Rashtriya Swasthya Bima Yojana: Eligibility Criteria | Key Feature | Benefits And Much More!

Unorganized sector workers account for approximately 93% of the overall labor force in the country. The government has implemented some social security measures for specific occupational groupings, although the reach is limited. The vast majority …

Rashtriya Swasthya Bima Yojana

Unorganized sector workers account for approximately 93% of the overall labor force in the country. The government has implemented some social security measures for specific occupational groupings, although the reach is limited. The vast majority of workers continue to be uninsured.

One of the primary concerns for workers in the unorganized sector is the frequent occurrence of disease and the need for medical care and hospitalization of such individuals and their family members. Despite the growth of healthcare services, the disease remains one of the most common causes of human deprivation in India.

Main Purpose of the RSBY Scheme

The Ministry of Labour and Employment, Government of India, introduced RSBY to give health insurance coverage to Below Poverty Line (BPL) families. The goal of RSBY is to safeguard BPL households from financial liabilities resulting from health shocks that require hospitalization.

Benefits Of Rashtriya Swasthya Bima Yojana

The recipient will be eligible for such in-patient health care insurance coverage as the respective State Governments create depending on the needs of the people/geographic area. However, it is recommended that state governments include at least the following basic benefits in the package/scheme:

  • The worker in the unregulated industry and his family (unit of five) will be covered.
  • On a family floater basis, the total sum covered will be Rs. 30,000/- per family per year.
  • Attendance for all covered diseases is free of charge.
  • Hospitalization costs, with as few exclusions as possible, for the most frequent ailments.
  • All pre-existing conditions must be covered.
  • Transportation costs (real with a maximum limit of Rs. 100 for each visit) within a Rs. 1000 overall limit.

Eligibility Criteria For Rashtriya Swasthya Bima Yojana

  • Beneficiaries of the scheme would include unorganized sector employees from the BPL category and their family members (a family unit of five).
  • It will be the responsibility of the implementing agencies to check the eligibility of the unorganized sector workers and their family members who are suggested to benefit from the scheme.
  • Beneficiaries will be issued smart cards for identification purposes.

Patterns of Funding For Rashtriya Swasthya Bima Yojana

Government of India contribution: 75% of the expected annual premium of Rs. 750, up to a maximum of Rs. 565 per family per year. The Central Government will bear the expense of the smart card.

Rashtriya Swasthya Bima Yojana

Contribution from the respective state governments: 25% of the annual premium plus any additional premium. The beneficiary would pay a registration/renewal cost of Rs. 30 every year.

The administrative and other costs associated with the scheme’s administration would be met by the respective state governments.

Unique Features of Rashtriya Swasthya Bima Yojana

The RSBY scheme is not the government of India’s first attempt to provide health insurance to low-income workers. The RSBY scheme, on the other hand, departs from these schemes in numerous significant respects.

  • Creating a Beneficial Business Model for All Stakeholders
  • Insurance Companies, Hospitals, and Intermediaries
  • IT (Information Technology) in Government Intensive
  • Safe and dependable portability
  • Transactions that are cashless and paperless
  • Effective Monitoring and Evaluation

Conclusion

It is well acknowledged that health insurance is one method of protecting impoverished households from the possibility of health expenses leading to poverty. The impoverished are unable or unwilling to obtain health insurance due to the high cost or perceived lack of advantages. It is extremely difficult to organize and administer health insurance, particularly in rural areas.

Recognizing the need to provide these workers with social security, the Central Government launched the Rashtriya Swasthya Bima Yojana (RSBY). The scheme had 34,285,737 Smart Cards and 5,097,128 hospitalization cases as of March 25, 2013. On the other hand, if you have any questions in your mind then ask freely for any queries at https://directorateheuk.org/

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