National Health Insurance in India: Rashtriya Swasthya Bima Yojana - New Dimensions

New Delhi, Aug 17, 2011 (Washington Bangla Radio / PIB India) The ‘Rashtriya Swasthya Bima Yojana’ for BPL families ( a unit of five)  in Unorganised Sector was launched on 1st October, 2007 and became operational from April 1, 2008.   Under the scheme, smart card based cashless health insurance cover of Rs. 30,000/- per annum on a family floater basis is provided to a BPL family in the organized sector.  The premium is shared on 75:25 basis by Centre and State Government. In case of States of North-East region and Jammu & Kashmir, the premium is shared in the ratio of 90:10.  The scheme provides for portability of smart card by the splitting the card value for migrant workers.

Till July 31, 2011,  27 States/Union Territories have initiated the process to implement the scheme.  Out of these 27 States/ UTs, 25 States namely  Assam, Arunachal Pradesh, Bihar, Chhattisgarh,  Delhi, Goa, Gujarat, Haryana,  Himachal Pradesh, Jharkhand, Karnataka, Kerala, Maharashtra, Manipur, Meghalaya, Mizoram, Nagaland, Orissa, Punjab, Tamilnadu, Tripura, Uttar Pradesh, Uttarakhand, West Bengal and Chandigarh Administration have started issuing smart cards. More than 2.4 crore smart cards have been issued as on July 31, 2011. Remaining States except, Andhra Pradesh and Rajasthan which have their own health insurance schemes, are in the process of implementation of the scheme.

RSBY has been extended to building and other construction workers registered under the Building and other Construction Workers (Regulation of Employment and Condition of Service) Act, 1996 and street vendors, beedi workers, MGNREGA beneficiaries who have worked for more than 15 days during the preceding financial year and Domestic Workers.

The Outlay and target for the year 2011-12 for RSBY for BPL families  and other target groups are as under :-

S.No.

Name of the scheme

Outlay

Target fixed for 2011-12

1

RSBY for BPL families

Rs. 312.42 crore

2.4 crore

2.

Extension of RSBY to  Building and other construction workers

To be met from the cess collected by the Boards constituted under the Building and other construction wokers (RECS), Act, 1996

-

3.

Extension of RSBY Street vendors

Rs. 19.91 crore

4.21 lakh

4.

Extension of RSBY MGREGA workers

Rs. 350

56    lakh

5.

Extension of RSBY Beedi workers

Rs. 62.25 crore

10    lakh

6.

Extension of RSBY Domestic workers

Rs. 350 crore

4.75 lakh


Basic features of the Scheme
·         All the BPL families in the unorganized sector to be covered in five years under the scheme;
·         The Government contributes 75% of the annual premium.  State Governments to contribute 25%.  Administrative cost to be borne by the State Governments. In case of North-East region, the premium is shared in the ratio of 90:10;
·         Beneficiaries are issued Smart Cards;
·         Total sum insured would be Rs. 30,000/- per family per annum on a family floater basis;
·         Cashless transaction;
·         All pre-existing diseases to be covered;
·         Hospitalisation expenses, taking care of most of the illnesses including maternity benefit;
·         Transportation cost of Rs. 100/- per visit with an overall limit of Rs. 1,000/- per annum within the limit of Rs. 30000/- and
·         Projects are prepared by the State Governments and submitted for approval of the Inter-Ministerial Approval and Monitoring Committee constituted by the Central Government.Unique Features Of The Scheme
·         The use of smart card, making the scheme truly cashless as also providing     interoperability to facilitate use by migrant labour;
·         Use of IT applications on such a large scale for the poorest of the poor;
·         Using both public and private service providers for delivering the insurance package;
·         Evolving a business model which could make the scheme sustainable in the   long  run;
·         Seeking contribution for the first time, by way of Registration fee, from the BPL beneficiary with a view to inculcating a sense of ownership in them and
·         No age limit has been prescribed. Hence, senior citizens are also covered.

PIB Features,  with inputs from the Ministry of  Labour and Employment


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