcare providers.
Rashtriya Swasthya Bima Yojana
The scheme covers hospitalization expenses, including surgeries, pre- and post-hospitalization expenses, and transportation costs. With a focus on inclusivity and accessibility, RSBY has been successful in providing financial protection and reducing the burden of healthcare expenses for millions of vulnerable individuals across the country. This initiative has played a crucial role in improving the overall health outcomes and well-being of marginalized communities in India.
Unorganized sector workers and their families (units of five) will be covered under this scheme. A major insecurity for workers in the unorganized sector is their frequent falling ill and the need for medical care and hospitalization of the workers and their family members. Despite expansion in health facilities, their diseases remain one of the biggest causes of human deprivation in India. Under the National Health Insurance Scheme, free medical care will be provided to the people of the country in the form of health insurance. RSBY was launched by the Ministry of Labor and Employment, Government of India to provide health insurance coverage to families living below poverty line (BPL). Has been.
Rashtriya Swasthya Bima Yojana Overview
|योजना का नाम
|राष्ट्रीय स्वास्थ्य बीमा योजना
|इनके द्वारा शुरू किया गया
|केंद्र सरकार द्वारा
|देश के गरीब लोग
What is Rashtriya Swasthya Bima Yojana?
Its full name is Rashtriya Swasthya Bima Yojana. This government-sponsored programme was created specifically with the BPL segment of society in mind. The corresponding state government contributes a little amount to the initiative, which is mostly funded by the Indian government (75%). The Indian government pays 90% of the premium for the northeastern states and Jammu & Kashmir, while the corresponding state governments contribute 10%.
The scheme’s administrative costs would be covered by the low registration fee that recipients must pay of Rs. 30.
Given below are the eligibility criteria for Rashtriya Bima Yojana:
- The program’s beneficiaries would include unauthorized workers who fall under the BPL category and their families, up to a maximum of five people.
It should be noted that in order for the unorganised sector workers and their families to be considered for coverage under the policy, the implementing agencies will need to confirm their eligibility. The beneficiaries will receive smart cards for identification purposes.
Click here:- Haryana BPL Ration Card List Status
Features of Rashtriya Swasthya Bima Yojana
Benefits of the Rashtriya Swasthya Bima Yojana include health insurance. The following are the aspects of the policy that you need to be aware of:
1. Easy Access to Healthcare Facilities
The Rashtriya Swasthya Bima Yojana is specifically intended for Indians who are classified as being below the poverty line. The policy helps by mostly removing such circumstances, as they typically do not receive the necessary care in the event of unintentional injuries or treatments.
2. Affordable Premium
Rashtriya Swasthya Bima Yojana has an extremely low premium. By paying a registration fee of Rs. 30, anyone who satisfies the qualifying requirements can get the benefits of the policy. The remaining sum of Rs. 750 is paid jointly by the federal government and the corresponding state governments.
3. No Limit on Maximum Entry Age
Rashtriya Swasthya Bima Yojana has no upper age restriction for applications, in contrast to standard health insurance schemes. This implies that a person who qualifies can sign up for the coverage at any age.
4. Option to Choose
The necessary medical care can be obtained by RSBY policyholders at any hospital that has been approved. Getting treatment in a public hospital is not required.
5. Technology and Security Enabled
Because the RSBY health insurance programme makes use of chips on smart cards and IT-enabled apps, it employs rigorous monitoring and assessment. Because the cards are locally connected to the servers, they guarantee fast data interchange and contain the biometric information of the policyholders. Having a high-security system makes it simple to monitor and report often.
6. Beneficial For All Stakeholders
The way that RSBY is structured, not only does it help the recipient and their family, but it also benefits the stakeholders. All parties involved, including MFIs and NGOs, are given incentives.
