Background and Scheme Objective
With a dramatic increase in population through the early years of this millennium, and a lack of corresponding growth in employment opportunities and wealth, it became evident that social security and healthcare for all was a pressing demand. According to reports from the early 2000's, about 93 percent of the work force of the country was employed with the unorganized sector. While many of these workers were already below poverty line (BPL), the occurrence of ailments and hospitalization costs sapped the people of whatever little wealth they had. Despite widespread availability of medical facilities, quality healthcare costs in the country have remained high.
In order to address this concern, the government of India had enacted the Unorganized Workers Social Security Act in 2008. The act made it incumbent on the government of India to provide for the welfare of workers in the unorganized sectors. In an effort to compensate these workers for their out-of-pocket (OOP) health expenses, the government launched the Rashtriya Swasthya Bima Yojana (RSBY) in 2008. The RSBY is a health insurance scheme for families living below the poverty line.
The main objectives of the RSBY as outlined in the scheme website are as follows -
- To provide financial protection against catastrophic health costs by reducing OOP;
- To improve access to quality healthcare for below poverty line households of pocket expenditure for hospitalization and other vulnerable groups in the unorganized sector.
- MNREGA workers who have been employed for over 15 days in the previous financial year
- Domestic helpers and workers
- Sanitation workers
- Miners and mine workers
- Rickshaw pullers and auto and taxi drivers
- Street vendors and railway porters
- Every BPL family holding a valid ration card may enrol to avail the insurance benefits as extended by the scheme;
- INR 30 will be charged as a one time registration fee;
- Upto 5 members of the family including one head of household, spouse and three dependent persons (children or parents) may be covered under the insurance scheme;
- Each family is entitled to claim (cashless) inpatient medical care up to INR 30,000 per annum;
- The hospitalization may be done in any of the empanelled hospitals;
- Pre existing ailments will be covered from Day 1 of the enrolment;
- Each family may also claim transport expenses of INR 100 per hospitalisation subject to a maximum of INR 1000 per family per annum.
