RASTRIYA SWASTHYA BIMA YOJANA
What is RSBY?
Ministry of Labour and Employment, Government of India has launched a health insurance scheme for BPL families which is called Rashtriya Swasthya Bima Yojana (RSBY).
Who is eligible?
The beneficiary is any Below Poverty Line (BPL) family, whose information is included in the district BPL list prepared by the State government. The eligible family needs to come to the enrollment station, and the identity of the household head needs to be confirmed by the authorized official.
What is the insurance coverage in RSBY?
Rashtriya Swasthya Bima Yojana provides cover for hospitalization expenses upto Rs. 30,000/- for a family of five on a floater basis. Transportation charges are also covered upto a maximum of Rs. 1,000/- with Rs. 100/- per visit.
What is premium for RSBY?
Government pays the premium for RSBY. Central Government pays 75% of the total premium (90% in case of Jammu & Kashmir and North east States) while State Government pays the remaining premium.
Will beneficiaries have to pay anything to get the policy?
Beneficiaries need to pay Rs. 30 per family at the time of enrollment.
What is the enrollment process?
An electronic list of eligible BPL households is provided to the insurer, using a pre-specified data format. An enrollment schedule for each village along with dates is prepared by the insurance company with the help of the district level officials. As per the schedule, the BPL list is posted in each village at enrollment station and prominent places prior to the enrollment and the date and location of the enrolment in the village is publicized in advance. Mobile enrollment stations are set up at local centers (e.g., public schools) in each village. These stations are equipped by the insurer with the hardware required to collect biometric information (fingerprints) and photographs of the members of the household covered and a printer to print smart cards with a photo. The smart card, along with an information pamphlet, describing the scheme and the list of hospitals, is provided on the spot once the beneficiary has paid the 30 rupee fee and the concerned Government Officer has authenticated the smart card. The process normally takes less than ten minutes. The cards shall be handed over in a plastic cover.
What is the purpose of smart card?
Smart card is used for a variety of activities like identification of the beneficiary through photograph and fingerprints, information regarding the patient. The most important function of the smart card is that it enables cashless transactions at the empanelled hospital and portability of benefits across the country.
When will the smart card be given to the beneficiary after the enrollment?
The authenticated smart card shall be handed over to the beneficiary at the enrollment station itself.
Why is there a photograph on smart card?
The photograph of the head of the family on the smart card can be used for identification purpose in case biometric information fails.
Why is the photograph of all family members taken when there is photograph of only head of household on the card?
Although on the card the head of the family photograph is printed, the photograph of all family members is stored in the chip so that in case of need it can be used for verification.