Check also:- Haryana BPL Ration Card List Status
Inclusions Under Rashtriya Swasthya Bima Yojana
Rashtriya Swasthya Bima Yojana covers the insured for the following healthcare expenses:
1. Hospitalisation Expenses
The RSBY provides coverage for hospitalization costs incurred during the course of treating an illness, disease, sickness, or accident. The following hospitalisation costs will be reimbursed by the health insurance provider, provided that the patient is admitted to a hospital or nursing home by a licenced doctor, medical professional, or specialist:
- Nursing and boarding expenses
- Bed expenses for the general ward
- Doctor’s consultation
- Consultation fee
- Surgeon’s expenses
- OT expenses
- Expenses related to the use of surgical appliances
- Prosthetic devices
- X-ray and diagnostic test
- Expenses related to food for the patient
2. Pre-Hospitalisation Expenses
For a maximum of one day, the policy reimburses the insured for costs incurred prior to hospitalization.
3. Post Hospitalisation Expenses
The policy covers the insured for expenses incurred after hospitalisation, on the treatment for which the patient was admitted to the hospital. This benefit is offered for up to 5 days after hospitalisation.
4. Transportation Expenses
Up to Rs. 100 in transportation costs are covered under the coverage for each visit. The maximum amount that may be claimed annually is Rs. 1,000.
5. Expenses Arising Due to Dental Treatment
The policy covers the insured for dental treatment arising due to an accident.
6. Daycare Treatments
Treatments for daycare centres are ones that don’t need to be hospitalized for more than 24 hours. The following are some creche services that are covered by RSBY:
- Ear surgery
- Dental surgery required due to an accident
- Eye surgery
- Genital surgery
- Contracture release of a tissue
- Gastrointestinal surgeries
- Hydro surgery
- Haemo-dialysis surgery
- Throat surgery
7. Expenses Related to Maternity
When it comes to costs associated with births, whether caesarean and natural, the insured is covered by RSBY. For a vaginal birth, Rs. 2,500 is covered, and for a caesarean delivery, Rs. 4,500. Pregnancy-related issues are also discussed.
It should be noted that the policy also pays for costs incurred by the insured in the event of an accident, an involuntary termination of pregnancy, or a scenario when rescuing the mother is required.
8. Newborn Coverage
Until the policy’s duration, the insurance will pay for newborn-related expenditures even if the number of beneficiaries has surpassed. At the time of renewal, it is the policyholder’s decision whether or not to include the infant in the policy.
Read also:- Ayushman Card List : करोड़ो लोगो को मुफ्त इलाज
Exclusions Under Rashtriya Swasthya Bima Yojana
Rashtriya Swasthya Bima Yojana does not cover the insured for the following healthcare expenses:
- Expenses related to HIV/AIDS treatment
- Any hospitalization claim that is not permitted under the policy will not be granted.
- The costs associated with hormone replacement treatment
- Corrective or cosmetic dentistry procedures are not covered.
- costs associated with treating illnesses brought on by heavy drinking, drug usage, etc.
- External congenital illness
- Costs associated with vitamins or tonics unless prescribed by a licenced healthcare professional as part of a treatment plan
- Gender-specific treatment changes
- aided conception and fertility
Rashtriya Swasthya Bima Yojana Enrollment Process
The first step in the RSBY enrollment procedure is to give the insurance firms authorized to administer this programme the electronic list of BPL homes who qualify, in a pre-specified data format. The insurance firms create an enrollment calendar for each town with assistance from district authorities.
According to the plan, the BPL list is displayed at the registration station in each hamlet, and the time and place of enrollment are announced beforehand. There are mobile enrollment terminals placed in strategic locations, such public schools. The insurance business outfits the stations with gear that facilitates the collection of biometric data and family photos. They also have a printer that can print photos on smart cards.
After paying a registration fee of Rs. 30, the recipients receive a smart card along with an information leaflet including all the details regarding the system, including a list of network hospitals. There is a plastic cover for the cards. The procedure is easy to follow and doesn’t take long. The entire procedure will be finished in only ten minutes.
