Rashtriya Swasthya Bima Yojana 2024, Objectives, Features, Eligibility & Benefits

Rashtriya Swasthya Bima Yojana 2024:- The expense of healthcare facilities is increasing dramatically in the modern day. It is challenging for even families who are fortunate enough to have a medical emergency to keep up with the rising expenses of care. Even though government hospitals run at the lowest possible cost, some impoverished families would not be able to afford medical care. This could be due to a variety of factors, including problems with transportation and infrastructure. The hospital of their choosing might not be able to provide the care they need. The purpose of the Rashtriya Swasthya Bima Yojana was to get over these obstacles. Its purpose is to assist people who are unable to cover the whole expense of an unexpected medical emergency.

Rashtriya Swasthya Bima Yojana 2024

The Indian government administers a national health insurance program called the RSBY scheme. The goal of this program is to give BPL individuals cashless insurance for hospital stays in both public and private facilities. Beginning on April 1, 2008, the Ministry of Labour and Employment oversaw the Rashtriya Swasthya Bima Yojana. On April 1, 2015, it was merged into the Ministry of Health and Family Welfare. As per the statistics from February 2014, the RSBY Scheme has enrolled 36 million families in total.

The Objective of the Rashtriya Swasthya Bima Yojana 2024

The following are the main goals of the Rashtriya Swasthya Bima Yojana:

• Protection from high medical costs: Over the past few decades, out-of-pocket medical costs have increased and health care has become the domain of the elite. The Government of India’s insurance program offers disadvantaged groups much-needed defense against costly medical care and treatments.
• Good Health Services for All: The Indian Constitution’s Directive Principles of State Policy (DPSP) underscore the government’s efforts to provide welfare services to different societal segments. The Constitution guarantees everyone access to high-quality healthcare. RSBY increases access to high-quality healthcare for a range of societal groups.

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Features

Among the key characteristics of RSBY are the following:

• Patients can receive cashless care at any hospital that is part of the program. To receive cashless benefits up to the insurance limit, all they have to do is present their RSBY smart card.
• Almost all paperwork is required to apply for the program or submit claims. For cashless care, recipients only need to present their RSBY smart card.
• The Central and State Governments jointly pay the ₹750 annual premium per family. Families only have to pay ₹30 to enlist or renew a member.
• There is no waiting period under the plan for pre-existing conditions. Beneficiaries are responsible for paying pre-existing condition charges starting on the first day of the coverage.
• Hospitals receive direct payment credit from insurance providers. It is done online to promote openness and expedite the resolution of disputes.
• Every enrolled household receives an RSBY smart card with a photo ID and details about every enrolled member. In hospitals, this card facilitates beneficiary identification.
• Under the scheme, insurance coverage of up to ₹30,000 is provided annually for each household. Babies are automatically protected.
• The program pays for things like coronary stents, dialysis, and cataract surgery. Additionally, it pays for lodging and nursing costs while a patient is in the hospital.

Benefits of Rashtriya Swasthya Bima Yojana 2024

The recipient will be qualified for the in-patient health insurance benefits that the corresponding State Governments would create according to the needs of the populace and the region. However, it is advised that the State Governments include these essential benefits in the package or plan:

• We will provide coverage for the unorganized sector worker and his family, which consists of five individuals. The annual total sum insured, based on a family floater, would be Rs. 30,000 for each family.
• Services that are cashless and for all covered illnesses
• Medical costs associated with hospital stays, treating the majority of common ailments with minimal exclusion
• Every single pre-existing condition needs to be taken care of.
• Within an overall cap of Rs. 1000, actual transportation costs (up to a maximum of Rs. 100 per visit) are covered.

Eligibility Criteria

• The program’s beneficiaries would be unorganized sector workers who fall under the BPL category and their families, up to a maximum of five family members.
• Verifying the eligibility of unorganized sector workers and their families who are recommended to receive benefits under the plan is the responsibility of the implementing agencies.
• Smart cards will be given to the beneficiaries so that they may be identified.

Exclusions

For those who fall under its coverage, the Rashtriya Swasthya Bima Yojana does not pay for the following medical expenses:

• Expenses related to HIV/AIDS treatment
• Hospitalization claims that violate the policy will not be approved.
• The costs associated with hormone replacement treatment
• Procedures related to cosmetic or corrective dentistry are not covered.
• costs associated with treating illnesses brought on by heavy drinking, drug usage, etc.
• external sickness that is congenital
• Costs associated with vitamins or tonics unless prescribed by a licensed healthcare professional as part of a treatment plan
• Gender-specific treatment changes
• aided conception and fertility

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How to Apply for Rashtriya Swasthya Bima Yojana

The first step in the RSBY enrollment process is to give the insurance companies authorized to administer this program the electronic list of BPL homes who qualify, in a pre-specified data format. The insurance firms develop an enrollment calendar for each village with assistance from district officials.

The idea is for each hamlet’s registration station to show the BPL list and provide advance notice about the enrollment time and location. Public schools and other strategic locations now have mobile enrollment terminals. The insurance business outfits the stations with hardware that facilitates the collection of biometric data and family photos. They also have a printer that can print photos on smart cards.

After paying a registration fee of Rs. 30, the recipients receive a smart card along with an information leaflet including all the details regarding the system, including a list of network hospitals. There is a plastic cover for the cards. The procedure is easy to follow and doesn’t take long. It will take only ten minutes to complete the full process.

RSBY – Smart Card

The RSBY Card, often called the Rashtriya Bima Card, is essential because it allows cashless transactions at network hospitals. Through the use of a smart card or RSBY card download, the insured can also benefit from portability throughout India. Other uses for a smart card include the storage of medical information and beneficiary identity through the use of photos, fingerprints, and other features. If the biometric data is not successful, identity can still be verified with the RSBY card photo. The beneficiary will pick up the smart card at the enrollment booth.

Claim Procedure for the National Health Insurance Scheme

The beneficiary must submit an electronic report to the insurance provider or the Third Party Administrator (TPA) following receipt of the necessary treatment. The insurance company or TPA, per the terms agreed upon by the hospital and the insurance company, pays the hospital after examining the record information.

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FAQ’s

Q.) What is RSBY?

Ans. A centrally sponsored insurance program known as the Rashtriya Swasthya Bima Yojana offers coverage to those who fall under the poverty line (BPL), or the most vulnerable segment of society.

Q.) What advantages do the Rashtriya Swasthya Bima Yojana Cards offer?

Ans. Treatment for diseases covered by this plan is cashless and covers the management of pre-existing conditions as well. The benefits of the Rashtriya Swasthya Bima Yojana also include reimbursement for transport expenses up to Rs 1000.

Q.) Where can I find the RSBY application?

Ans. The Rashtriya Swasthya Bima Yojana Application Form PDF is available for download on the website of your state government.

Q.) How can I obtain a card for national health insurance?

Ans. The beneficiary must pay Rs 30 to register for this scheme. These recipients will receive a smart card with an information brochure attached that lists the names of the hospitals covered by the insurance network. A Field Key Officer and a health insurance company official certify the enrollment’s legitimacy.

Q.) Who is eligible to apply for the Rashtriya Swasthya Bima Yojana?

Ans. Anyone who falls below the federal poverty level is eligible to apply for this program. Particularly those who engage in mining, sanitation, rickshaw pulling, rag picking, commercial worker driving, etc., will benefit from this approach.

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