Biju Swasthya Kalyan Yojana (BSKY)

Biju Swasthya Kalyan Yojana was launched by the Government of Odisha with the objective of establishing an extensive healthcare network across the state, especially for the economically weaker sections of the population.

About Biju Swasthya Kalyan Yojana (BSKY)

Launched In2018
Date of Announcement 12th June
Date of Launch 15th August
Launched ByCM Naveen Patnaik, Government of Odisha
Supervised ByGovernment of Odisha
Target TowardsImprove the overall health structure of healthcare state

Features of Biju Swasthya Kalyan Yojana (BSKY)

Financed and authorized by the Government of Odisha: Initiated and implemented by the Government of Odisha, the residents of Odisha who are enrolled under the Biju Swasthya Kalyan Yojana are covered against any chances of financial issues.

Universal Health Coverage: Biju Swasthya Kalyan Yojana not only finances medical treatments of residents of Odisha who are cardholders of this scheme, but also support the medical expenses for treatments being undertaken at sub-central owned public healthcare centres of any district.

Health insurance for cardholders: Under this scheme, every family is eligible for a health insurance plan. This promotes the state government’s objective of improving health conditions of its residents. Every family enrolled under Biju Swasthya Kalyan Yojana is eligible for Rs. 5 lakhs from the state government, while females get cover of Rs. 7 lakhs under this scheme.

Medical Treatments: Biju Swasthya Kalyan Yojana offers financial assistance to as many as 4,036 medical treatment packages like cancer, kidney ailments, heart diseases, etc.

Number of Surgeries: As per the scheme, it covers approximately 255 operative procedures.

Drop Back Assistance: The recently launched Drop Back Assistance Scheme is especially designed for pregnant women and newborns in need of special health support. The scheme makes these women and babies eligible for Rs. 500 towards their commute to get back home treatment after delivery.

Indemnity Assistance: Indemnity amount can channelled towards secondary and triennial treatments by family members. Coverage: This scheme extends its benefits to 70 lakh families belonging to the state of Odisha. This implies that the scheme covers more than 3.5 crore people.

Beneficiaries of Biju Krushak Kalyan Yojana: The existing applicants of Biju Krushak Kalyan Yojana have got automatically integrated to the newly launched BKKY scheme.

Collaboration between private and government medical institutes: The state government plans to unify all government and private medical centres to ensure speedy and more efficient treatments for all.

Travel Expenses: The scheme is not only planned to offer financial assistance for specific medical treatments, but also includes commutation grant of a maximum of Rs. 2,000 for treatments outside the state. The travel allowance is transferred to the active bank account of cardholders.

Empanelled List Of Hospitals: The Government of Odisha has an extensive network of hospitals and medical centres, not just within the state, but outside it as well. Certain complex surgeries and treatments are offered at apex medical institutes. Some of the esteemed hospitals that this scheme collaborates with are Tata Memorial Hospital (Mumbai), CMC Vellore, Narayana Hrudayalaya across India, just to name a few.

Benefits of Biju Swasthya Kalyan Yojana (BSKY)

  • All health services are free of cost, including free drugs, free diagnostics, free dialysis, free cancer chemotherapy, free OT, free I.C.U., free in-patient admission etc., in all government health institutions up to district headquarters hospital level, for all persons.
  • Families having BSKY, BKKY card, RSBY card, BPL card, or AAY card and low income certificate holders can avail additional facility of cashless treatment beyond District Headquarters Hospital level, at all public health care facilities and 208 empanelled Private Hospitals.

Treatment Coverage of BSKY

Cashless healthcare assistance will be provided.

  • Free healthcare services for every citizen of the state at all state government medical centres – right from sub-centre to district headquarter hospital level.
  • Annual health coverage of Rs. 5 lakhs per family and Rs. 7 lakhs per women members of the family.

Biju Swasthya Kalyan Yojana (BSKY) Card & Registration Process

Biju Swasthya Kalyan Yojana Card is a membership card that is assigned to every individual registered under the scheme. It contains information about the members of the family that are registered under the Biju Krushak Kalyan Yojana (BKKY) card. The scheme has been especially designed for families with an annual income of Rs. 50,000 in rural and Rs. 60,000 in urban India.

Biju Swastya Kalyan Yojana is designed for all residents of the state of Odisha, irrespective of whether they belong to the Below Poverty Line (BPL) or Above Poverty Line (APL).

Eligibility Criteria of Biju Swasthya Kalyan Yojana (BSKY)

  • All families are eligible for free health care services at government health care Institutions up to district headquarter hospital level.
  • Residents of Odisha enrolled under BSKY and earning an annual income below Rs. 50,000 in rural areas and below Rs. 60,000 in urban areas are eligible.
  • For additional facility of free healthcare beyond district headquarters hospital level, an annual health coverage of Rs. 5 lakhs p.a. per family and Rs. 7 lakhs p.a. for women members of the family, all members enrolled under these schemes/categories are eligible for benefits of Biju Swasthya Kalyan Yojana - Biju Krushak Kalyan Yojana, Rashtriya Swasthya Bima Yojana, Anatodaya Anna Yojana (AAY).

