Bhamashah Swasthya Bima Yojana (BSBY)

Understanding BSBY: Features, Benefits, and Eligibility

The Rajasthan State Government has introduced the Bhamashah Swasthya Bima Yojana (BSBY) to provide health insurance benefits to the citizens of the state. This scheme, started on 13 December 2015, offers cashless health insurance coverage up to ₹5 lakhs. If a family is eligible for the Rashtriya Bima Yojana (RSBY) or National Food Security Act (NFSA), they can also apply for this scheme.

At present, Socio-Economic Census families are also included in the BSBY scheme, enhancing its scope broadly. With this, the scheme is renamed as the Ayushman Bharat Mahatma Gandhi Swasthya Bima Yojana. Families enrolled in this insurance policy with floating coverage are required to pay a fixed annual premium. Learn more about this scheme below!

Highlights & Perks  of Bhamashah Swasthya Bima Yojana

The notable features and benefits of the BSBY scheme are represented in the table below:

How to Apply for the Bhamashah Swasthya Bima Yojana?

Beneficiaries can follow both the online and offline procedures to apply for BSBY Rajasthan.

The online application process goes as follows:

1. Open the official website of the Rajasthan Medical and Health sector.
2. Select the "Apply Online" option.
3. Enter your basic information on the registration page, such as name, address, contact information, etc.
4. Upload the required documents, such as the domiciliary certificate, BPL (below the poverty line) certificate, etc., to the BSBY portal.
5. Complete the process by double-clicking the "Submit" option.
6. A unique application reference number will be provided as an acknowledgment receipt. It will help you track the Bhamashah status.

Also check: Health Insurance Premium Calculator Online

You can also follow these steps for an offline application:

1. Visit the district health authority's office and collect the application form for BSBY enrollment.
2. Fill out the form with all necessary details and attach your documents.
3. Submit the documents and application form to the concerned authority.
4. They will verify the documents and notify you once you are registered under the Bhamashah Swasthya Bima Yojana.

Note: The offline procedure is time-consuming; it may take a few days or weeks to complete the registration.

What are the eligibility criteria for Applying for BSBY?

Here are some of the criteria that a beneficiary needs to fulfil for Bhamashah Swasthya Bima Card enrollment:

• The applicant must hold a valid Aadhaar Card and Jan's Aadhaar Card.
• You must be a permanent resident of Rajasthan to apply for the BSBY card.
• Members of the economically weaker sections of Rajasthan are only allowed to enrol in BSBY.
• The Socio-economic Survey 2011 must include the applicant as an eligible family under the NFSA.

What are the Inclusions and Exclusions Under BSBY?

Listed below are the coverage offered by BSBY Rajasthan:

• ₹100-500 is provided to the beneficiaries as transport allowance in case of cardiac and polytrauma.
• It covers 7 days of pre-hospitalization costs and 15 days of post-hospitalization expenses of a beneficiary.
• BSBY covers the OPD and PED expenses.
• It provides cashless benefits to treat secondary and tertiary medical conditions.
• A ₹5 Lakh coverage for critical illnesses and ₹30,000 coverage general illnesses is provided under this scheme.
• It also covers the nursing and consultation charges, the concerned beneficiary's food expenses, etc.

Here are the exclusions of the BSBY scheme:

• Individuals who are not included in the RSBY and NFSA scheme are not eligible for BSBY
• If the applicant is not a family member of the NFSA and RSBY scheme, they do not qualify for BSBY card

Also check: Benefits of Health Insurance

What is a Bhamashah Card?

The Rajasthan Government has introduced the Bhamashah card to make the female member of the family their head. Under this scheme, a health card is provided to the senior woman of every family to cover the family members' medical needs. The eligible female member can avail of a personal bank account from the government upon receiving this card.

Financial grants from the government will be transferred to this bank account. The Bhamashah card must be linked to the beneficiary's mobile number through SMS for all transaction-related updates.

How to Claim the Bhamashah Swasthya Bima Yojana Benefits?

Here are the steps to follow while claiming the Bhamashah Swasthya Bima Yojana Benefits:

1. Visit any of the network hospitals for your treatment and produce the BSBY health card.
2. The designated coverage amount will be authorized by the insurer.
3. The hospital will send all the treatment details and bills to the insurance company. 
4. The Bhamashah claim will be directly settled by the insurer.

What Packages are Included Under the BSBY Scheme?

The BSBY, also known as the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana, includes the following medical packages:

• Appendicectomy
• Lensectomy + Vitrectomy
• Septoplasty + FESS
• Pneumonectomy
• Prolapse Uterus LeFort's
• Fistulectomy
• Chelation Therapy for Thalassemia Major
• Pemetrexed
• Pacemaker Implantation Temporary
• Colonoscopy with Biopsy

The following medical speciality packages are included under the BSBY scheme:

• General surgery
• ENT
• Ophthalmology
• Chest surgery
• Gastroenterology
• Gynaecology
• Cardiology & CTVS
• Dentistry
• Medical oncology
• General medicine

The Bhamashah Swasthya Bima Yojana (BSBY) represents a significant step towards improving healthcare accessibility for economically disadvantaged families in Rajasthan. Providing comprehensive health insurance coverage and facilitating cashless treatment options aims to reduce financial barriers associated with healthcare access. This initiative promotes health equity and empowers women by linking benefits to their identity cards.

Also check: Section 80D Deductions

As Rajasthan continues to develop its healthcare infrastructure through programs like BSBY, it sets a precedent for other states in India, aiming to enhance social welfare through effective health insurance schemes