Rashtriya Swasthya Bima Yojana (RSBY)- The Scheme

Rashtriya Swasthya Bima Yojana (RSBY) is a government- run health insurance scheme for the BPL family under the Ministry of Health and Family Welfare, Government of India. It provides cashless insurance for hospitalization in public as well as selected private hospitals. The objective of RSBY is to provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalization.

Objectives:

• To recognise the diversity with regard to public health infrastructure, their socio -economic conditions and the administrative network.
• The health insurance scheme aims to facilitate launching of health insurance projects in all the districts of the States in a phased manner for BPL workers.

Eligibility:

• Every Below Poverty line (BPL) subjects and their family members (a family unit of five) holding a yellow ration card
• The beneficiary has to pay Rs. 30 per annum as registration/renewal fee to get biometric-enabled smart card for identifying their eligibility.
• All pre-existing illnesses are also covered from day one.

Benefits:

The beneficiary shall be eligible for such in – patient health care insurance benefits as would be designed by the respective State Governments based on the requirement of the people/ geographical area. However, the State Governments are advised to incorporate at least the following minimum benefits in the package / scheme:

• The unroganised sector worker and his family (unit of five) will be covered.
• Total sum insured would be 30,000/- per family per annum on a family floater basis.
• Cashless attendance to all covered ailments.
• Hospitalization expenses, taking care of most common illnesses with as few exclusions as possible.
• All pre-existing diseases to be covered.
• Transportation costs (actual with maximum limit of 100 per visit) within an overall limit of Rs. 1000.

Funding Pattern:

• Contribution by Government of India: 75% of the estimated annual premium of Rs. 750, subject to a maximum of Rs. 565 per family per annum. The cost of smart card will be borne by the Central Government.
• Contribution by respective State Governments: 25% of the annual premium, as well as any additional premium.
• The beneficiary would pay Rs. 30 per annum as registration/renewal fee.
• The administrative and other related cost of administering the scheme would be borne by the respective State Governments

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