Rashtriya Swastha Bima Yojana: All You Need To Know  

The current times have witnessed skyrocketing prices of healthcare facilities. Even the ones who are financially well-off at times find it difficult to pay for hospitalisation with the increasing cost of healthcare. Some underprivileged individuals cannot afford treatments even at government-run hospitals that operate at the lowest possible costs. To tackle these problems and make healthcare facilities accessible to all, the government introduced Rashtriya Swasthya Bima Yojana (RSBY). 

What is Rashtriya Swasthya Bima Yojana (RSBY)? 

RSBY is a government-sponsored programme that ensured individuals belonging to the lower-income strata or below poverty line (BPL) have access to healthcare facilities. It primarily is designed to make healthcare accessible to the underprivileged. The scheme can be classified as a family floater health insurance policy where the entire family can avail benefits under this programme. 

At present, the RashtraSwasthya Bima Yojana is available in the form of Ayushman Bharat Yojana launched by the government of India. It is the world’s largest and completely state-sponsored scheme.

What is the eligibility criteria for RSBY?

For enrollment under the Rashtriya Swasthya Bima Yojana, the applicant needs to meet the following terms – 

  • The employment of the applicant must be in one of the unorganised sectors and belongs to the below poverty line household.
  • Those individuals who are marginally above the poverty line can also apply for coverage under RSBY. Further, those who are registered under welfare boards are also eligible for benefits under this scheme. 

What are the features of RSBY?

  • RSBY offers coverage up to a sum of ₹30,000 for hospitalisation.
  • The premiums are borne by the central as well as the state government. 
  • There is no age limit under the scheme. Thus, it can serve as health insurance for senior citizens meeting the eligibility requirements. 
  • The registration charge for beneficiaries at a meagre amount of ₹30.
  • This scheme aims at lowering the out of pocket expenses in times of medical emergencies for the eligible individuals and their families.
  • Any pre-existing ailments of the beneficiaries are also covered under this scheme. 
  • It is a family floater policy that ensures complete cover for the entire family. 
  • Smart cards are issued to insured individuals that contain biometric details of the insured individual. 

What is excluded from the coverage of RSBY?

  • This scheme is facilitated to provide emergency medical services and thus the following exclusion falls outside the purview of policy cover. 
  • The cost of any vitamins or tonics that are not prescribed by a medical practitioner is not covered under the policy.
  • Cosmetic surgeries or dental treatments are excluded from the scope of the policy. Congenital external diseases are specifically left out. 
  • Illnesses that arise due to substance abuse like alcohol or drugs or other intoxicating substances are not covered by this policy. 
  • Hormone replacement therapy, plastic surgery unless required due to accidents or other treatment is not included.
  • Further, any vaccination required is not covered by the policy.
  • Treatments under AYUSH are also excluded by RSBY.
  • There are further exclusions relating to maternity benefits like prenatal expenses, abortions, and cases where hospitalisation ends 48 hours after delivery are not included under RSBY. 

RSBY is one of the many types of health insurance schemes that are introduced by the government for the welfare of the people. Make sure to take advantage of these schemes and make the best use for ensuring the safety of you and your family. Stay healthy, stay insured!


Paul diverson