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Bhamashah Swasthya Bima Yojana Scheme (BSBY): Objectives, application process and benefits

Team AckoFeb 27, 2024

As per the 2011 Socio-Economic Census, 26.17% of Rajasthan’s population live on daily wages and don’t own a house. The availability of quality healthcare is one of the struggles these families face. The State Government introduced the Bhamashah Swasthya Bima Yojana to combat such issues. In this article, you will learn how to enrol under this scheme and get the benefits.

Contents

What is Bhamashah Swasthya Bima Yojana (BSBY)?
Bhamashah Health Insurance Scheme Features
Benefits of Bhamashah Swasthya Bima Yojana Scheme
Objectives of Bhamashah Swasthya Bima Yojana Scheme
Eligibility criteria for Bhamashah Swasthya Bima Yojana
Bhamashah Swasthya Bima Yojana application process
What's covered and what's not covered under Bhamashah Swasthya Bima Yojana
How to Make a Claim Under Bhamashah Swasthya Bima Yojana
- Required documents
How to download a Bhamashah Card
- Benefits of Bhamashah Card
Activating Bhamashah Health Insurance Cards
How to Edit the Bhamashah Card Online
How to Update Bhamashah Card Bank Account
List of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana Medical Packages
Customer Helpline Number Contact Details
The Bottom Line
Frequently Asked Questions (FAQs)

What is Bhamashah Swasthya Bima Yojana (BSBY)?

Bhamashah Swasthya Bima Yojana was a programme created by the State Government of Rajasthan and introduced on December 13, 2015, with a focus on the people of Rajasthan. Families eligible for benefits under the National Food Security Act (NFSA) and Rashtriya Swasthya Bima Yojana (RSBY) can sign up for the programme. The new name for Bhamashah Swasthya Bima Yojana Scheme is Ayushman Bharat Mahatma Gandhi Health Insurance Scheme. The scheme now includes the Socio-Economic Census families as well. This has increased the scope of the program.

This scheme offers cashless health insurance benefits that include coverage of up to Rs. 5 lakhs for regular medical treatment and Rs. 5 lakhs for life-threatening ailments to its beneficiaries. To receive the advantages of coverage, the families covered by the insurance on a floating basis must pay a set premium each year.

Bhamashah Health Insurance Scheme Features

The Bhamashah Swasthya Bima Yojana scheme for below-poverty-line families in Rajasthan has some notable features, including:

Coverage of pre and post-hospitalisation medical expenses incurred before and after admission.
Cashless treatment facility enabled through an extensive network of empanelled hospitals.
No age limit restrictions - eligibility for enrollment is open to all members of a family.
Inclusion of 7 days pre and 15 days post-admission expenses under insurance cover.
Single-family floater policy covering hospitalisation costs of all enrolled family members.
Cover provided for a wide variety of treatments, surgical procedures and medical packages.
Miscellaneous hospital expenses like devices, supplies, meals, etc., also accounted for.

Benefits of Bhamashah Swasthya Bima Yojana Scheme

Benefits from the Bhamashah Yojana are credited directly to the account of the female head of the family. Here are detailed benefits that the scheme provides.

The benefits are transferred directly, ensuring maximum transparency and reducing the likelihood of fund degradation allocated under the scheme.
It pays out a reward of Rs. 2,000 in two instalments to qualified applicants.
For women beneficiaries, the Bhamashah Card acts as a biometric identity verification that allows them to purchase rations from authorised PDS outlets.
The programme also provides an extra 100 rupees for each family member in a home with an active Aadhaar Card.
The Bhamashah Yojana scheme offers economically disadvantaged groups medical insurance for treatment and emergencies costing Rs. 5 lakh.
The Bhamashah Yojana (Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana) has distributed about Rs. 2,600 crores to eligible scheme members. In addition, the Rajasthan State Government has also implemented several other comparable programmes, including the Bhamashah Rojgar Yojana and Bhamashah Swasthya Bima Yojana, to guarantee the state's continual development.

Objectives of Bhamashah Swasthya Bima Yojana Scheme

The main objective of this scheme is to provide insurance coverage to all eligible citizens of Rajasthan. It allows them to avail treatment at any government or private hospital. The citizens of Rajasthan can get medical treatment of up to Rs. 5 lakhs for free without worrying about their finances. Through this scheme, the people of Rajasthan can get access to quality healthcare.

By facilitating cashless treatment for thousands of medical conditions and procedures, the scheme eliminates hefty out-of-pocket expenditure that often lead to treatment issues. Thereby, it protects beneficiaries against catastrophic health events that may push entire households into poverty in case of the materialisation of risks.

