The government-run health insurance scheme for poor people. Rashtriya Swasthya Bima Yojana scheme provides health insurance coverage to the unorganized sector workers who belong to below the poverty line category. The family members will also be beneficiaries under the scheme. Cashless insurance for hospitalization is provided in public as well as private hospitals. The scheme was launched on April 1 in the year 2008 and has been implemented in 25 states of India.
A total of approx 36 families have been enrolled under the scheme.
The scheme is under the Ministry of Health and Family welfare from the year 2015. Health insurance is the way to provide protection to poor households against the spending on health services due to low income. Recognizing the need for providing social security to the poor people, the Central government introduces Rashtriya swasthya bima yojana. This scheme is initiated to basically work towards the welfare of the economically backward people and unorganized sector workers.
Website detail – https://www.india.gov.in/
BENEFITS OF THE SCHEME (RASHTRIYA SWASTHYA BIMA YOJANA)
1) The unorganized sector worker and his family is covered under the scheme.
2) The amount will be 30,000 per family o per annum basis.
3) Cashless attendance to all the ailments covered under the scheme.
4) Expenses related to hospitalization.
5) All the pre-existing diseases will be covered under the scheme.
6) All the healthcare-related services free of cost to poor people.
OBJECTIVES OF THE SCHEME (RASHTRIYA SWASTHYA BIMA YOJANA)
To provide health protection against chronic illnesses.
To improve the access to the health care system to BPL families
To cut down the health expenses for low-income people.
To provide economically backward people free of cost health-related services under the scheme.
To create awareness while increasing access to health care.
FEATURES OF THE SCHEME
Freedom of choice of hospital to poor people for treatment either in private or public hospitals.
It is safe and secure as a biometric smart card will be enabled under the scheme. It makes the service safe and secure from fraud claims.
It is backed by a network of hospitals that makes the scheme truly unique and beneficial for low-income people.
The smart card can be used across all the networks of hospitals and is not restricted to one district.
The cashless benefit is availed in an authorized hospital.
It is a paperless procedure as every document is sent through online mode and payment is also done through electronic means by the insurer.
The insured families will be issued smart cards which will contain biometric details of the insured.
No age limit is there under the scheme.
The scheme also covers pre-existing conditions of the beneficiary.
It provides complete medical coverage to the whole family.
The use of a data management system is there which is responsible for tracking transactions across the country and sends reports in a periodic manner.
BENEFICIARIES OF THE SCHEME
Building and construction workers
Licensed railway porters
Auto/ taxi drivers
ELIGIBILITY CRITERIA FOR THE SCHEME
- If the person works in an unorganized sector.
- The part of BPL families.
- A person who registers themselves under the welfare board is also eligible for the scheme.
- No upper age limit is there.
- The scheme is available for any member of the person’s family.
- A maximum of 5 family members can apply for this scheme.
- The one-third population of India is eligible for the scheme.
ENROLLMENT PROCESS OF THE SCHEME (RASHTRIYA SWASTHYA BIMA YOJANA)
• An electronic list of eligible BPL families is provided to insurers through electronic data format.
• Then an enrollment schedule for each village is decided along with the date is prepared by the insurance company with the help of district-level officials.
• According to the schedule BPL list is posted in the village enrollment station.
• Mobile enrollment stations are placed at local centers to give information to people.
• The stations are equipped with insurers and with the hardware needed to collect biometric information of the beneficiaries of the scheme.
• A smart card is given along with information about the scheme and a list of hospitals under the scheme.
• Beneficiary has to paid rupees 30 to the government official.
The scheme aims to provide the best healthcare service and social security to BPL families and unorganized workers who are above the poverty line. The scheme is against health hazards like old age, maternity, disability, and general illnesses. The scheme involves a unique cashless procedure to enable the provision of medical services to unorganized workers and poor people and their families with low income. It focuses on improving their health conditions and providing the best of services in public or private hospitals without any worry or fraud. The scheme is majorly financed by the central government and the rest is paid by state governments.