RSBY provides the participating BPL household with freedom of choice between public and private hospitals and makes him a potential client worth attracting on account of the significant revenues that hospitals stand to earn through the scheme.The RSBY scheme, however, differs from these schemes in several important ways. The RSBY scheme is not the first attempt to provide health insurance to low income workers by the Government in India. The cards shall be handed over in a plastic cover. The process normally takes less than ten minutes. The smart card, along with an information pamphlet, describing the scheme and the list of hospitals, is provided on the spot once the beneficiary has paid the 30 rupee fee and the concerned Government Officer has authenticated the smart card. These stations are equipped by the insurer with the hardware required to collect biometric information (fingerprints) and photographs of the members of the household covered and a printer to print smart cards with a photo. Mobile enrollment stations are set up at local centres (e.g., public schools) in each village. As per the schedule, the BPL list is posted in each village at enrollment station and prominent places prior to the enrollment and the date and location of the enrolment in the village is publicized in advance. An enrollment schedule for each village along with dates is prepared by the insurance company with the help of the district level officials. The administrative and other related cost of administering the scheme would be borne by the respective State GovernmentsĪn electronic list of eligible BPL households is provided to the insurer, using a pre-specified data format.30 per annum as registration/renewal fee. Contribution by respective State Governments: 25% of the annual premium, as well as any additional premium.The cost of smart card will be borne by the Central Government. Contribution by Government of India: 75% of the estimated annual premium of Rs.100 per visit) within an overall limit of Rs. Transportation costs (actual with maximum limit of Rs.All pre-existing diseases to be covered.Hospitalization expenses, taking care of most common illnesses with as few exclusions as possible.Cashless attendance to all covered ailments. 30,000/- per family per annum on a family floater basis. The unroganised sector worker and his family (unit of five) will be covered.However, the State Governments are advised to incorporate at least the following minimum benefits in the package / scheme: The beneficiary shall be eligible for such in - patient health care insurance benefits as would be designed by the respective State Governments based on the requirement of the people/ geographical area. The beneficiaries will be issued smart cards for the purpose of identification.It will be the responsibility of the implementing agencies to verify the eligibility of the unorganized sector workers and his family members who are proposed to be benefited under the scheme.Unorganized sector workers belonging to BPL category and their family members (a family unit of five) shall be the beneficiaries under the scheme.The objective of RSBY is to provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalization. RSBY has been launched by Ministry of Labour and Employment, Government of India to provide health insurance coverage for Below Poverty Line (BPL) families. Till March 25, 2013, the scheme had 34,285,737 Smart Cards and 5,097,128 hospitalization cases. Recognizing the need for providing social security to these workers, the Central Government has introduced the Rashtriya Swasthya Bima Yojana (RSBY). Organizing and administering health insurance, especially in rural areas, is also difficult. The poor are unable or unwilling to take up health insurance because of its cost, or lack of perceived benefits. It has been clearly recognized that health insurance is one way of providing protection to poor households against the risk of health spending leading to poverty. Despite the expansion in the health facilities, illness remains one of the most prevalent causes of human deprivation in India. One of the major insecurities for workers in the unorganized sector is the frequent incidences of illness and need for medical care and hospitalization of such workers and their family members. Majority of the workers are still without any social security coverage. The Government has been implementing some social security measures for certain occupational groups but the coverage is miniscule. The workers in the unorganized sector constitute about 93% of the total work force in the country.
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