National Health Insurance Scheme. Through the implementation of the scheme, benefits will be provided to those involved in unorganized employment. In today’s article, we will share the specifications of the National Health Insurance Scheme with everyone. In this article, we will share the process through which you can apply online for National Health Insurance Scheme. Under this article, we will also share a step-by-step guide through which you can implement yourself under the scheme. We have shared important details like eligibility criteria, features, benefits, and other things.
Rashtriya Swasthya Bima Yojana
Name | Rashtriya Swasthya Bima Yojana (RSBY) |
Launched by | Central Government |
Beneficiaries | Workers of the Unorganized Sector |
Objective | Providing insurance |
Official website | – |
National Health Insurance Scheme (RSBY)
The unorganized sector of India is in a very poor condition, people who work for the unorganized sectors are sometimes below the poverty line. Unorganized workers suffer from various problems such as physical or mental disability due to irregular working hours. The extent of an unorganized sector is the unavailability of financial incentives for workers. To overcome all these limitations, the government has launched the National Health Insurance Scheme.
Benefits of National Health Insurance Scheme
- Government officials also provide insurance cover up to Rs 30000 which is available to all patients in the unorganized sector.
- Medical insurance cover is paid jointly by the central government and the respective state governments.
- The main objective is to provide health benefits to all beneficiaries through the implementation of this medical insurance.
- The government will also pay up to Rs.750 per family per year as premium amount.
- Smart cards will be issued by government officials to ensure smooth functioning of the scheme.
- Poor families will get cashless treatment in any hospital located across the country.
Rasthriya Bima Yojana Eligibility criteria
- Applicant should be below poverty line (BPL) category.
- The applicant should be included in the District BPL list created by the government.
- Applicant must be an unorganized worker.
- You can apply for the scheme if you
- Construction Workers (Registered with Welfare Boards)
- Railway porter
- Cleaners
- domestic servant
- MNREGA workers
- Rickshaw puller
- Ragpicker
- There is no age limit
Process to Apply under RSBY for 2021
- First, the insurer will be provided with an electronic list of eligible BPL homes.
- The company will then create an enrollment schedule for each village, with dates.
- The BPL list with important dates will be posted in each village at the enrollment station.
- Finally, mobile enrollment stations will be set up at local centers in each village.
- Enrollment stations will collect all the details of the beneficiaries.
- The beneficiary will have to pay a fee of Rs. 30
- Smart card will be provided with important information on the spot.
- The list of families to whom the smart cards have been issued will be sent to the state nodal agency.
- This list of nominated houses is maintained centrally and is the basis for financial transfers from the Government of India to the state governments.
How to utilize the services of RSBY
- The beneficiaries have to visit the hospital or the official website..
- After this the beneficiary has to go to the RSBY Help Desk.
- Identification will be verified.
- In the event of hospitalization, the assistant at the help desk checks if the procedure is in the list of pre-specified packages.
- If the process is in the list, the appropriate defined package is selected from the menu.
- If the process is not on the package list, the help desk assistant checks with the insurer about the cost of that process.
- Upon discharge, the pre-determined cost of the process is deducted from the amount available on the card.
- Transport expenses of Rs. 100 is also paid by the hospital authorities at the time of discharge.
Incentives under RSBY
- Hospitalization expenses – An incentive amount of Rs 30,000 will be provided per year to waive the medical bills of the beneficiaries. Incentives will be based on predetermined package rates
- Transport Expense– Rs. A maximum of Rs.1000 per year per hospital, will be provided as transportation expenses to all the beneficiaries.
How to claim settlement under RSBY
After the hospital pays the beneficiaries transportation and medical bills, hospitals are required to send an electronic report to the insurer / third party administrator (TPA). The insurer / TPA will go through the verification information it sends to the hospital authority. Payment will be made to the hospital within the specified time period after successful verification.