Further, through its emphasis on covering costs across an extensive network of public and private hospitals, the scheme enhances the availability and accessibility of quality inpatient services for rural, remote and marginalised communities that otherwise have limited options. Thus, it aims to uplift the overall health standards of the state's vulnerable section in line with its inclusive policy focus.

Eligibility criteria for Bhamashah Swasthya Bima Yojana

Here is a list of people that can enrol under or get benefits from the Bhamashah Swasthya Bima Yojana.

The beneficiary must be a permanent resident of Rajasthan.
To take advantage of this scheme, the beneficiary must have an Aadhaar card and Jan Aadhaar card.
Beneficiaries should be included in the Socio-Economic Survey 2011 eligible families of National Food Security.
Beneficiaries should be from economically low-income families.

Bhamashah Swasthya Bima Yojana application process

Following are the two ways in which you can apply for the Bhamashah Swasthya Bima Yojana.

Bhamashah Swasthya Bima Yojana online application process

Here are the steps to apply for this scheme online.

To begin, go to the Bhamashah Swasthya Bima Yojana Scheme's official website.
You must click the Apply Online option on the home page.
Following that, an application form will appear in front of you.
You must fill out all of the required information on this application form.
Following that, you must attach all relevant documents.
Then click the submit button.

Bhamashah Swasthya Bima Yojana offline application process

Here are the steps to apply for this scheme online.

Personally visit your district's health department and collect the scheme form.
Fill out all of the required information on this form.
Attach all relevant papers to the form.
Submit this form to the Health Department.
You will then be able to apply for the Ayushman Bharat Mahatma Gandhi Swasthya Bima Yojana (Bhamashah Swasthya Bima Yojana Scheme).

What's covered and what's not covered under Bhamashah Swasthya Bima Yojana

What's Covered	What's Not Covered
Pre and Post-Hospitalization	- Non-members of NFSA and RSBY not covered
- Medical expenses 7 days prior to hospitalization	- Non-family members of the scheme not covered
- 15 days of coverage after discharge
Transportation Allowance
- ₹100 - ₹500 transportation allowance for cardiac and polytrauma cases
Cashless Treatment
- Cashless facility for secondary and tertiary medical treatment
- Coverage for OPD cases
Pre-Existing Ailments
- Coverage for most pre-existing conditions
Secures Against Critical Diseases
- ₹3 Lakhs coverage for critical ailments
Covers General Illnesses
- ₹30,000 coverage for general illnesses
Other Inclusions
- Cover for expenses such as nursing charges, room rent, food for the beneficiary, consultation fees, and more

How to Make a Claim Under Bhamashah Swasthya Bima Yojana

Show your Bhamashah card and ID proof to the hospital. (network hospital is a must)
Insurance provider will authorize the amount.
Hospital will share the bills and receipts with the insurance company
Claims will be settled directly with the company

Required documents

You will need the following documents to enrol for the Bhamashah Swasthya Bima Yojana.

Aadhar card
Jan Aadhar Card
Ration card
Income certificate
Proof of residence
Proof of age
Passport size photograph
Mobile number

How to download a Bhamashah Card

If you want to get a Bhamashah card, you must first register with the Rajasthan SSO portal. You can also download a Rajasthan Bhamashah e-card from any SSO centre. Here are the steps to download the Bhamashah Card.

1. Log in to your SSO account. You will see a Citizen App link on the left side.

2. When you select the Bhamashah option from the Citizen App, the Bhamashah e-card option will appear.

3. By selecting this option, you can easily download the Bhamashah card by entering all the necessary details.

Benefits of Bhamashah Card

All qualified candidates will be given Bhamashah Cards connected to the female beneficiary's bank account. The following advantages are offered to the beneficiaries and their family members.

Student education scholarships
Loan for starting a business
Helping women undergo professional training to begin a career.
Free surgeries and medical care available at government-approved institutions for some medical conditions
Bhamashah Card acts as an ID card necessary to get discounted or free rations. It also offers beneficiaries a variety of monetary advantages that are sent directly into bank accounts. Additionally, you can use the card for core banking services and biometric identification.

Activating Bhamashah Health Insurance Cards

To activate cards under the Bhamashah Swasthya Bima Yojana scheme, beneficiaries must complete these key steps:

First, you need to register and enrol on the scheme by filling out an online form.
After registration, locate the citizen enrollment option and enter your reference ID to pull up details.
Then verify and submit personal and contact information in the enrollment form displayed.
On successful form submission, note down the system-generated enrollment receipt number for future usage.

How to Edit the Bhamashah Card Online

Click on Rajasthan SSO portal (https://sso.rajasthan.gov.in/register)
Login using your SSOID and password.
Choose ‘Edit’ option
Make and save the changes

How to Update Bhamashah Card Bank Account

With an eMitra account your Bhamashah card bank account can be updated.

