Medical Scheme for BPL Families

As the name suggests, Rashtriya Swasthya Bima Yojana is a medical health insurance scheme which has been brought out by the Ministry of Labor, Government of India to benefit the families which are below the poverty line. The objective of Rashtriya Swasthya Bima Yojana is to provide protection against financial liabilities which arise out of health issues where hospitalization is required for poor people in India. Under this medi claim program, the beneficiaries are entitled up to Rs. 30,000 of hospitalization coverage for several diseases where hospitalization is needed. This health insurance India program was started in April 2008. At the end of 2011, more than 26 million smart cards have been issued till date and up to more than 3 million hospitalized cases have been registered.

This health insurance India program has various advantages such as acceptance of preexisting conditions, no age limit, coverage for up to five members in a single family with couple and three dependents. The beneficiaries of this medi claim plan will only have to pay Rs.30/- to register while the state government and the central government shall pay the premiums to the insurance companies assigned to offer health cover. The central government provides 75% of the finance in all the states and the respective state governments contribute the rest of the amounts. While for north-eastern states and Jammu and Kashmir, the central government of India will pay 90% of the finance and these state governments have to contribute only 10% of the remaining finance.

One of the major features of this health insurance India program is that it has been designed as business model where proper measures have been taken to ensure that various stakeholders such as the central government, state government, insurance companies, intermediaries and hospitals do not face any losses in the long run.

For cost reduction, an extensive help of information technology is being used which includes the introduction of smart cards which are given to the beneficiaries, hospitals equipped with biometric systems and computers connected to the servers which provide information at the district level. The introduction of information technology has helped in significant cost reduction thanks to the minimal usage of paper.

This health insurance India scheme comes with the advantage of portability which means that an individual can get treatment any hospital in India where the RSBY Smart card is accepted.

This medi claim program has been equipped with a high level monitoring system which monitors every activity and transaction which takes place and ensures that the program is running smoothly.