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Home / IAS Preparation / Government Schemes of India / Rashtriya Swasthya Bima Yojana

Rashtriya Swasthya Bima Yojana (RSBY) - Vision, Objectives, Features, Eligibility, Benefits & Issues

Last Updated on Nov 11, 2024
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Rashtriya Swasthya Bima Yojana (RSBY) is a health insurance scheme for below-poverty-line (BPL) families in India. The scheme was launched in 2008 by the Ministry of Labour and Employment, Government of India. RSBY provides cashless hospitalization cover of up to ₹30,000 per family per year. The scheme is implemented by state governments and union territories.

The topic of Rashtriya Swasthya Bima Yojana (RSBY) is an important topic for UPSC Exam under General Studies Paper 2 in UPSC CSE Mains. The scheme comes under the topic ‘Welfare Schemes for Vulnerable Sections’, and it also is an important topic for UPSC Prelims Exam. We are going to cover the scheme holistically, its objectives, details, coverage, and issues related to it.

Also, read about Swachh Bharat Abhiyaan here!

Latest News about Rashtriya Swasthya Bima Yojana (RSBY)

The scheme has extended coverage to about 50 crore Indians throughout the country and is now providing quality healthcare to underprivileged citizens. The process involves total cashless transactions from beneficiaries to hospitals.

What is the Rashtriya Swasthya Bima Yojana?

Rashtriya Swasthya Bima Yojana (RSBY) is a National Health Insurance scheme launched by the Government of India. The scheme aims to provide cashless insurance to vulnerable sections of society with free treatment in a list of hospitals. It is a scheme for people from the unorganized sector who can’t afford quality healthcare. 

Launch of RSBY

The Rashtriya Swasthya Bima Yojana was launched on 1st April 2008 under the Ministry of Labour and Employment. Later, on 1st April 2015, the scheme was transferred to the Ministry of Health and Family Welfare (MoH&FW).

Control Ministry of RSBY

As discussed previously, the controlling ministry was the Ministry of Labour and Employment, but from 1st April 2015, the scheme came under the purview of the Ministry of Health and Family Welfare.

Vision of RSBY

The vision of the government of India behind this insurance coverage scheme is as follows:

  • To improve access to quality health services to the vulnerable sections of society like people below the poverty line and people working in unorganized sectors like construction laborers and street vendors.
  • It seeks to provide Financial Assistance against fatal health issues to provide equitable health to all country citizens.

Read about the PAT Scheme here!

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Major Objectives of Rashtriya Swasthya Bima Yojana

The major objectives of the Rashtriya Swasthya Bima Yojana are as follows:

  • Protection against hefty health expenses: Health has become a thing of the elites with changing times, and out-of-pocket expenditure has been increasing in the last decades. The insurance scheme by the Government of India provides much-needed protection to vulnerable sections against expensive treatments and medical aid.
  • Quality Health Services to All: Government tries to bring welfare services to various sections of society, and this has also been emphasized by the Directive Principles of State Policy (DPSP) in the Constitution of India. The Constitution directs the State to ensure quality healthcare for all. RSBY improves access to quality healthcare for various sections of society.

Also, read more about the Kusum Scheme.

Features of Rashtriya Swasthya Bima Yojana

Some of the salient features of RSBY include the following:

  • Beneficiaries can avail cashless treatment at any hospital covered under the scheme. They just need to show their RSBY smart card to avail cashless benefits up to the policy limit.
  • The scheme involves very little documentation for enrolment and claims. Beneficiaries just need to show their RSBY smart card for cashless treatment.
  • The annual premium of ₹750 per family is jointly paid by the Central and State Governments. Families just need to pay ₹30 at the time of enrolment/renewal.
  • The scheme does not have any waiting period for pre-existing diseases. Beneficiaries can claim expenses for pre-existing illnesses from day one of the policy.
  • Insurance companies directly credit the payments to the hospitals. It is done electronically for faster claim settlement and transparency.
  • Each enrolled family is provided with an RSBY smart card with photo ID and details of all enrolled members. This card helps easily identify beneficiaries at hospitals.
  • The scheme provides insurance coverage of up to ₹30,000 per family per annum. Newborns are automatically covered.
  • The scheme covers expenses related to cataract operations, dialysis, cardiac stents, etc. It also covers accommodation and nursing expenses during hospitalization.

Rashtriya Swasthya Bima Yojana Smart Card

Applicants are expected to submit photographs and above mentioned documents. The beneficiary is provided with an RSBY Smart Card for his identification. It enables beneficiaries to perform cashless transactions at listed hospitals and provides portability benefits to applicants across the country.

Eligibility for RSBY Scheme

The Eligibility criteria for an individual to apply for a health insurance scheme under RSBY are as follows:

  • Citizenship: The beneficiary needs to be a Citizen of India.
  • Below Poverty Line (BPL) Member: The beneficiary should be listed under the Below Poverty Line (BPL) list with the government of India. The workers from unorganized sectors who are listed are also eligible under this.
  • Welfare Board Member: The beneficiary must be registered with the welfare board.
  • Documents to be submitted: The beneficiary is supposed to submit the following documents in order to register for RSBY: Ration Card, Aadhar Card, BPL Certificate, Income Certificate, Passport size photograph and Address proof. 

