{"id":5880,"date":"2023-11-23T14:45:40","date_gmt":"2023-11-23T09:15:40","guid":{"rendered":"https:\/\/www.medfin.in\/blog\/?p=5880"},"modified":"2024-02-01T16:14:13","modified_gmt":"2024-02-01T10:44:13","slug":"all-about-rashtriya-swasthya-bima-yojana","status":"publish","type":"post","link":"https:\/\/www.medfin.in\/blog\/health\/government-schemes\/all-about-rashtriya-swasthya-bima-yojana\/","title":{"rendered":"All About Rashtriya Swasthya Bima Yojana"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">The Rashtriya Swasthya Bima Yojana (RSBY) is a health scheme that provides health insurance to those below the poverty line and workers serving the unorganized sectors. It offers a sum of Rs. 30,000 on a floater basis.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The scheme is an initiation of the Department of Labor and Employment, Government of India. Coverage extends to the individuals\u2019 families of up to five members.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">With the help of this scheme, those from society\u2019s economically weaker sections can avail of free medical facilities in the network hospitals.<\/span><\/p>\n<h2><b>Rashtriya Swasthya Bima Yojana: Features<\/b><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Guaranteed Treatment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">No age limit<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low premium (Rs. 30 registration fee)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Option to choose (from a list of network hospitals)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Incentives for all stakeholders<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Claim up to Rs. 30,000 for different healthcare expenses<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Technology and security-enabled (IT-enabled apps are used. Chips on the smart card support rigorous monitoring and evaluation. The cards also contain biometric data and are connected to local servers for speedy data sharing. A high-security system keeps tabs, does regular reporting and manages biometric data and transaction records.)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pre-existing disease coverage (an illness which the policyholder was not aware of at the time of policy purchase)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Family coverage (family head, spouse and three dependents)<\/span><\/li>\n<\/ul>\n<h2><b>What Does the Scheme Cover?<\/b><\/h2>\n<h3><b>Hospitalization expenses<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Such expenses related to an illness, a disease or an accident are also receivable by the policyholder\u2019s family members. Such medical expenses include bed charges, doctor\u2019s consultation fees, nursing and boarding charges, implants, surgeon\u2019s charges, blood, diagnostic tests charges, prosthetic devices, anesthetics, consultation fees, oxygen, OT (Operation Theatre) charges, food expenses and medicines.<\/span><\/p>\n<h3><b>Pre-Hospitalization Expenses<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">This includes expenses concerned with diagnosis and medicines.<\/span><\/p>\n<h3><b>Post-Hospitalization Expenses<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The scheme covers all medical expenses for up to 5 days of post-hospitalization in case of surgery or long-term treatment.<\/span><\/p>\n<h3><b>Transportation Expenses<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">While such expenses are receivable up to Rs. 100\/visit, a maximum of Rs. 1,000 can be claimed.<\/span><\/p>\n<h3><b>Dental Treatment<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The RSBY incurs the cost of dental treatment that\u2019s occurring due to an accident.<\/span><\/p>\n<h3><b>Daycare Treatment<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">For daycare treatment, the patient is hospitalized for less than 24 hours. Treatments covered include ear surgery, eye surgery, dental surgery required due to an accident, lithotripsy, hemodialysis surgery, etc.<\/span><\/p>\n<h3><b>Maternity Expenses<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Rs. 2,500 are receivable for normal delivery and Rs. 4,500 for caesarean delivery. The scheme also covers unintentional pregnancy termination which could be due to an accident or to save the mother\u2019s life.<\/span><\/p>\n<h3><b>Newborn Coverage<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">RSBY covers the healthcare expenses incurred on a newborn even when the number of beneficiaries has exceeded. This can be claimed until the end of the term of the policy. However, it is up to the policyholder to add the name of the newborn under the BSBY during renewal.<\/span><\/p>\n<h2><b>What is Not Covered Under RSBY?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Having known all that the RSBY scheme covers, let us come to what it does not cover:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hospitalization charges for treatments not mentioned in the policy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Expenses related to HIV\/AIDS treatment, change of gender, hormone replacement therapy and substance abuse (like excessive intake of alcohol\/drugs)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Congenital external disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dental treatments that are cosmetic or corrective in nature and expenses of a root canal or cavity filling<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Suicide, AYUSH and vaccination<\/span><\/li>\n<\/ul>\n<p><b>Rashtriya Swasthya Bima Yojana: Eligibility Criteria<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The applicant should be an Indian citizen<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Family members should be listed in the BPL list<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">S\/he should be registered under welfare boards<\/span><\/li>\n<\/ul>\n<h2><b>How to Apply for Rashtriya Swasthya Bima Yojana<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">An enrolment schedule will be issued at villages by the insurance company that has partnered with RSBY. The schedule will be available at all village-level government centres before the registration date. The eligible people willing to register for the scheme need to reach the enrolment centre as per the date and time.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">After registration, you\u2019re given an RSBY card in a plastic cover. The card contains your biometric details and RSBY customer care number.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The entire procedure takes ten minutes and happens in the presence of a government officer, a representative of the insurance company and a file officer.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Documents required during application include an Aadhaar card, ration card, BPL certificate, income certificate, address proof and a passport-size photograph.<\/span><\/p>\n<p><b>Checking RSBY Smart Card Status Online<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Visit<\/span> <span style=\"font-weight: 400;\">http:\/\/www.rsby.gov.in\/<\/span><span style=\"font-weight: 400;\">, go to \u2018Scheme Status\u2019 and select \u2018State Wise\u2019.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Select your state and enter your RSBY insurance number.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Finally, submit and check the status.<\/span><\/li>\n<\/ul>\n<p><b>Filing Claims Under RSBY<\/b><\/p>\n<p><span style=\"font-weight: 400;\">One can avail of the cashless treatment facilities by carrying the Smart Card to an RSBY empanelled\/network hospital. The officials of the hospital will send the necessary details to the insurance company. Post-verification, the claim will be settled between both the parties.<\/span><\/p>\n<p><b>A Few Points to Note<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The renewal fee per annum is Rs. 30.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any of the family members can give their biometric information for the Smart Card.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The enrolment forms can also be downloaded from the website of the state government.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Family members can be removed or added in the middle of a policy period only when there\u2019s been a birth or death of one of the beneficiaries in the family.<\/span><\/li>\n<\/ul>\n<p><b>Conclusion<\/b><\/p>\n<p><span style=\"font-weight: 400;\">The government had tried to provide health insurance to selected beneficiaries in the past but to no avail. RSBY was finally started while keeping in mind a design that avoids the pitfalls of the earlier schemes and provides a world-class model. This scheme started to roll from the 1<\/span><span style=\"font-weight: 400;\">st<\/span><span style=\"font-weight: 400;\"> of April, 2008.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Rashtriya Swasthya Bima Yojana (RSBY) is a health scheme that provides health insurance to those below the poverty line and workers serving the unorganized sectors. It offers a sum of Rs. 30,000 on a floater basis. The scheme is an initiation of the Department of Labor and Employment, Government of India. Coverage extends to [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":7181,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4127],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>All About Rashtriya Swasthya Bima Yojana - Medfin Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.medfin.in\/blog\/health\/government-schemes\/all-about-rashtriya-swasthya-bima-yojana\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"All About Rashtriya Swasthya Bima Yojana - Medfin Blog\" \/>\n<meta property=\"og:description\" content=\"The Rashtriya Swasthya Bima Yojana (RSBY) is a health scheme that provides health insurance to those below the poverty line and workers serving the unorganized sectors. 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