Login to your eMitra account
Select ‘Bank Details’.
Enter Bhamashah receipt number, your bank account details will be visible.
Make the necessary changes and save them

List of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana Medical Packages

Medical Package	Medical Specialty
Septoplasty + FESS	ENT
Appendicectomy	General Surgery
Prolapse Uterus LeFort's	Gynecology
Lensectomy + Vitrectomy	Ophthalmology
Pacemaker implantation Temporary	Cardiology & CTVS
Pneumonectomy	Chest Surgery
Fistulectomy	Dentistry
Colonoscopy with Biopsy	Gastroenterology
Chelation Therapy for Thalassemia Major	General Medicine
Pemetrexed	Medical Oncology

Customer Helpline Number Contact Details

Dr. Vikram Singh, Consultant:
[email protected]
9529963867

Ms. Aachu Agrawal, Programme Officer, BSBY
[email protected]
8764848541

Sh. M.P Jain, SNO(M), BSBY
[email protected]
9414057269

Sh. Buddhi Vardhan, Programme Officer
[email protected]
8146545515

Ms. Priyanka Kapoor, SNO(P), BSBY
[email protected]
9414063905

The Bottom Line

The Bhamashah Swasthya Bima Yojana (now known as Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana) represents a significant stride towards enhancing healthcare accessibility and affordability for the economically vulnerable sections of Rajasthan's population. With its comprehensive coverage, including cashless treatment for up to Rs. 5 lakhs for regular medical treatment and an additional Rs. 5 lakhs for life-threatening ailments, the scheme ensures that financial constraints do not hinder access to necessary medical care.

Frequently Asked Questions (FAQs)

Here are some common questions and answers about the Bhamashah Swasthya Bima Yojana Scheme.

What is the Bhamashah Swasthya Bima Yojana (BSBY)?

Bhamashah Swasthya Bima Yojana is a health insurance scheme introduced by the Government of Rajasthan to provide quality healthcare to eligible citizens.

Who is eligible for Bhamashah Swasthya Bima Yojana?

Eligible beneficiaries include permanent residents of Rajasthan who have Aadhaar and Jan Aadhaar cards and are from economically low-income backgrounds.

How do I apply for Bhamashah Swasthya Bima Yojana?

You can apply online through the official website or visit your district's health department to apply offline.

What is covered under the Bhamashah Swasthya Bima Yojana?

The scheme covers pre and post-hospitalisation expenses, transportation allowance, cashless treatment, pre-existing ailments, critical diseases, general illnesses, and various medical packages.

How do I claim under the Bhamashah Swasthya Bima Yojana?

Show your Bhamashah card and ID proof to a network hospital, and the insurance provider will authorise the amount. The hospital will then share bills and receipts with the insurance company, and claims will be settled directly.

Are there any camps for Bhamashah Swasthya Bima Yojana Scheme enrollment?

Yes, for individuals interested in the Bhamashah Card Offline Enrollment, the government will set up two three-day camps at Gram Panchayats, as well as permanent centres at Raj Sampark Bharat Nirman Seva Kendra and Panchayat Samitis. You can visit these offices to complete the enrollment process offline.

What do secondary and tertiary diseases indicate in terms of Bhamashah Swasthya Bima Yojana?

In terms of Bhamashah Swasthya Bima Yojana, secondary diseases are ordinary health problems such as tooth extraction, fractures, tonsillectomy, and so on. Whereas, tertiary diseases are issues related to serious illnesses such as lung injury, Thyroplasty, Colonoscopy, etc.

How to check the eligibility of the Ayushman Bharat Mahatma Gandhi Health Insurance scheme?

Here are the steps to check the eligibility of this health insurance scheme.

Visit the official Public Information website.
Then click on the scheme eligibility link on the home page.
Select Ayushman Bharat Mahatma Gandhi Health Insurance. Here You will see the eligibility criteria.

How to update my Bhamashah Card bank account details?

You can update the bank account details for your Bhamashah Card by visiting the scheme’s official website.

What are the coverages of the Bhamashah Swasthya Bima Yojana?

In addition to the expenses incurred during hospitalisation, the expenses from 7 days before admission, i.e. pre-hospitalisation and 15 days after discharge, i.e. post-hospitalisation are covered. 1,715 diseases are covered in this scheme. Additionally, more than 300 speciality treatments, including psychiatry, gastrology, nephrology, and neurology, are also included.

Source:

https://secc.gov.in/getAllHhdSummaryStateReport.htm/08

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet, and is subject to changes.