Rashtriya Swasthya Bima Yojana

RSBY Logo

Rashtriya Swasthya Bima Yojana (RSBY) is a government-run health insurance scheme in India aimed at providing health insurance coverage to the below poverty line (BPL) families. Launched in 2008 by the Ministry of Labour and Employment, RSBY was designed to protect these families from financial liabilities arising out of health shocks that involve hospitalization. The scheme has been pivotal in facilitating access to quality medical care for the poor, thereby reducing their out-of-pocket expenditure on healthcare.

Overview

RSBY provides for cashless insurance for hospitalization in public as well as private hospitals. Each enrolled family under the scheme is entitled to coverage up to Rs. 30,000 per annum for most of the diseases that require hospitalization. The scheme covers five members of a family, including the head of the family, spouse, and up to three dependents. Beneficiaries under RSBY are issued biometric-enabled smart cards that are used to access health services and hospitalization benefits across the country.

Eligibility

The primary beneficiaries of RSBY are families that fall under the BPL category. The identification of these families is carried out by the state governments through a predefined criteria. Migrant workers and their families are also covered under RSBY, making it one of the few schemes to explicitly consider the health insurance needs of this marginalized group.

Implementation

The implementation of RSBY involves multiple stakeholders, including the central and state governments, insurance companies, and healthcare providers. The central government provides funding and guidance, while the state governments are responsible for the scheme's implementation at the ground level. Private and public insurance companies, selected through a bidding process, administer the insurance coverage. Healthcare providers are empaneled after meeting certain criteria set by the government, ensuring beneficiaries have access to a wide network of hospitals.

Impact

RSBY has been recognized for its innovative approach to providing health insurance to the poor. It has significantly increased the number of people with access to healthcare services, reducing their financial burden. Studies have shown improvements in the utilization of healthcare services among the enrolled families, indicating the scheme's effectiveness in achieving its objectives.

Challenges

Despite its successes, RSBY faces several challenges. These include issues related to the enrollment process, delays in the issuance of smart cards, fraud, and the quality of healthcare services provided. Ensuring the sustainability of the scheme, given its financial implications for the government, remains a critical concern.

Future Directions

The future of RSBY is geared towards expansion and integration with other health insurance schemes under the umbrella of the Ayushman Bharat program. This integration aims to create a more comprehensive health insurance ecosystem in India, addressing the needs of a broader population beyond the BPL families.