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Bhamashah Swasthya Bima Yojana is a family floater health insurance scheme designed and launched by the government of Rajasthan to ensure comprehensive health insurance coverage, especially for the economically weaker section of society.
This is an initiative introduced by the Rajasthan State Government. It was launched back in 2015 for the benefit of the people of the state. However, the current name of this initiative is Ayushman Bharat Mahatma Gandhi (ABMG) Health Insurance Scheme. The scope of this scheme has been enhanced with the inclusion of the families of the socio-economic census.
This scheme is noted for offering cashless health insurance facilities allowing coverage of up to INR 5 lakhs for generic health ailments and INR 5 lakhs for critical illnesses for the beneficiaries. To enjoy uninterrupted family floater health insurance coverage, you must ensure to pay a fixed premium every year.
To get enrolled under Bhamashah Swasthya Bima Yojana, you need to fulfill the following criteria:
• The beneficiary must be a permanent citizen of Rajasthan.
• The concerned beneficiary must be a holder of Jan's Aadhaar card and Aadhaar card.
• The beneficiary must be included in the Socio-economic Survey of 2011 for eligible families under NFS.
• The beneficiaries must belong to the economically weaker section of the society.
As designed for the BPL families of Rajasthan, some of the salient features of the BSBY include:
BSBY allows pre- and post-hospitalisation expenses of up to 7 and 15 days respectively.
BSBY allows cashless treatment facilities across a wide network of listed and impanelled hospitals.
There are no age criteria for enrolling under this scheme.
This offers family floater coverage allowing hospitalization cost coverage for all the family members who are enrolled.
It covers several types of treatments, medical packages, and surgical procedures.
It also covers hospitalization expenses like meals, supplies, devices, etc.
Some of the most highlighting benefits of the Bhamashah Swasthya Bima Yojana include:
The benefits are directly transferred to ensure optimum transparency and eventually reduce the possibility of degradation of the fund that is allocated.
Qualified applicants receive a reward of INR 2000 in two parts.
There is a special biometric card identity verification for the women beneficiaries. It allows them to acquire rations from qualified PDS outlets.
BSBY pays an additional INR 100 for every family member in a family holds an active and genuine Aadhaar card.
This scheme allows comprehensive medical insurance coverage for the economically backward section of society.
This scheme has distributed over INR 2600 crores to its eligible beneficiaries.
BSBY was launched with certain clear motives and objectives. Some of the most intriguing objectives of this scheme include:
The principal objective of BSBY is to offer comprehensive health insurance coverage for economically weaker people across Rajasthan. The beneficiaries can avail of free medical treatment up to INR 5 lakhs.
BSBY allows quality healthcare treatment for a variety of ailments, eventually reducing OUP expenses to an extent, especially for the BPL people.
This scheme allows easy accessibility to quality healthcare services across the state for financially backward people. It is targeted to uplift the treatment standards across the state for the common people.
BSBY covers the following medical expenses:
▪ Pre- and post-hospitalization expenses of up to 7 and 15 days respectively
▪ Transportation allowance of up to INR 100- INR 500 for polytrauma and cardiac cases
▪ Cashless facility for secondary and tertiary medical treatment
▪ OPD coverage
▪ Allows PED coverage
▪ Allows INR 3 lakh coverage for critical ailments
▪ Allows INR 30000 coverage for general ailments
▪ Allows coverage for room rent, nursing charges, food for the concerned beneficiary, consultation charges, etc.
Some of the typical exclusions of the BSBY scheme are:
▪ Any individual who is not a member of the NFSA and BSBY is not covered.
▪ Non-family members of the concerned scheme do not get any coverage.
You can avail of BSBY coverage using both online and offline methods:
◦ First, visit the official BSBY website.
◦ Click on the “Apply online” tab present on the home page.
◦ Fill out the application form that opens with relevant and true information as necessary.
◦ Attach all the relevant documents.
◦ The “Submit” tab needs to be clicked to complete the transaction.
◦ Physically visit the health department office of the district to collect the relevant scheme form.
◦ Duly fill in the form with relevant information.
◦ Attach all the necessary papers.
◦ Submit all the documents to the health department to complete the application procedure.
If you need to download a genuine BSBY card, you need to first complete registration under the SSO portal of Rajasthan. You must follow these simple steps:
• Log in to the designated SSO account to find the link to the Citizen App on the extreme left.
• Select the Bahamashah option in your mobile application and the option of the BSBY e-card will appear.
• Enter all the relevant details to download the card.
To activate the health insurance card under the BSBY scheme, you must follow these steps:
• Fill out the online form for registration and enrolment under the scheme.
• After this, seek the citizen enrolment option to enter the reference ID to acquire the details.
• You need to first verify and then submit relevant information as required on the enrolment form.
• Note the auto-generated number of the enrolment receipt for your future reference.
To edit a Bhamashah Swasthya Bima Yojana card online, you must:
• Visit the official Rajasthan SSO portal.
• Log in using your designated SSO ID and password.
• Select the “edit” option.
• Make the necessary alterations and then save.
You can easily update a BSBY card bank account using a valid eMitra account:
• Log in to the relevant eMitra account.
• Select the “bank details” option.
• Enter the BSBY receipt number and the details of the bank account will be displayed.
• Make the relevant alterations and save.
• Show your ID proof and Bhamashah Swasthya Bima Yojana card to the network hospital.
• The insurer will authorise the designated amount.
• The concerned hospital will share all the bills and reports with the insurer.
• The company will directly settle the claim.
The list of medical packages under BSBY includes:
• FESS+septoplasty
• Appendicectomy
• LeFort’s uterus prolapse
• Vitrectomy+lensectomy
• Temporary pacemaker implantation
• Pneumonectomy
• Fistulectomy
• Colonoscopy with biopsy
• Pemetrexed
• Chelation therapy for major thalassemia.
1. Dr. Vikram Singh bsbyraj@yahoo.com | 9529963867
2. Ms. Achu Agarwal, Programme Officer, BSBY bsbyraj@yahoo.com | 8764848541
Bhamashah Swasthya Bima Yojana has been launched to relieve the financial pressure on poor people while getting quality medical treatment. This comprehensive health insurance scheme acts as a boon for economically weaker people.
Rajasthan’s permanent residents with valid Jan Aadhaar cards and Aadhaar cards belonging to the background of low-income groups are eligible for this scheme.
Yes, respective Gram Panchayats hold these temporary camps while Panchayat Samitis and Raj Sampark Bharat Nirman Seva Kendra hold permanent centres.
Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.
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