RSBY is a health insurance scheme in India that provides cashless insurance coverage of Rs. 30,000 per year for hospitalization to below poverty line families. It was launched in 2008 to provide health insurance to families not covered by other government schemes. The scheme uses smart cards and is funded jointly by the central and state governments. It aims to empower beneficiaries and provide a business model for various stakeholders like insurers, hospitals, and intermediaries. However, there are some shortcomings like unnecessary treatment, lack of primary care coverage, and not accounting for state-specific health needs.

1. Department of Community Medicine
JN Medical College
AMU, Aligarh
TEAM JNMC

2. RASHTRIYA SWASTHYA
BIMA YOJANA (RSBY) –
HEALTH INSURANCE FOR
POOR

3. Before 11th five
year plan health
insurance was
only available to Only 16%
population
 government covered
employees
organised sector
private health
insurance
RSBY started rolling from 1st April 2008.

4. WHAT IS RSBY
 ‘cash-less’
 smart card based
 health insurance
cover of Rs
30,000 per
annum
 each enrolled
family, comprisin
g up to five
individuals.

5. BENEFICIARIES
Originally limited to Below Poverty
Line (BPL) families
building and other construction workers,
MGNREGA beneficiaries, street
vendors, beedi workers, and domestic
workers.
Registration/renewal fee – Rs 30/annum per family
Premium – centre and state in 75:25 ratio.

6. INSURERS HOSPITALS INTERMEDIARIES GOVERNMENT
BUSINESS
MODEL FOR
ALL STAKE
HOLDERS
INFORMATION SAFE AND
TECHNOLOGY
INTENSIVE FOOLPROOF
PUBLIC UNIQUE
HOSPITALS FEATURES
EMPOWERING
THE PORTABILITY
BENEFICIARY
PRIVATE
HOSPITALS ROBUST
CASH LESS AND
MONITORING
PAPER LESS
AND TRANSACTIONS
EVALUATION

7. SHORTCOMINGS
• Unnecessary treatment
• lack of coverage for primary health and out patient
care
• upward escalation towards the secondary level of
patients
• does not take into account state specific variations in
disease profiles and health needs
Intensified Information, Education & Communication
(IEC) activities
Coverage of all the beneficiaries