Health Expenses Covered and Excluded under the RSBY Scheme

The health insurance programme includes multiple benefits under RSBY Scheme. The healthcare expenses that are covered under the scheme are:

  • Hospitalisation Expenses: Expenses with respect to Disease and Accidents are covered under Hospitalisation Expenses. This includes the Consultation charges of the Doctor, Treatment charges, Medicine Charges, Test charges and Food charges of the patient. These charges cover the holistic treatment of patients in the hospital.
  • Transportation Expenses: The Beneficiary receives an amount of Rs 100 per visit and receives a maximum amount of Rs 1000 per annum for transportation.
  • Day Care Treatment: Day Care Treatment refers to the patient’s treatment within 24 hours. This includes various types of surgery like Ear Surgery, Eye Surgery, Dental Surgery, Radiotherapy, Chemotherapy etc.
  • Pre-Hospitalisation Expenses: Expenses related to various diagnostics and medicines are also included under this Scheme.
  • Post-Hospitalisation Expenses: Surgery and long-term treatment require medicines after hospitalisation. RSBY Scheme includes the post-hospitalisation expenses of the applicant.

RSBY Scheme doesn’t include the following:

  • Expenses related to Substance Abuse, HIV AIDS Treatment, Hormonal Replacement Therapy, Cosmetic Dental Treatments etc.
  • Suicide, Vaccination and Gender Change Treatment.
  • Expenses related to AYUSH.

Key Issues Associated With RSBY
  • Failed at providing Financial Protection: RSBY has seen huge penetration among the targeted sections of people, yet the out-of-pocket expenditure on healthcare slumped over the year, and the insurance scheme has failed in providing the desired financial protection against expensive health expenses.
  • High Hospitalisation Expenses: Over the years, hospitalisation charges have increased in the country, and people have been pushed below the poverty line again and again. The benefits under RSBY haven’t changed the situation of these vulnerable sections.

Click to learn about the National Urban Health Mission here!

Learn about Kisan Credit Card Scheme here!

Current status of Rashtriya Swasthya Bima Yojana

The Rashtriya Swasthya Bima Yojana has covered around 50 crore Indians with its facility to provide cashless insurance for quality healthcare.

Advantages of Rashtriya Swasthya Bima Yojana
  • Beneficiaries in this program get insurance coverage of up to Rs. 30,000 per year on a family floater basis.
  • Coverage extends to a maximum of five family members, including the head of the household, spouse, and up to three dependents.
  • Recipients receive a smart card or swasthya card equipped with biometric functionality.
  • In J&K and Northeastern states, the Central Government covers 90% of the expected annual contribution and 75% of the estimated annual premium.
  • State governments contribute 25% of the total annual premium, with a reduced 10% for J&K and Northeastern states.
  • The program ensures cashless insurance coverage for all medical procedures and hospital stays.
  • Transportation allowances, one day's pre-hospitalization, and five days' post-hospitalization expenses are provided.

Rashtriya Swasthya Bima Yojana: Facts and figures for UPSC
  • RSBY was introduced by the Ministry of Labour and Employment (1st April 2008), but it was later shifted under the Ministry of Health and Family Welfare (1st April 2015). The Scheme became operational in 2008.
  • The Premium cost of Rupees 750 is contributed by both Central and State governments. The Central government contributes 75% of the amount, and the rest 25% is contributed by the state government.
  • The beneficiary who is registered under the scheme is entitled to an amount of Rs 30,000 per year for a list of healthcare expenses covered under the scheme.
  • An applicant is required to pay an amount of Rs 30 for the renewal of the insurance coverage under the scheme.
  • In the case of Jammu and Kashmir, Ladakh and North Eastern states, the contribution of the Central government stands at 90% instead of 75% in the case of other states.

We hope all your doubts regarding RSBY Scheme are cleared. Here at Testbook, we are making a constant endeavour to provide you with the best and most updated study material to keep you ahead with your UPSC IAS exam preparations.

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Rashtriya Swasthya Yojana FAQs

The benefits of RSBY are: Better Coverage, Rs 30,000 insurance cover, All pre-existing diseases included and Hospitalisation charges included with Transportation cost.

A total amount of Rs 30,000 is assured under Rashtriya Swasthya Bima Yojana.

Rashtriya Swasthya Bima Yojana is a Centrally Sponsored Insurance Cover provided to the vulnerable section of society i.e. people below poverty line (BPL).

No, AYUSH is not covered under the RSBY Scheme.

Rashtriya Swasthya Bima Yojana was launched on 1st April 2008.

The RSBY is now provided as Ayushman Bharat Yojana. The Senior Citizen Health Insurance Scheme has now subsumed RSBY under Ayushman Bharat Yojana.
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