Thursday , April 26 2018

Rashtriya Swasthya Bima Yojana | National Health Insurance Scheme

Rashtriya Swasthya Bima Yojana | National Health Insurance Scheme

The new health insurance scheme named Rashtriya Swasthya Bima Yojana is for families and individual citizens of India who are in BPL status and also for people who are working in small organization or unorganized sectors.

One of the major concerns of the government is the social security of certain working groups in the society is about providing proper health coverage. On accounting that issue, recently government of India purposely launched this Rashtriya Swasthya Bima Yojana for providing better health insurance coverage for those people who are in need and for those who not able to spend huge sum for getting proper medication.

Name of the Scheme Rashtriya Swasthya Bima Yojana
Launched by Ministry of Labour and Employment
Scheme is currently under Ministry of Health and Family Welfare
Launch date 1st April, 2008
Target group BPL families and workers of unorganized sectors
Main objective of the scheme Provide health insurance
Status Active

Rashtriya Swasthya Bima Yojana

Objective of the scheme

It is very important to have social and health security in the country so as to bring up development. It is said that almost 93 percent of the people in the country belong to the unorganized sector of the society which has a lot of risk and uncertainty. It is very important that this section of the people and families are provide with some security and coverage, keeping in mind their occupation and financial status. it is very commonly seen that in BPL families or among the people working in the unorganized sector the instance of illness is high, but they cannot afford treatment and medical care.

So the main goal of the scheme is provide such people with health insurance which can help them financial for getting medical care for themselves or their families. With the help of this scheme the government will try its best in providing financial support to the BPL families and the people belong to the unorganized working class, for their medical requirements. The scheme will help such families in availing medical facilities without worrying about the expenses. The scheme would try and bring up better and affordable medical facilities for the needy individuals and families of the country.

People covered under this scheme

The scheme was launched for the people and families belonging to the BPL or Below Poverty Line category. But then later 11 categories of the unorganized working class were recognized, and the coverage of this scheme was extended to them as well. Here are the 11 categories-

  • Street vendors
  • Licensed railway potters
  • Construction workers who are registers under the Welfare Boards
  • Beedi workers
  • MNREGA workers
  • Sanitation workers
  • Domestic workers
  • Rickshaw pullers
  • Mine workers
  • Rag pickers
  • Taxi and auto drivers

Beneficial features of the scheme

Options to the beneficiary– This scheme provides a unique option or choice to the beneficiaries. It leaves it to the beneficiaries to choose if they want to avail a public or a private hospital. This features will attract many hospitals and health care facilities toward the beneficiaries.

Good insurance coverage– under this scheme the government will provide overage up to a price of Rs.30000 for a family of 5 members. Along with this amount the scheme also provide a transportation charge of Rs.100 for each visit made to the hospital. The maximum transportation coverage is Rs.1000.

Smart Card– The scheme makes use of the IT very smartly in the form of a Smart Card. To achieve maximum success in providing a better and proper social security the schememakes use of the information technology.

Under this scheme the beneficiaries will be given a Smart Card which will make sure that no misuse of the scheme is carried out. The card is a biometric-enabled card containing photo and the fingerprint of the beneficiary. The hospital that are registered under this scheme will be IT enabled and hence connected to server at the district level. With this they will be able to get the information about the beneficiary and will be able to provide proper service.

Transaction without cash– In the hospitals registered under this scheme the beneficiaries will get the benefit of cashless treatment. The person who is the beneficiary, need to carry his or her Smart Card to the medical facility or the hospital and verify his or her identity with a fingerprint. All the other process of verification and payment will be managed online. The beneficiary need not worry about these matters.

Seamless validity– Another amazing features of the scheme is that the beneficiary who is one enrolled to the scheme can use the Smart Card in any of the registered hospitals across the country. So even if the beneficiary is re-located or transferred to some other district, he or she will be able to make use of the insurance anywhere in the country.

Safe scheme– The government has tried its best to create a safe and a protected use of the scheme by using biometric enabled Smart Card. It is also trying its best that the Smart Card reached the right and eligible beneficiary. The system established makes sure that only the beneficiary of the card uses the smart card and the insurance money.

Monitoring and evaluation– Under this scheme a robust monitoring and evaluation system has been established with all the data that is required to operate the scheme effectively.

Beneficial for stakeholders-The scheme has been overall designed in a way that each of the stakeholder of the scheme re benefited by it in some or the other way. In case of the insurer, the insurer will be paid a premium for the households that are registered under the scheme. This would be a benefit for the insurance company and they would be motivated in attracted more and more BPL families to their list.

For the hospitals, they will be paid an incentive for each of the patients (beneficiaries) that they treat. The incentive will be provided to both public and private hospitals.

The intermediaries like NGOs and MFIs who are involved in dealing and motivating the BPL categories or the workers of the unorganized section, will also be paid incentives. For the government the scheme would be beneficial, as by paying a small amount every year they will able to provide good health to the people of the country and generate a healthy competition between public and private healthcare facilities.

Eligibility criteria

  • The person or the family applying for the scheme should belong to a BPL family or one of the above category of unorganized working class.
  • Under this scheme 5 members of the beneficiary’s family will be covered.

Enrollment procedure

  • The people who are eligible for the scheme should visit the earing enrolment station along with an identity proof and give it to the official there. The government official present will confirm the identity, and your belonging to the BPL or unorganized working category. Once the verification is done you will have to pay a fee of Rs.30 for your family and get yourself enrolled for the scheme.
  • After this a list will be made of the families eligible and will be provided to the insurance companies. These companies will the fix a date district wise and on that date you have to visit the given place for the complete registration process. During the registration process you biometric details will be collected and then at the end a Smart Card will be provided to the beneficiary.
  • Once this is done, you policy will be active from the 1st day of the following month.

Some common questions on the scheme

Questions Answers
After enrollment how much time will it take to avail the scheme benefits? Once enrolled for the scheme, you will be able to avail the scheme benefits from the 1st of the next month. So if you get enrolled in March, you can use the policy from the 1st of April.
When will I be given my Smart Card? The beneficiary will be given the Smart card during the registration process.
Who will pay the premium? The 755 of the premium will be paid by the Central government and the rest will be paid by the State government.
Is there is any registration fee for renewing the policy? A fee of Rs.30 is to be paid every year for policy renewal.

From the time of its launch many BPL families and people belonging to unorganized work culture have registered for it. The scheme is quite beneficial for them, and provides them an opportunity for better treatment.

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