Rashtriya Swasthya Bima Yojana (RSBY)

The Government of India is taking strong interest to provide social security and healthcare assurance for which various steps are been taken.

For instance, Central Government started Unorganized Workers Social Security Act (2008) to provide social security and welfare for the unorganized workers. It was initiated to mitigate risks due to disability, medical emergencies, maternity and old age that unorganized workers may suffer from.

Ministry of Labour and Employment, Government of India, has introduced Rashtriya Swasthya Bima Yojana (RSBY), a Health Insurance Scheme. RSBY was launched in 2008 and is meant for all the families living below poverty line. The objective of RSBY is to cut down the medical expenditure on health which they have to shell out of their pocket. Moreover, this has helped to create awareness while increasing the access to health care.

RSBY has been expanded to cover other defined categories of unorganised workers.

Rashtriya Swasthya Bima Yojana (RSBY) also covers

  • Building and other construction workers registered with the Welfare Boards
  • Licensed Railway Porters
  • Street Vendors
  • MNREGA workers who have worked for more than 15 days during the preceding financial year
  • Beedi Workers
  • Domestic Workers
  • Sanitation Workers
  • Mine Workers
  • Rickshaw pullers
  • Rag pickers
  • Auto/Taxi Driver

Objective of RSBY

RSBY has two fold objectives:

  1. To provide financial protection against catastrophic health costs by reducing out the financial burden

  2. To improve access to quality health care for below poverty line households of pocket expenditure for hospitalization and other vulnerable groups in the unorganized sector .

Details of the Rashtriya Swasthya Bima Yojana (RSBY) Scheme

  • The sum insured offered is up to Rs.30,000 year in case the insured is hospitalized on family floater basis.
  • The coverage is provided in case of hospitalization under the defined diseases mentioned in the plan.
  • Under RSBY, pre- existing diseases are covered from day one and there is no age limit.
  • The maximum number of family members that can be covered under RSBY is five, which includes the head of the house, spouse and up to three dependents.
  • In case of hospitalization, the transport expenses are covered up to Rs.100/- per hospitalization, subject to a maximum of Rs.1000/- per year per family.

How Rashtriya Swasthya Bima Yojana (RSBY) works?

Registration Fee: The registration fee to be paid is only Rs.30 year while Central and State Government pays the premium as per their sharing ratio to the insurer. The insurer is selected by the State Government on the basis of a competitive bidding.

Registration Process: The State Government sets up a State Nodal Agency (SNA). The SNA is responsible for implementing, monitoring supervision and part-financing of the RSBY scheme. The SNA is also responsible for coordinating with insurance company, hospitals, district authorities, and other local stake holders.

Features of Rashtriya Swasthya Bima Yojana (RSBY) Scheme

Choice of Hospital – RSBY offers freedom of choice between public and private hospitals to the below poverty line family participating in RSBY.

Safe and Secure – It is for the first time that IT applications are being used for social sector scheme on such a large scale. RSBY scheme issues with biometric enabled smart card with insured’s fingerprints and photographs. All the registered hospitals under RSBY are IT enabled with the facility to use biometric enabled smart card and connected to the server at the district level. This makes this scheme safe and secure from fraud claims.

The key management system of RSBY make sure that the smart card reaches to the right insured person. It is also, responsible for accountability in terms of issuance of the smart card and its usage. The biometric ensures that only the real beneficiary can use the smart card.

Backed by Network of Hospital – The smart card provided under RSBY can be used in any RSBY empaneled hospital across India. It makes RSBY scheme, a truly unique and highly beneficial scheme for the below poverty line family, especially, to the poor families that migrate from one place to the other because of work. RSBY smart card is not restricted to the district under which the card was issued. RSBY smart cards can be used across the network of empaneled hospital in India. Moreover, also provides the split for migrant workers to carry a share of the coverage with them separately.

Cashless Claim Settlement – Because of the smart card provided to the insured under RSBY, one doesn’t have to worry about money or reimbursement. One can avail cashless benefit in any of the authorised hospitals. But to avail cashless benefit, the beneficiary needs to carry and show the smart card, which is then verified through the help of finger prints.

Paperless – No paper work is involved. The participating network hospital does not need to collect all the papers or documents manually. It is send to the insurer online. The payment of expenses is done electronically by the insurer.

Review – Rashtriya Swasthya Bima Yojana (RSBY) Scheme

Rashtriya Swasthya Bima Yojana (RSBY) Scheme is based on strong pillars of cost-effective health care plan, freedom of choice of hospitals – private and public, smart card facility, network of hospitals across the country, cashless claim service, family floater plan, and so on. This truly makes RSBY one of the unique health care system laid down by Government of India.

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