What is Rashtriya Swasthya Bima Yojana?

In our country, there are about 93% of the total workers. They are included under the unorganized worker sector. For many years the government is executing security for social measures. But at that time the coverage was very low. One of the notable uncertainty was the frequent illness of the workers.

Keeping this in mind, the Government Of India decided to provide social security. It will be through health insurance to poor households. While this social security is for the rural areas where they are unable to take health insurance.

The GOI introduced “Rashtriya Swasthya Bima Yojana”. It came into action on 1st April 2008.

The Rashtriya Swasthya Bima Yojana is under the ministry of employment and labor. It will give below poverty line families better health insurance coverage.

Objectives of the scheme

There is a need to recognize diversity with regard to three things. It includes socio-economic conditions. Further, public health framework & executive networks. The scheme aims to launch various projects on health insurance in all the states district. It will be in step by step manner for the workers of BPL.

Eligibility of the scheme

• Unorganized working sectors from the BPL category.
• The payees will also include family members of the BPL category.
• The implementing agencies will be responsible to verify the workers of the unorganized sector.
• The agency will also verify the family members who are offered the benefits of the scheme.
• The smart cards will be issued to the payees for confirmation purposes.

Benefits of RSBY

The eligibility for the payee will be in-patient health care benefits. It would be designed on the basis of the need of the people. Hence, by the respective State Government. But, at least the following minimum benefits are advised by the state government to incorporate in the scheme:

• The scheme will cover workers of unorganized sector and their family members,
• On a family allowance basis, the total amount would be RS. 30,000/- per annum & per family,
• To cover all the conditions for cashless appearance,
• To cover all the pre-existing diseases,
• Expenses for treatment,
• To take care of the most common diseases with as few expulsions as possible,
• Cost of transit with an overall limit of RS. 1000.

Salient features of the scheme

1. Funding pattern

• Government of India contribution: there will be 75% contribution of the annual premium. The amount is roughly RS. 750. It is given to a maximum of RS. 565 per annum to per family.
• The central government will carry the cost of the smart card.
• State government contribution: with the annual premium or any additional premium contribution of 25%.
• The renewal or registration fee would be payable by the recipient. The amount is RS. 30 per annum.
• The respective state government will carry the executive or other costs of executing the scheme.

2. Formulation & application agency for the project

While developing the pilot project, the state government will determine the agency. It will be for implementing this scheme.

The enrollment process for the scheme

• The insurer will get the list of all the eligible BPL households. While the list will be in the prespecified data format.
• Each village will get an enrollment schedule, with dates prepared by the insurance company. It is done with the help of officials at the district level.
• On the basis of schedule, the BPL list in each village is posted at the enrollment station.
• In the village, there is an advance publication of the prominent places for enrollment. The location and date of the enrollment are also properly informed.
• In each village, the local centers are set up for mobile enrollment stations.
• The insurer provides these stations with the hardware necessary to collect biometric information.
• It includes the coverage of photographs of the household members.
• There will be a printer for the printing of smart cards with a photo.
• If the holder has paid the RS 30 fee, then they will be provided with the following things:

1. 1. An information pamphlet describing the scheme
   2. The smart card
   3. The list of hospitals
   4. The confirmation of the smart card will be by the concerned government officials.

• There will be less than 10 minutes taken to process the above procedure.
• In a plastic cover, the smart cards will be given to the eligible.

What is a Smart card for RSBY?

A Smart card is described as a useful card used for various activities. It includes the photography & fingerprint information of the holder. Hence, all the information about the patient.

The smart card has an important function benefiting across the country. It enables flexible & cashless transactions at the listed hospital.

At the enrollment station, the accurate smart card will be handed over to the holder itself. It includes the photography of the family head. The card can be used for confirmation if there is a failure of biometric information.

The special qualities of the RSBY scheme:

The government of India has not made its first try to provide health insurance. However, there are some ways that describe the RSVY scheme as different. These ways are as follows:

• All stakeholders, business model
• Recipient empowerment
• Hospitals
• Insurers
• Government
• Paperless and cashless transactions
• Mobility
• Foolproof and safe
• Advanced information technology
• Assessment and monitoring system