Thursday, 28 January 2016
RSBY (Rashtriya Swasthya Bima Yojana) Scheme
Rashtriya Swasthya Bima Yojana (RSBY) is a insurance scheme for the family who belong to BPL to provides them cashless insurance for their treatment (hospitalization) in public or private hospitals. RSBY is current running and active in 25 states which was started in 01st of April 2008.
It provides cashless healthy insurance cover, up to Rs. 30,000/- per annum on a family floater basis to BPL (a unit of five) and 11 occupational groups in the unorganized sector and importantly for those workers who have worked in MGNREGS for 15 days.
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Objective of RSBY
Proper Facilitation of health insurance scheme for BPL workers in all districts of states
How RSBY Works?
· RSPY scheme works with the support of both Centre and State government. Out of total premium of Rs 750 central govt pay Rs 565 that is 75% and rest 25% is paid by state govt.
· BPL families (a family unit of five) who have yellow ration card are beneficiaries under this scheme.
· Rs 30 is to paid per annum for registration/ renewal fee to get a smart card for checking their eligibility.
· Under this scheme beneficiary is able to get Rs 30,000 for medical care per annum.
Transfer of RSMY from Ministry of Labour and Employment:
Earlier RSBY projects were under Ministry of Labour and Employment Ministry and got transferred to Ministry of Health and Family Welfare on 1st April 2015.
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Unique Features of RSBY
The RSBY scheme is not the first attempt to provide health insurance to low income workers by the Government in India. The RSBY scheme, however, differs from these schemes in several important ways.
Empowering the beneficiary – RSBY provides the participating BPL household with freedom of choice between public and private hospitals and makes him a potential client worth attracting on account of the significant revenues that hospitals stand to earn through the scheme.
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Business Model for all Stakeholders – The scheme has been designed as a business model for a social sector scheme with incentives built for each stakeholder. This business model design is conducive both in terms of expansion of the scheme as well as for its long run sustainability
Information Technology (IT) Intensive – For the first time IT applications are being used for social sector scheme on such a large scale. Every beneficiary family is issued a biometric enabled smart card containing their fingerprints and photographs. All the hospitals empanelled under RSBY are IT enabled and connected to the server at the district level. This will ensure a smooth data flow regarding service utilization periodically.
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Safe and foolproof – The use of biometric enabled smart card and a key management system makes this scheme safe and foolproof. The key management system of RSBY ensures that the card reaches the correct beneficiary and there remains accountability in terms of issuance of the smart card and its usage. The biometric enabled smart card ensures that only the real beneficiary can use the smart card.
Portability – The key feature of RSBY is that a beneficiary who has been enrolled in a particular district will be able to use his/ her smart card in any RSBY empanelled hospital across India. This makes the scheme truly unique and beneficial to the poor families that migrate from one place to the other. Cards can also be split for migrant workers to carry a share of the coverage with them separately.
Cash less and Paperless transactions – A beneficiary of RSBY gets cashless benefit in any of the empanelled hospitals. He/ she only needs to carry his/ her smart card and provide verification through his/ her finger print. For participating providers it is a paperless scheme as they do not need to send all the papers related to treatment to the insurer. They send online claims to the insurer and get paid electronically.
Robust Monitoring and Evaluation – RSBY is evolving a robust monitoring and evaluation system. An elaborate backend data management system is being put in place which can track any transaction across India and provide periodic analytical reports.
The basic information gathered by government and reported publicly should allow for mid-course improvements in the scheme. It may also contribute to competition during subsequent tender processes with the insurers by disseminating the data and reports.
For more information on RBSY scheme you can go through official site and get aware of all your queries what have not been solved on this page.
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