Access to healthcare remains a challenge for economically weaker sections in India for a long time. To manage this issue, the government of India has introduced various health insurance schemes. One such initiative was the Rashtriya Swasthya Bima Yojana (RSBY), launched to provide affordable healthcare to Below Poverty Line (BPL) families. RSBY enabled beneficiaries to receive cashless treatment at empanelled hospitals across India. However, the scheme has been replaced by Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (Ayushman Bharat-PMJAY), which now provides health insurance in India.
Let's explore how the scheme worked, its benefits and eligibility criteria.
What is Rashtriya Swasthya Bima Yojana?
Rashtriya Swasthya Bima Yojana (RSBI) is a National Health Insurance Scheme launched to help financially underprivileged families by providing financial support for healthcare.
Features of RSBY scheme
The RSBY scheme is different from other government-initiated programs. It is operated through insurance companies and state and central governments subsidise premiums. Here are some of the features of this policy:
- Each beneficiary family receives a biometric smart card called an RSBY card or Swasthya card that facilitates cashless transactions.
- Beneficiaries can choose between public and private hospitals enrolled under the RSBY scheme.
- A registered beneficiary can use the RSBY card in any RSBY-empanelled hospital nationwide.
What is covered under RSBY?
Rashtriya Swasthya Bima Yojana covers a wide range of healthcare expenses. The coverage under this scheme includes:
- Hospitalisation Expenses
- Pre- and Post-hospitalisation Costs
- Transportation
- Dental Treatments
- Daycare Treatments
- Maternity Benefits
- Newborn Coverage
What is not covered under RSBY?
The Rashtriya Swasthya Bima Yojana scheme covers many health expenses, but some exceptions exist. The RSBY benefits do not apply to elective, cosmetic or not medically necessary treatments. Additionally, illnesses caused by intoxication or fertility-related procedures are not covered under this scheme.
RSBY Scheme benefits
Here are some of the unique RSBY benefits:
- The beneficiary and their families can claim up to Rs. 30,000 for various expenses using the RSBY scheme
- Pre-existing diseases before the policy purchase are also covered
- All beneficiaries get cashless hospitalisation
How does Rashtriya Swasthya Bima Yojana health insurance scheme work?
BPL families identified by the government are eligible for Rashtriya Swasthya Bima Yojana registration and enrolled through mobile camps. The selected families submit their biometric data and receive a smart card for a nominal fee.
Although the 'Rashtriya Swasthya Bima Yojana apply online' facility is unavailable, the beneficiaries can check the official website to receive essential details like insurance coverage, eligibility criteria and more.
Eligibility of Rashtriya Swasthya Bima Yojana
To be eligible for the RSBY scheme, the applicant must be:
- Member of a welfare board who are under BPL
- Listed under below poverty line
- A worker in any unorganised sector
How to make a claim under Rashtriya Swasthya Bima Yojana?
A beneficiary can produce the smart card in any hospital listed under RSBY. Post-treatment, the hospital sends the beneficiary's details to the insurance company or Third Party Administrator (TPA). They verify the claim and process the payment directly to the hospital, ensuring a cashless experience for the beneficiary.
How to apply for RSBY scheme?
Eligible RSBY scheme participants can enroll through enrollment camps. Families can approach the camp authorities and provide essential proof, biometrics and photographs. There may be a minimal registration fee. Once all the documents pass verification, the smart card will be delivered. By entering their details, the beneficiaries can run the Rashtriya Swasthya Bima Yojana name check online at the RSBY website.
How RSBY is different from other government health insurance schemes?
A beneficiary can produce the smart card in any hospital listed under RSBY. Post-treatment, the hospital sends the beneficiary's details to the insurance company or Third Party Administrator (TPA). They verify the claim and process the payment directly to the hospital, ensuring a cashless experience for the beneficiary.
The RSBY differs from other government health insurance schemes in the following ways:
- A wide variety of medical expenses are covered, unlike other policies.
- Smartcard ensures cashless transactions that focus on legitimate beneficiaries.
- No paperwork is required in the whole process.
- The policy targets below-poverty-line (BPL) families and unorganised sector workers.
FAQ
- Is the 'Rashtriya Swasthya Bima Yojana online apply' facility available?
No, the RSBY card online apply facility is not available. Beneficiaries must visit enrollment centres to apply for RSBY. However, they can check the Rashtriya Swasthya Bima Yojana card status online from enrollment centres.
- How do you perform a Rashtriya Swasthya Bima Yojana validity check?
Visit the official RSBY website or the designated enrollment centre and provide your details to perform the Rashtriya Swasthya Bima Yojana card validity check.
- Is Rashtriya Swasthya Bima Yojana (RSBY) still available?
No, the RSBY scheme does not exist anymore. However, people can take advantage of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana, which continues the legacy of providing health coverage to BPL families in India.
Conclusion
The Rashtriya Swasthya Bima Yojana (RSBY) was a landmark initiative that provided essential health coverage to economically disadvantaged families in India. This health insurance policy made access to necessary medical care feasible for individuals under BPL. Registering for government-aided health insurance for family reduces financial strain on these participants while receiving quality medical care.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.