Documents Required For Biju Swasthya Kalyan Yojana (BSKY)

For getting Rs. 5 lakhs health coverage per annum per family and Rs. 7 lakhs health coverage per annum for women members of the family, the existing Biju Krushak Kalyan Yojana (Stream I & II) or Rashtriya Swasthya Bima Yojana or BPL or AAY cards have to be produced at the empanelled hospital. For low income families who do not have these cards, valid income certificate (annual income below Rs. 50,000 in rural areas and below Rs. 60,000 in urban areas) is to be produced at the empanelled hospital, for availing cashless treatment.

  • Residential Papers – The scheme will only allow those people to get the benefits, who will be able to furnish their residential certificates.

  • Aadhar Card – Submission of this document is a must for all ID related verifications. In case a person does not have this card yet, he/she must make arrangements to get it before the scheme completes its first year.

  • BPL Certificate – All applicants must submit a photocopy of their BPL certificate to attain the perks of this scheme.

  • Income Certificate – Due to the presence of the income related criterion, individuals applying from villages as well as cities, must submit legal papers, which highlight that they fall within the permissible margin.

  • Profession Related Papers - As this scheme will offer health care benefits to poor people, applicants need to submit documents that highlight that these individuals are not earning any regular salary from any organization.

  • Compulsion Regarding Aadhar Card - Though Aadhar Card is a compulsory ID document, Odisha government has announced that people, applying for this project will get the benefits even if they don’t possess their Aadhar Card. But they will have to get their Aadhar Cards before the completion of one year of this project. Otherwise, they will no longer enjoy the perks.

Claims Settlement Process against BSKY

Claim settlement against Biju Swasthya Kalyan Yojana is undertaken via insurance companies. As per Odisha State Treatment Fund (OSTF), claims against this scheme are currently processed manually. However, the Government of Odisha soon plans to digitalize the mode of payments in the near future.

After the completion of treatment, the empanelled hospital has to notify the relevant insurance company or Third Party Administrator (TPA) through an electronic report. The insurer or TPA records the information from the report and then reimburses the payment to the hospital within the time period, as mutually agreed upon by both the parties.

Documents Required For Making a Claim against BSKY

Biju Swasthya Kalyan Yojana Smart Health Card is required for availing cashless benefit under this scheme.

List of Hospitals Cover Biju Swasthya Kalyan Yojana (BSKY)

You can access the list of empanelled hospitals under Biju Swasthya Kalyan Yojana Click Here

Customer Helpline Number & Contact Details

For raising queries or complaints against Biju Swasthya Kalyan Yojana, any citizen of Odisha can get in touch via the toll-free number: 1553696 anytime between 6 a.m. to 10 p.m.

To know about Biju Swasthya Kalyan Yojana online, one can visit their websites: health.odisha.gov.in and nrhmorissa.gov.in

Conclusion & Reviews

Conclusion

Biju Swasthya Kalyan Yojana is a step towards the right direction in upgrading the healthcare sector in the state of Odisha. It makes an active effort to extend comprehensive yet affordable medical treatments to the residents of the state, with special emphasis to the economically weaker sections.

Reviews of Biju Swasthya Kalyan Yojana (BSKY)

“Registering for Biju Swasthya Kalyan Yojana has made it possible for me to get the right treatments. I belong to the BPL category and financing my treatment would not have been possible without assistance. I am thankful to the Government of Odisha for introducing this scheme.” – Bibhu Soren

“I was referred to a hospital outside Odisha for my treatment. Being a cardholder of Biju Swasthya Kalyan Yojana, I was eligible for financial help even for treatment outside the state.” – Gopinath Mohapatra

“Biju Swasthya Kalyan Yojana has made sure that I get financial security whenever anyone in my family requires hospitalisation or medical treatments. Also, I don’t have to apply for a separate health insurance plan. I’m glad that I decided to be the cardholder of this scheme.” – Shila Mohanty

FAQ's On Biju Swasthya Kalyan Yojana (BSKY)

What is the maximum insurance cover under Biju Swasthya Kalyan Yojana (BSKY)?

The maximum insurance coverage for Biju Swasthya Kalyan Yojana is Rs. 5 lakhs, and Rs. 7 lakhs for the women covered under the scheme.

How does Biju Swasthya Kalyan Yojana (BSKY) work?

  • Selection of insurance company/Third Party Administrators (TPA)
  • Preparation of BPL data, i.e., details of all the family members -names, age, gender and relationship with the head of household.
  • Enrolment of beneficiaries, i.e., families enrolled under the scheme
  • Empanelment of hospitals and medical institutes within and outside Odisha
  • Going through the electronic reports, comprising of medical expenses incurred, submitted by cardholders after treatment
  • Claim settlement after verification of the authenticity of medical bills and receipts as proofs of expenses incurred
  • Issuing Smart Cards to families enrolled under the scheme to make them eligible for cashless treatment at the empanelled hospitals
  • Monitoring and evaluation of reimbursements made against claims, track claims and transfer funds to hospitals, and investigate suspicious claims