Rashtriya Swasthya Bima Yojana
The Rashtriya Swasthya Bima Yojana (RSBY) is a health insurance program for Below Poverty Line (BPL) families launched in 2008 by the Government of India’s Ministry of Labour and Employment. Its main aim is to cover the unorganised workforce in the country that constitutes nearly 93% of the total Indian workforce. Citizens belonging to this group have almost no health cover. The RSBY is an attempt to rectify this and reduce the anxiety of losing the worker’s means to earn due to illness, hospitalisation, accident, or any such mishaps.
Cost to Beneficiary
The RSBY is free to the beneficiary. The Central government bears 75% of the ₹750 annual premium, while the beneficiary’s State government bears 25%. The beneficiary has to pay just the ₹30 as registration upon signing up and renewal fees of ₹30. All additional premiums and administrative costs will be borne by the respective State government.
How It Works
The RSBY is a pro-active scheme by the Government, where it provides a list of eligible BPL households to the insurer. The insurance company uses this date to create a schedule for enrollment in the villages under its purview. The insurer then sets up mobile enrollment stations in each village, with equipment to collect biometric information like fingerprints as well as photographs of the beneficiary and their family. Once this is done, the beneficiary is supplied with a smart photo card. The beneficiary can use the smart card to avail health care at the various assigned hospit
als in the vicinity, both government and private.
Anyone in the unorganised sector who qualifies in the BPL category as well as their families (members capped at five) are eligible for the RSBY.
The scheme allows the State Governments to set the scheme benefits based on requirements in a particular area. They are advised to incorporate the following minimum benefits:
- Unorganised sector worker and family (unit of five) to be covered.
- Family floater assured sum of ₹30,000.
- Cashless facility for all illnesses covered under the policy; it is the hospital’s responsibility to claim expenses from the insurer.
- Hospitalisation coverage for most common illnesses with as few exclusions as possible.
- Coverage for all pre-existing diseases.
- Transportation costs, capped at ₹100 per visit, up to ₹1000.
Advantages of RSBY
- Hospitals incentivised to serve BPL beneficiaries as they get paid per the number of beneficiaries treated.
- The insurer is incentivised since the more people enrolled, the more premium they can collect.
- The beneficiary has a wider choice for their medical needs.
- The smart card provides all requisite data of the beneficiary, and they have to carry just their smart card to the hospital.
- Cashless interactions at the hospitals.
- The smart card holder can use it in any RSBY-empaneled hospital across India. This is key because such beneficiaries are migrant workers who move from place to place for their work. The smart cards can also be split so that the migrant worker can carry a portion of the coverage with them separately.