Rashtriya Swasthya Bima Yojana: Benefits and Features | Eligibility Criteria for Rashtriya Swasthya Bima Yojana

25 Oct, 2021 Last Update 11 months ago

The Rashtriya Swasthya Bima Yojana is a social security scheme launched by the Government of India for the country's unorganized employees. Unorganized workers in the country face a variety of health concerns, including old age, disability, general ailment, maternity, and so on.

This health insurance program assures that these employees are protected from these health risks. This scheme was initially launched in 2008 to provide coverage for low-income families. It was eventually expanded to include unorganized workers from households with incomes just above the poverty level.

Features of Rashtriya Swasthya Bima Yojana

  • This Yojna provides up to Rs.30,000 in coverage for various hospital charges and expenses.
  • The Central Government and the different State Governments share the cost of the premiums for this medical insurance coverage.
  • This Yojna covers all early conditions from the first day of operation.
  • The primary goal of this yojna is to lower out-of-pocket payments spent by low-income families in the event of a catastrophic medical emergency.
  • There is no upper age limit for receiving payments under this policy.
  • The beneficiaries must pay Rs.30 as a registration fee, and the government would cover the remainder.
  • This policy is a family floater that covers everyone in the member's family.
  • This plan is intended to be a business model that provides incentives to all stakeholders. The government pays the premiums for all enrolled members to the insurers.
  • The government pays a premium of up to Rs.750 per family every year. This enables the government to give simple access to quality healthcare for all low-income families.

Benefits of Rashtriya Swasthya Bima Yojana

  • A total annual amount insured of Rs.30,000 per family
  • The beneficiary is not required to pay anything to the hospital for any treatment up to Rs.30,000.
  • Transportation expenses are reimbursed up to Rs.1,000.
  • The system is transferable, with beneficiaries eligible to use any accredited hospital in any state, which is advantageous to migrating employees.

Eligibility Criteria For Rashtriya Swasthya Bima Yojana

  • Employees in the unorganized sector
  • Families living on or near the poverty line.
  • Members of a five-person family unit who match the aforementioned conditions.

Enrolment and Registration Process of Rashtriya Swasthya Bima Yojana

  • The RSBY authorities have established various enrolling centers across the country to make it easier for qualified beneficiaries to register under the scheme. If you match the above-mentioned eligibility criteria, you must provide verification of your eligibility. Furthermore, if you want to expand coverage to family members, give them information and identity papers during enrollment.
  • To register/renew their coverage under the RSBY plan, an eligible household must pay Rs.30 per year. After successful registration/renewal, each enrolled member will be issued a smart card with which to access the scheme's advantages.
  • Enrolment centers typically keep a list of local households who qualify for the Rashtriya Swasthya Bima Yojana scheme. As a result, they can ensure that only the appropriate household is enrolled, greatly simplifying the enrollment and registration procedure.

What is Covered Under Rashtriya Swasthya Bima Yojana?

  • The program provides coverage for qualifying RSBY beneficiaries who require hospitalisation as a result of an illness or accident. This coverage extends to their family members as well. Everyone who is eligible, however, should seek care at an accredited facility.
  • The insurance will pay for any dental treatment required as a result of an accident.
  • Daycare treatments are surgical procedures that do not necessitate a lengthy hospital stay. These are also referred to as out-patient operations and are covered by RSBY. The following are the childcare therapies that are covered under the scheme

  • RSBY also pays the costs of pre-hospitalization diagnosis and medicines. Furthermore, the insurance covers expenses incurred after discharge (for check-ups and other emergencies). Furthermore, the patient will be covered for five days following hospitalisation.

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