Who is Eligible for Bhamashah Swasthya Bima Yojana?

BSBY Explained: Eligibility, Coverage & How to Apply for Free Treatment

The Indian government, particularly Rajasthan, has launched various schemes to improve medical facilities to support disadvantaged and low-income families. One of the most significant initiatives in this direction is the Bhamashah Swasthya Bima Yojana (BSBY). Bhamashah health insurance scheme has been started on December 13,2015

The Rajasthan government introduced this health insurance scheme to provide free, quality medical care services for those in need. But a common question arises: Who is eligible for Bhamashah Swasthya Bima Yojana? Read ahead to understand the eligibility criteria for BSBY, its benefits, and other details.

Eligibility Criteria for Bhamashah Swasthya Bima Yojana

To take advantage of the scheme, individuals or families must meet specific eligibility criteria set by the Rajasthan government. The main eligibility rules are outlined below:

1  Resident of Rajasthan

To be eligible for the BSBY, the applicant must be a permanent resident of Rajasthan. This scheme is exclusively for individuals from Rajasthan; those from other states are not eligible to apply, even if they temporarily live there.

2  Registered under the National Food Security Act (NFSA)

The essential eligibility requirement is that the family must be registered under the National Food Security Act (NFSA). NFSA cardholders are automatically enrolled in the Bhamashah Swasthya Bima Yojana.

The NFSA provides subsidized food grains to economically disadvantaged families. As these families often struggle the most with medical expenses, linking the BSBY with the NFSA ensures the scheme reaches those who need it the most.

3  Bhamashah Card Holders

BSBY is directly linked to the Bhamashah Card, an identity card issued under the Bhamashah Yojana that contains the family's financial and demographic details. The family must hold a valid Bhamashah card to claim the benefits under BSBY.

The card is used to verify and authenticate beneficiaries at hospitals and for digital record-keeping. Without the card, access to benefits may not be possible.

4  Families Below Poverty Line (BPL)

Apart from NFSA recipients, there are also families who qualify as part of the Below Poverty Line (BPL) group. This includes families identified as economically weaker through official surveys and government-designated criteria. Inclusion as a BSBY is mandatory.

5  Eligible Government Employees (Limited Cases)

While BSBY mainly targets the underprivileged, specific notifications might also cover some categories of low-ranking government employees who do not receive medical allowances. However, this eligibility is limited and not universal across all government employees.

6  Specific Social Categories

The scheme also includes marginalized groups such as impoverished women, elderly citizens without support, widows, and people with disabilities, particularly those enrolled in specific government welfare programs. These individuals are predominantly included in state-sponsored social security initiatives and are, therefore, automatically considered eligible for BSBY.

Who Is Not Eligible for BSBY?

While the scheme aims to be inclusive, there are specific groups that are not covered under BSBY:

• People from non-NFSA households who are not part of any of the other eligible categories
• Income taxpayers and those categorized under the above poverty line (APL), unless specially notified
• People who already have private insurance may not be eligible unless they also fall under one of the eligible groups.
• Government employees and their dependents are typically covered under government medical reimbursement schemes and, hence, are not eligible for BSBY.

How do you Check Eligibility for Bhamashah Swasthya Bima Yojana?

You can check your eligibility through:

1. BSBY Official Portal:Visit BSBY Official Portal.
2. Jan Aadhaar Portal:If you have a Jan Aadhaar number, use it to verify your scheme eligibility.
3. Hospital Kiosk/Help Desk:Empanelled hospitals have BSBY help desks to check eligibility and provide assistance.
4. E-Mitra Centers:Rajasthan’s e-governance kiosks provide eligibility checks and card registration services.

Documents Required for Availing Benefits

Eligibility must be supported by appropriate documentation. The documents listed below are typically required:

• Bhamashah card (or Jan Aadhaar card, as per updated state policy)
• NFSA ration card or RSBY smart card
• The Aadhaar card of the beneficiary
• Government-approved ID proof (like voter ID, PAN, etc.)
• Recent passport-size photographs

Benefits to the Eligible Families of BSBY

Eligible beneficiaries under BSBY can claim the following benefits:

• Cashless treatment is offered by the government and empanelled private hospitals.
• Coverage for general illnesses up to Rs. 30,000 per family annually.
• Coverage of up to Rs. 3 lakhs for critical illnesses.
• Coverage for 1,715 diseases, including emergency procedures and medical, surgical, and maternity procedures.
• Pre- and post-hospitalization fees are included.
• Free treatment for road accident victims, regardless of eligibility, in case of emergencies.
• It is a scheme to provide cashless facilities to IPD patients.
• Every eligible family is being provided 30,000 rupees for general ailments every year and Rs. 3 lakhs for critical illnesses.
• Additionally, for expenses incurred during hospitalisation, expenditure up to 7 days before and 15 days after the hospitalisation has also been included.
• Mou has been signed with New India Insurance for Bhamashah Scheme.
• In this plan, 1715 diseases have been included. New packages of more than 300 speciality treatments will also be added, including Nephrology, Gestrology, Neurology and Psychiatry.
• Prior to Bhamashah Scheme, only medicines and checks were available in cash in the ongoing schemes, but now in the Bhamashah health insurance scheme all the checks, treatment, doctor's fees, operations etc. have been included.

The Bhamashah Swasthya Bima Yojana is a powerful welfare initiative that has brought quality healthcare within reach of thousands of underprivileged families in Rajasthan.

If you or someone you know falls into one of the eligible categories, it is highly recommended that you register and ensure you make use of the scheme’s benefits. Access to timely medical care can make all the difference, and BSBY aims to deliver that promise to the doorstep of every eligible family in Rajasthan.