The Bhamashah Swasthya Bima Yojana (BSBY) is a health insurance scheme specifically launched for the residents of Rajasthan on 13th December 2015. The scheme was designed by the government of Rajasthan to provide access to the cashless facility to IPD patients living in rural areas. The scheme was set in motion by Vasundhara Raje and provides health benefits of up to Rs. 30,000 for general ailment and Rs. 3, 00,000 for critical disease.
Families covered under the Rashtriya Swasthya Bima Yojana (RSBY) and National Food Security Act (NFSA) can avail benefit from this scheme. The beneficiaries of the scheme can avail of medical facilities at government as well as private network hospitals.
Premium payments for each family are fixed and must be made on an annual basis on floater policy to avail of the coverage benefits.
The insurer for such schemes is often selected via an open competitive public sector insurance company along with a two-stage bidding process. The insurer selected by the Bhamashah Swasthya Bima Yojana is the New India Assurance Co. Ltd. (NIACL). This insurance company offers the most attractive insurance plans with comprehensive features at affordable premiums across the country.
Features of Bhamashah Swasthya Bima Yojana:
In Bhamashah Swasthya Bima Yojana all the medical expenses incurred by the patients are borne by the insurance company and the medical bills are directly settled at the network hospital within the approved package limit. Following are some of the key features of the scheme:
- The main objective of the scheme is to reduce the burden of additional expenses by offering financial cover to customers against diseases.
- The scheme aims to promote and prioritize healthcare by introducing insurance as a potential solution.
- The health insurance scheme supports the vision of minimum government and maximum governance.
- There is no bar on age limit to avail of scheme benefits. Anyone with a BPL card is eligible under this scheme.
- The scheme also targets creating a large health database that can be proved useful in the future during changing or creating new policies.
- The purpose of the scheme is to bring a revolution in the healthcare sector, especially in rural areas by encouraging the private sector to provide medical services while reducing the rapidly increasing concerns on government facilities.
Benefits of Bhamashah Swasthya Bima Yojana:
Bhamashah Health Insurance Scheme offers benefits to beneficiaries of the NFSA and RSBY and the scheme is expected to be implemented via Bhamashah Cards. However, identity information related to RSBY and NFSA must also be honored until the issuance of the Bhamashah card. Some of the key benefits of the Bhamashah Health Insurance Scheme are as follows:
- Beneficiaries will be provided with in-house claims processing software and transparent grading criteria for hospitals.
- Beneficiaries will get access to the mobile application for monitoring all government officials in the district.
- The scheme will help in the removal of third-party administrators and will provide an effective monitoring mechanism for the prevention of cost escalation and leakages.
- Beneficiaries will get the advantage of immediate cost reduction on government health institutions/facilities.
- The scheme will provide an opportunity for the people of the weaker section of society to approach private health institutions for medical services.
- The scheme will help in providing financial aid to the Medicare Relief Societies of Government Health Institutions.
Heath Insurance Covers
- Heath Insurance Cover for common illness Rs. 30,000
- Critical Illness CoverUp to Rs. 3, 00,000
- Pre-hospitalization expenses Cover seven days
- Post-hospitalization expenses Cover fifteen days
- Transportation allowance for polytrauma and cardiac cases is Rs. 100 to Rs. 500
Apart from the above-mentioned benefits, patients eligible under this scheme will also receive 1045 packages to choose from under general disease, 170 packages for government hospitals, and 500 packages under critical illness. The package costs include bed charges, consultancy fees, blood, anesthesia, medical supplies, implants, pathological and radiological tests, along with food for patients during their stay in the hospital.
How to apply for Bhamashah Swasthya Bima Yojana?
Since the Bhamashah Swasthya Bima Yojana is designed to help the poor and needy, the application process will be held offline. To avail of insurance coverage, only manual enrollment is required.
- The applicants interested in the scheme can reach out to any of the network hospitals to seek help.
- Every network health institution will have an appointed individual to help such candidates in filing the application form.
- The candidates are required to bring their documents such as aadhar card, ration card, etc. The appointed individual at the hospital will assist them in filling up the form.
Documents required for the application of Bhamashah Swasthya Bima Yojana
Following is a list of documents required for a claim under Bhamashah Swasthya Bima Yojana:
- Copy of doctors prescription
- Valid photo ID of the patient
- Copy of Ration card or BPL card
- Aadhar card
- Bhimashah card, RSBY card, or NFSA card
- Discharge file
- Copy of investigation report