Bhamashah Swasthya Bima Yojana

Bhamashah Swasthya Bima Yojana (BSBY) was launched in the State of Rajasthan on 13th December 2015. Second phase (2017-19) of BSBY scheme was launched on Dec 2017.

BSBY is a cashless health insurance scheme provided to the families covered under National Food Security Act (NFSA) and Rashtriya Swasthya Bima Yojana (RSBY).

Benefits

• BSBY scheme provides a coverage of INR 30,000 for general illnesses and INR 300,000 for serious ailments.

• BSBY scheme provides a transportation allowance of INR 100 upon the discharge of the beneficiary, with an annual ceiling of INR 500.

• Provides pre-hospitalisation expenses for seven days and post-hospitalisation expenses for 15 days. 

• All government hospitals and a significant number of private hospitals in the state have enrolled under the scheme.At present (May 2019), 892 private and 519 government hospitals are empanelled under the scheme.

• BSBY scheme covers 1,401 packages/illnesses – 46 reserved for government hospitals, 14 for private, 678 for secondary packages (general illnesses), and 663 for tertiary/critical illnesses.

Eligibility

To avail BSBY, beneficiaries must not only be eligible under NFSA but should also have taken rations at least once in the three months prior to the hospitalisation. If a medical facility is not available in a particular enrolled hospital, the hospital management is responsible to ensure that they contract such facilities so that patients can receive complete coverage under BSBY and do not need to spend out of their own pocket.

Documents Required

• Bhamashah ID card: Every beneficiary family household receives a Bhamashah card, which uses the Aadhaar number. The scheme identifies a woman above the age of 21 as the Mukhiya or the head of the household. If a family does not have a female member above 21 years of age, the oldest male member is appointed as the Bhamashah Mukhiya.

  

  Bhamashah card displays the unique Bhamashah family identity number, which is a unique, random, seven-digit hexadecimal number) along with a photograph, Aadhaar, and bank account details of the Mukhiya. The other side of the card displays the photograph of other family members along with their respective Aadhaar numbers. The Bhamashah card is a simple plastic card and does not hold any beneficiary information in digital form. The card itself cannot be used for any transaction.

• Identity Proof - Hospitals prefer Aadhaar over other IDs because insurance companies prefer Aadhaar verification).

Beneficiary List

Follow the below steps to check whether you are beneficiary of the scheme

• Visit the Official Website of Department of Food, Rajasthan

• Click on "NFSA Report"

• Click on "Report of NFSA and non-NFSA Beneficiary".

• Select your district

• Select your Area

• Select your FPS (Fair Price Shop)

• After that, list of Ration UID will appear on your screen. Search your ration card UID number by the name of the family head.

If your name is available in this list, then you are eligible for the scheme.

Avail BSBY services

• The beneficiary has to give his Bhamashah ID and an ID proof.

• Swasthya Sahayak (health helper) in the hospital will check if the beneficiary has coverage under NFSA and if the beneficiary has taken ration from an FPS dealer in the past three months. If yes, the Swasthya Sahayak verifies the beneficiary through Aadhaar by biometric authentication.

• Beneficiaries can now receive free treatment if their treatment requires hospitalisation for more

  than 24 hours. After the treatment, the beneficiary is required to fill out the feedback form. One copy of the feedback form remains with the hospital, which the hospital authorities upload to the Bhamashah portal. The feedback form accounts for details of the treatment, total expenditure, the total balance left under BSBY, and comments from the patient

• The entire process is completely cashless.

Treatment Coverage

The scheme covers 1,401 packages/illnesses – 46 reserved for government hospitals, 14 for private, 678 for secondary packages (general illnesses), and 663 for tertiary/critical illnesses.

• Visit BSBY website

• Click on BSBY Phase II (2017-19)

• You will see the following page. Now you can check the secondary packages, tertiary packages, packages under government and private hospitals.

Hospital List

The two-year scheme was launched in December 2015, with the second phase (2017-19) commencing in December 2017. At present (May 2019), 892 private and 519 government hospitals are empanelled under the scheme. 

• Visit BSBY website

• Click on Navigation button on the top right side of website.

• Select "List of Empanelled Hospitals". You can download the details about hospital in PDF and Excel format.

• Details include contact number, name and email id of the concerned person in the hospital.

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