Sanil Basutkar
Author
The Rashtriya Swasthya Bima Yojana (RSBY) is a health insurance scheme that the Indian government provides to the unorganized sector workers. Around 2021-22, almost 43.00 crore workers from the unorganized sector have been found working without any protective health coverage. This report was published by the Ministry of Labour & Employment, highlighting the problematic situation of the unorganized sector.
Employment in this unorganized sector is mostly characterized by low or fluctuating income and poor job security. People living in this sector usually have little to no income, and many are also living below the poverty level. Because of this, most of the members of the unorganized sector cannot afford healthcare services that require hospitalization, or expensive medical diagnosis.
To mitigate this healthcare problem, the Government of India has launched the Rashtriya Swasthya Bima Yojana (RSBY) scheme. Now, over 3 crore Indians have subscribed to the RSBY scheme, which has gained massive popularity among the masses. This blog aims to explain the coverage details and benefits of the RSBY scheme in detail. It will also cover sections such as the registration process, and the eligibility to apply.
Rashtriya Swasthya Bima Yojana (RSBY) was launched on April 1, 2008, under the Ministry of Labour and Employment. The main objective behind the scheme is to offer insurance coverage to the below the poverty line families. Critical diagnosis and hospitalization expenses would be quite high for these people, which is why the RSBY scheme is so widely adopted in India.
This government policy offers hospitalization coverage up to ₹30,000 per family annually, on a family floater basis. This insurance scheme is a central scheme empaneled across multiple insurance companies and hospitals across India. The reason the scheme is famous is because of its cashless benefits and smart card access for the beneficiaries.
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The features of this scheme are a combination of both unique as well as highly impactful. Here are all of them:
The scheme offers a total health coverage of ₹30,000 to every family on a family floater basis. Families belonging to the unorganized sector are highly benefited by the coverage, as it helps them to cover their pre- and post-hospitalization expenses.
During the registration, the beneficiaries pay a nominal fee of ₹30, while the remaining premium is borne by the central and state governments. To be noted, the Central government bears 75% of the premium, while the remaining 25%is borne by the State government.
The smart card is another astonishing feature of the Rashtriya Swasthya Bima Yojana. This card is biometric-enabled, hence has a high degree of encryption. Moreover, the card uses fingerprint and other biometric details of the patient to verify identity, hence no one can bypass it.
The beneficiary can choose between public and private hospitals easily with the card, which makes it a highly convenient option. Also, the smart card can be easily carried in a pocket, which ensures that migrant workers and their families get the complete benefit of the coverage.
A great feature of the scheme is that it allows any family to choose between public and private hospitals easily. This makes the scheme highly convenient also, as patients can easily switch to a hospital providing personalized healthcare.
RSBY provides the workers coverage for pre-existing diseases from the day one day of enrollment. The beneficiaries do not have to pay any extra costs for pre-existing diseases coverage, which is a great option for most people.
For both public and private hospitals that are empaneled with the scheme, the beneficiary can avail of cashless treatment. Migrant workers, especially, are highly aided because of this as they do not always carry cash while migrating to various states for workers, and a smart card helps them much.
Also know more about Pradhan Mantri Fasal Bima Yojana.
Almost 3 crore workers have been helped by Rashtriya Swasthya Bima Yojana. The scheme has been benefiting workers since 2014, where the wide range impacts of the scheme have not only stabilized the economic condition of the nation, but also has benefited numerous labourers to avail quality healthcare. Here are some key benefits:
Recovering from these medical emergencies is financially challenging for the unorganized workforce. This government health insurance scheme lowers this burden by covering major expenses such as inpatient care, major surgeries, and diagnosis expenses.
BPL families, domestic workers, street vendors, and any gig sector workers are quite vulnerable without any health insurance. These workers are regularly met with medical emergencies and, hence, are covered with RSBY insurance.
Laborers who may incur a lot of transportation expenses while visiting the city because of treatment factors are helped by this scheme to a great extent. High transportation cost is also another factor that earlier prevented the migrant workers from visiting quality healthcare in cities, which is now eased by the scheme.
The Rashtriya Swasthya Bima Yojana offers a family floater policy type for all the members, hence covering all the family members including spouses and children.
One of the greatest benefits of the scheme is that it offers cashless hospitalization during medical emergencies. This means that anyone who is stuck in a health emergency is immediately helped with emergency admission to the hospital by just swiping the smart card.
Read also the benefits and steps to apply for Ayushman Bharat Card
There are also specific cases that the scheme does not cover. Here are these:
The following criteria must be met for RSBY enrollment:
Here’s a step-by-step process:
The insurance provider will publish an electronic list of all the eligible households for the scheme. This list will also be published by your nearest gram panchayat or zilla panchayat for public access.
The eligible households can check their names by visiting a cyber cafe. They can also check their names by directly visiting their nearest gram panchayat. If they are eligible, they will have to check the date of enrollment. This will be provided to the village council directly by the insurance provider.
Every village will have a specific schedule for enrollment in the scheme. These enrollment centers are usually held in government schools or temporary camps. Beneficiaries can visit the enrollment camp with their BPL certificates and identity proof.
On collecting the biometrics details, the presiding officer will be issuing a smart card on-spot or within a few days.
If you want to do Rashtriya Swasthya Bima Yojana name check online, always check for the following details.
First, visit any empaneled hospital nearest to you in case of any medical emergency
Verify your identity with the smart card by producing the card at the hospital counter. The impaneled hospital will be verifying your biometric details along with your family members
Once verified, the hospital proceeds with treatment up to the coverage limit. All the costs will be reimbursed along with the coverage details
After varying the same card and appropriating the expenses, the hospital shares the claim online with the insurance company. The insurance-providing company then proceeds to process the claim benefits
Claims are processed and settled digitally within a few days. In case of any post-hospitalization expenses, it may take a few additional days for the claims to get settled.
You must also do a Rashtriya Swasthya Bima Yojana card check online in case your insurance claim settlement is delayed to know if your card has expired. In case of expiry, the insurance company needs to be notified immediately for a renewal. The process is cashless, which makes it highly convenient and secure.
Access to quality healthcare is still a constraint in India for millions of people from the unorganized sector. The lack of financial resources and health security pushes most people into a debt trap, and hence poverty. The Rashtriya Swasthya Bima Yojana still stands out as one of India’s most impactful health insurance schemes to support the economically weaker sections of our society. The insurance scheme has been a boon for most people from the disorganized sector, protecting them from all health vulnerabilities during medical emergencies.
There are multiple benefits of the Rashtriya Swasthya Bima Yojana that offer multiple benefits such as cashless hospitalization, coverage for 5 family members,. Few other benefits are offering maternity benefits, providing coverage for pre-existing diseases and so on.
It costs only ₹30 for one-time registration for making a smart card under the RSBY scheme. You can check your Rashtriya Swasthya Bima Yojana card details online even by just registering for this nominal fee during registration.
You will get coverage till 65 or 70 years with health insurance. However, the actual coverage term will depend on the state-level instructions also.
You can make the smart card by visiting the nearest enrollment center during the time of announcement. Usually, an announcement of the smart card in the enrollment center is made for smart card issuance.
There are a few health insurance policies that the government has rolled out, of which the Rashtriya Swasthya Bima Yojana (RSBY) is a famous policy. For all workers belonging to the disorganized sector at the BPL level, the RSBY scheme is a great opportunity as it covers most diseases at a minimal cost.
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