Rashtriya Swasthya Bima Yojana (RSBY)

Rashtriya Swasthya Bima Yojana means "National Health Insurance". Rashtriya Swasthya Bima Yojana is a government health insurance coverage programme for the unrecognized sector workers and those in the Below Poverty Line (BPL) category of families. The aim of the scheme is to provide financial protection against catastrophic health costs and to ensure quality health care to the below poverty line households and people of unorganized sectors. Rashtriya Swasthya Bima Yojana (RSBY) scheme was inaugurated by the Ministry of Labour and Employment on April 1, 2008, and implemented in 25 states around India. It was later transferred to Ministry of Health and Family welfare on April 1, 2015. In this article, we look at the various aspects of the Rashtriya Swasthya Bima Yojana (RSBY) scheme in detail.

Below Poverty Line (BPL)

The government of India uses various parameters to assess and identify the individuals and households in need of government assistance and aid - through an economic benchmark. That assessment is called as Below Poverty Line. Under Rashtriya Swasthya Bima Yojana scheme, health insurance is provided for up to 5 members of a family who are under the Below Poverty Line or in the unorganised sector.

Unorganized Sector Employees

In the beginning, the Rashtriya Swasthya Bima Yojana scheme targeted only those under Below Poverty Line. The scheme was then extended to unorganized workers like:

Welfare Boards' registered building and other construction
Street Vendors
Authorised Railway Porters
Workers of MNREGA for the 15 days in the period of the financial year.
Domestic Workers
Beedi workers
Sanitation worker
Rickshaw riders
Auto/ Taxi Driver
Mine workers

Features of RSBY scheme

The government of India introduced many health insurance schemes to the below income workers, but Rashtriya Swasthya Bima Yojana has differed in various ways as under:

The cost of the insurance scheme is shared by both the Central Government @ 75% and State Government @ 25% on the insurance scheme.
It enables the BPL households to choose between public and private hospitals.
For each household enrollment, the insurer will be paid the premium payment.
Hospital gets an incentive for treating a large number of beneficiaries, even public hospitals will have the incentives under RSBY.
NGOs and MFIs will be paid for assisting services to the BPL households.
RS. 750 is the payment for the family per year to provide access to quality healthcare in any hospitals.
Using the IT applications every beneficiary is issued a biometric-enabled smart card with their photographs and fingerprints.
Biometric enabled smart card allows only the real beneficiaries and make this scheme safe and foolproof.
Using this smart card the beneficiaries can use this in any other RSBY empanelled hospital across India.

Enrollment Process

Eligible BPL household's details will be given to insurer through the government's BPL enrollment list in the format of electronic list.
District level officials and the insurance company will prepare the enrollment schedule and dates for each village.
Eligible BPL household's list will be posted in each village at the enrollment station and prominent places with the date and the exact enrollment location.
Mobile enrollment stations will be installed at local places such as public schools in each village.
This stations will be equipped with the hardware and printer for printing smart cards and for collecting biometric information such as fingerprints and photographs of the members.
The smart card, an information pamphlet, and the list of hospitals name, scheme description will be given once the payment of Rs.30 has been paid by the beneficiary.
After the concerned government officer's authentication, the cards will be handed over to the beneficiaries within ten minutes in a plastic cover.

Enrollment Period

The smart card will be issued during the month of April and the scheme will commence from 1st of May of each year. The policy would be valid for one year till 30th of April of the next year from date of issue. Hence, if the card issued in the month of May, June, July then the scheme will start immediately from the next day and would be valid till the 30th April of next year.

Renewal of Policy

If a policy is getting over on 30th April and the new card can be renewed in the month of Apri, then the new policy will start from the 1st May and would be valid until 30th April of next year. However, if the card issued in the month of May, June, and July, then the insurance scheme will start immediately from the next day and the policy validity till 30th April of next year.

Company Registration

OPC Registration