Rashtriya Swasthya Bima Yojana Scheme Guide

Posted on: Oct 29, 2025 | 3 mins | Written by: HDFC ERGO Team

Rashtriya Swasthya Bima Yojana Scheme Guide

Many people live on a limited income, and this makes it difficult for them to access quality healthcare. When there is a medical emergency, they often have to use their savings or skip treatment because they can’t afford the costs. To make healthcare more accessible, the Government of India introduced schemes like the Rashtriya Swasthya Bima Yojana (RSBY), which covered hospital expenses of the eligible families without upfront payment.

What is the Rashtriya Swasthya Bima Yojana (RSBY)?

RSBY, or Rashtriya Swasthya Bima Yojana, is a health insurance scheme started by the Indian government in 2008 to help families with low income, especially those living below the poverty line (BPL). It was designed to make healthcare more affordable for individuals who may not otherwise be able to afford medical treatment.

Under this scheme, a family can get health insurance coverage for hospitalisation and certain medical expenses. The main policyholder, along with up to four family members, can use the benefits. It covers expenses such as hospital stays, pre- and post-hospitalisation costs, specific surgeries, transportation costs, and more.

Features of Rashtriya Swasthya Bima Suraksha (RSBY)

The following are the features of the RSBY scheme:

1. Timely and guaranteed medical help

RSBY was made for families living below the poverty line, to make sure they can get proper medical care when they are sick or injured, without the stress of high hospital bills.

2. Option to select hospitals

Eligible members can get treatment at any RSBY-approved hospital, whether it is a government or private one.

3. No age limit

There is no age restriction under the scheme, so any member of the eligible family can be covered.

4. Smart card and secure system

Each family gets a smart card with biometric details, which makes it easy to access treatment and keeps everything secure. All records are digital, making the process faster and more transparent.

Benefits of Rashtriya Swasthya Bima Yojana (RSBY)

The benefits of the Rashtriya Swasthya Bima Yojana scheme are:

1. Coverage amount

Each enrolled family can get up to INR 30,000 per year to cover medical expenses under the scheme.

2. Covers the whole family

The plan covers up to five members in a family, typically the head of the family, their spouse and three dependents. If a baby is born during the policy period, they can also be added as a beneficiary.

3. Cashless treatment

Beneficiaries can get treatment at empanelled hospitals without paying anything upfront. The hospital expenses are settled directly through the scheme.

4. No waiting period

With RSBY, coverage begins immediately upon enrollment. Beneficiaries can access treatment without any delay, making it easier to get the care they need.

5. Covers pre-existing conditions

RSBY covers illnesses that a person may already have before enrolling, even if they didn’t know about the condition. Moreover, coverage for pre-existing conditions begins from day one, regardless of the person's age.

Eligibility criteria Rashtriya Swasthya Bima Suraksha (RSBY)

To be eligible for the RSBY scheme, the applicant must be:

• Listed in the official Below Poverty Line (BPL) category.

• A worker in the unorganised sector.

• A registered member of a welfare board.

What documents are required for Rashtriya Swasthya Bima Yojana

The following documents are required to enrol in the RSBY scheme:

• Aadhaar card

• Ration card

• BPL card

• Income certificate

• Proof of residence

How to apply for Rashtriya Swasthya Bima Yojana?

The application process includes the following steps:

1. Visit an enrolment camp

Eligible families can enrol at special RSBY enrolment camps set up in their area.

2. Submit required documents

Families must submit documents such as their Aadhaar card, BPL card, and proof of residence for verification.

3. Provide biometric details

Family members will need to give fingerprints, photographs, and other basic details.

4. Pay a small fee

A minimal registration fee (usually INR 30) is required during the enrolment process.

5. Receive the smart card

After verification, a smart card will be issued. This card is needed to access treatment under the scheme.

How to check the Rashtriya Swasthya Bima Yojana status

Once registered, beneficiaries could check their enrollment status and details by visiting the official RSBY website and entering their smart card number or other identification details.

FAQs

1. What is the RSBY scheme?

RSBY (Rashtriya Swasthya Bima Yojana) was a government health insurance scheme for Below Poverty Line (BPL) families. It has now been replaced by the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY), which offers broader and more comprehensive health coverage.

2. Who pays the premiums for the RSBY scheme?

The premium for the RSBY scheme was jointly paid by the central and state governments. Eligible families only had to pay a small registration fee of INR 30 per year.

3. Is the Rashtriya Swasthya Bima Yojana currently active?

The RSBY scheme is no longer active. It has been replaced by the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY), which offers free health insurance to millions of families in India.

Conclusion

The Rashtriya Swasthya Bima Yojana (RSBY) was a crucial government programme that enabled BPL families to access essential medical care without incurring significant medical bills. By signing up for this scheme, many low-income households could afford the treatment they needed. In 2018, RSBY was replaced by the PM-JAY (Pradhan Mantri Jan Arogya Yojana) scheme, which now provides even better coverage and stronger financial support to millions of families across the country.

With healthcare costs rising quickly, it is important to have both health insurance and critical health insurance. While a health insurance plan helps cover your regular medical bills, a critical illness cover can provide extra support if you are diagnosed with a serious illness. Therefore, having both gives you peace of mind when it comes to your health and finances.

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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