https://wp-api.bajajfinservhealth.in/wp-content/uploads/2022/04/20-1903x687.jpg

GENERAL HEALTH

Rashtriya Swasthya Bima Yojana : Coverage, Eligibility and 4 Benefits

Rashtriya Swasthya Bima Yojana is a health insurance plan for those in the BPL category

Rashtriya Swasthya Bima Yojana also covers people from unorganized sector

Maternity benefits and dental treatments are available under Swasthya Bima

B
Bajaj Finserv Health
April 29th, 2022
8 mins read

Rashtriya Swasthya Bima Yojana is a national health insurance programme of the government for the citizens of India. This scheme provides health insurance cover to individuals or families who fall below the poverty line or belong to the unorganized sectors [1].

This Swasthya Bima Yojana provides protection against any financial liabilities that may arise as a result of expenses related to healthcare like emergency or planned hospitalization. The policyholders and their family members can receive proper healthcare without facing financial challenges. Read on to know more about this Rashtriya Swasthya Bima Yojana.

Eligibility criteria for availing the RSBY 

Here are the eligibility parameters you need to meet to avail the RSBY scheme.  

  • Members of a family listed below the poverty line list created by the state government can enroll for this scheme   
  • Applicant can be a worker at any unorganized sector

Additional Read: Health Insurance Benefits

Things that are covered under Rashtriya Swasthya Bima Yojana

This scheme offers wide coverage and many benefits that allow for better healthcare for those who need it [2]. The coverage includes:

Dental treatment 

The cost of dental treatments required as a result of any accident are financed under this scheme.

insurance

Hospitalization expenses 

Beneficiaries can enjoy hospitalization coverage for the following: bed charges in general ward, boarding charges, doctor visits, doctor’s consultation fee, blood, medicines, foods for the patient, oxygen, nursing, OT charges, surgeon charges, implants, prosthetic devices, anesthesia, anesthetist’s fee, X-ray and diagnostic tests.

Pre-hospitalization 

This scheme will pay for all costs of diagnostics medicines and tests up to one day before hospitalization.

Post-hospitalization 

The expenses associated with a surgery or ailment for which the beneficiary was hospitalized will be covered for 5 days since the patient gets discharged.

Transportation expenses 

Policyholders are eligible for getting a transport compensation of Rs.100 for every visit to hospital, with an annual cap of Rs.1000.

Daycare treatments 

Daycare treatments are surgical procedures that do not need prolonged hospitalization and can be completed same day. These are also covered by the scheme.

Maternity benefits 

The Swasthya Bima Yojana covers both caesarean and natural deliveries. The beneficiary can avail a compensation of Rs.4500 for caesarean and Rs.2500 for natural delivery. The expenses of involuntary termination of pregnancy will be covered when it is a result of an accident or performed in situations where saving the mother’s life is the priority.

Things not covered under the Rashtriya Swasthya Bima Yojana 

The following features are excluded from the RSBY scheme:  

  • Cost of the tonics or vitamins, unless you take it as part of your doctor’s prescription  
  • AYUSH treatments 
  • Voluntary termination of pregnancy 
  • Dental treatments that are corrective or cosmetic in nature 
  • Any illness caused by substance abuse like excessive use of drugs or alcohol 
  • Sex reassignment surgery
  • Congenital external diseases 
  • Fertility treatments 
  • Cosmetic or plastic surgery, unless done as a part of covered treatment 
  • AIDS/HIV 
  • Vaccinations 
  • Hormone replacement therapy 
  • Suicide 
  • Pre-natal expenses 
  • War

Additional Read: Ayushman Bharat Registration

Benefits of availing the Rashtriya Swasthya Bima Yojana 

Coverage for your family 

Under this scheme, head of the family, spouse and three dependents are covered. So, the coverage is applicable to your whole family and there is no need of separate plans for each family member.

Sum insured 

Beneficiaries can make a maximum claim of Rs.30,000 for the different healthcare expenses included in the policy

No age limits 

You can opt for this swasthya bima at any age

No waiting period 

In most health policies, a policyholder cannot make a claim against certain conditions as specified by the insurance company. This period of time is known as the waiting period. One usually needs to bear the expenses of treatment from their own pocket during the waiting period. Thankfully, RSBY scheme does not have any waiting period.

If you are eligible for Rashtriya Swasthya Bima Yojana, you can avail this scheme via different health insurers. However, if you are not eligible or want more options in health insurance, you can check out the plans under Aarogya Care on Bajaj Finserv Health. Choose from a wide range of packages, and avail benefits like online doctor consultation, preventive healthcare and lab test discounts. You can also sign up for a health card to finance healthcare more affordably!

Rashtriya Swasthya Bima Yojana : Coverage, Eligibility and 4 Benefits-banner

Related Articles

View All

National Dengue Day: 3 Things for You to Learn About Dengue

General Health

National Dengue Day: 3 Things for You to Learn About Dengue

7 mins

International Nurses Day: Role and Importance of Nurses

General Health

International Nurses Day: Role and Importance of Nurses

8 mins

Vitiligo Disease: 4 Vitiligo Treatment Remedies You Can Try

General Health

Vitiligo Disease: 4 Vitiligo Treatment Remedies You Can Try

8 mins

Mother’s Day 2022: 6 Tips To Help Prioritize Mom’s Health

General Health

Mother’s Day 2022: 6 Tips To Help Prioritize Mom’s Health

8 mins

World Thalassemia Day: 4 Important Things You Need to Know

General Health

World Thalassemia Day: 4 Important Things You Need to Know

9 mins

Trending Articles

View All

Total Iron Binding Capacity Test: 5 Important Things to Know

Health Tests

Total Iron Binding Capacity Test: 5 Important Things to Know

9 mins

National Dengue Day: 3 Things for You to Learn About Dengue

General Health

National Dengue Day: 3 Things for You to Learn About Dengue

7 mins

All About Razor Bumps: 4 Easy Razor Bumps Treatment Options

Skin & Hair

All About Razor Bumps: 4 Easy Razor Bumps Treatment Options

8 mins

Vrikshasana or Tree Pose: 6 Benefits of This Yoga Pose

Yoga & Exercise

Vrikshasana or Tree Pose: 6 Benefits of This Yoga Pose

9 mins

6 Watermelon Seeds Benefits That You Should Keep In Mind

Immunity

6 Watermelon Seeds Benefits That You Should Keep In Mind

7 mins

background-banner
Mobile Frame
Download our app

Download the Bajaj Health App

Stay Up-to-date with Health Trends. Read latest blogs on health and wellness. Know More!

Get the link to download the app

+91
Google PlayApp store

CIN

U85320PN2019PLC185286

Registered Office

Bajaj Auto Limited Complex, Mumbai – Pune Road, Akurdi, Pune – 411 035

Corporate Address

Phoenix Fountainhead, 4th floor, Nagar Road, Clover Park, Viman Nagar, Pune, Maharashtra - 411014

© 2021, Bajaj Finserv Health Limited.
All rights reserved.