See also:- Bihar Antarjatiya Vivah Yojana All Details
RSBY Card Details (Swasthya Bima Card)
The Wasthya Bima Card, also known as the RSBY Card, is crucial because it enables cashless purchases at network hospitals. The insured can also benefit from mobility within India by downloading an RSBY card or using a smart card. A smart card can also be utilised for other purposes, such as patient data and beneficiary identification using images, fingerprints, and other features. In the event that the biometric data is not successful, the RSBY card’s photo can alternatively be utilised for identification. At the enrolling station, the recipient will get the smart card.
Steps for RSBY Card & Check Online
The steps to check the Rashtriya Swasthya Bima Yojana Smart Card status online are as follows:
Step 1: First, visit the RSBY website and choose “Scheme Status.”
Step 2: Then, pick your state from the list under “Scheme Status.”
Step 3: Click on “Track your State” and choose your state.
Step 4: After doing that, the status of yo
Rashtriya Swasthya Bima Yojana Claim Process
The beneficiary must submit an electronic report to the insurance provider or the Third Party Administrator (TPA) upon receipt of the necessary treatment. After reviewing the record information, the insurance company or TPA pays the hospital when the predetermined deadline is reached in agreement with both the hospital and the insurance company.
Rashtriya Swasthya Bima Yojana (RSBY) is a government-run health insurance scheme in India that aims to provide financial protection to families living below the poverty line. Under this scheme, eligible beneficiaries are provided with a smart card that can be used to access cashless treatment at empanelled hospitals and healthcare facilities. The scheme covers hospitalization expenses up to a specified limit, including pre-existing conditions and maternity benefits. RSBY has been successful in improving access to quality healthcare for millions of vulnerable individuals and families, ensuring that they receive the necessary medical care without facing financial hardship.
Rashtriya Swasthya Bima Yojana FAQ’S
राष्ट्रीय स्वास्थ्य बीमा योजना कार्ड क्या है?
इस योजना के तहत कवरेज में बीमारियों के लिए कैशलेस इलाज उपलब्ध करवाया जाता है, और इस कैशलेस इलाज में पहले से मौजूद रोग का इलाज करना भी शामिल है। इसके अतिरिक्त राष्ट्रीय स्वास्थ्य बीमा योजना के लाभ(rashtriya swasthya bima yojana benefits) में १००० रुपए की सीमा के साथ परिवहन लागत भी शामिल है।
स्वास्थ्य बीमा योजना कब शुरू हुई?
इसे 1 अप्रैल 2008 से आरंभ किया गया है। आरएसबीवाय श्रम एवं रोजगार मंत्रालय, भारत सरकार द्वारा गरीबी रेखा से नीचे (बीपीएल) रहने वाले परिवारों को स्वास्थ्य बीमा कवरेज प्रदान करने हेतु आरंभ की गई है।
आयुष्मान भारत स्वास्थ्य बीमा के लिए कौन पात्र है?
एक व्यक्ति जो कर्नाटक का निवासी है और राष्ट्रीय खाद्य सुरक्षा अधिनियम 2013 द्वारा निर्दिष्ट 'योग्य परिवार' से संबंधित है, वह आयुष्मान भारत कर्नाटक आरोग्य के तहत लाभ के लिए पात्र है।
भारत में स्वास्थ्य बीमा किसने शुरू किया?
मील का पत्थर . जनरल इंश्योरेंस कॉर्पोरेशन ने स्वास्थ्य बीमा के तहत नियमों और शर्तों को मानकीकृत करने के लिए 1986 में भारत की पहली मेडिक्लेम पॉलिसी लॉन्च की। यह स्वैच्छिक स्वास्थ्य बीमा योजना गर्भावस्था, पूर्व-मौजूदा बीमारियों, एचआईवी-एड्स, प्रसव आदि जैसे बहिष्करणों के साथ अस्पताल में भर्ती लागत की क्षतिपूर्ति करती है।