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RASHTRIYA BIMA

SWASTHYA YOJANA

INDIA …COMPOSITION OF WORKFORCE .

CHARACTERSTICS OF UNORGANIZED SECTOR WORK FORCE  Poor  Self-Employed  Employers  Illiterate  Migratory  Lack not identifiable of skills .

WHY HEALTH INSURANCE? Lack of financial capability amongst the poor  Inadequate Health infrastructure  .

RSBY GOALS Major insecurity for unorganized workers relates to:  Inability to deal with medical emergencies without facing a financial crisis  Heavy expenditure on medical care and hospitalization  Recourse to adequate and competent treatment .

 Provision of Smart Card.SWASTHYA BIMA YOJANA BENEFITS Total sum insured of Rs 30.100 per visit upto maximum of Rs 1000  .000 per BPL family on a family floater basis  Pre-existing diseases to be covered  Coverage of health services related to hospitalization and services of surgical nature which can be provided on a day-care basis  Cashless coverage of all eligible health services.  Transport allowance @ Rs.  Provision of pre and post hospitalization expenses.

IMPLEMENTATION OF THE SCHEME  Identification of Insurance agency  BPL data base  Enrollment of Beneficiaries and Delivery of Smart Card to commence  Empanelment of Government and private institutions  Payment of insurance premium to the insurance service provider.  Delivery of health services .

000 families or more under one group insurance policy in 2005-06 or 2006-07  . designing and implementing large health care schemes  Atleast one year experience in catering Health Insurance of 50.QUALIFICATION OF INSURANCE COMPANY Registered with IRDA  Should have full-fledged establishment with experience in conceptualizing.

etc. like: Atleast 10 inpatient medical beds.  Medical & Surgical facilities alongwith Diagonistic facilities i.WHO CAN PROVIDE HEALTH SERVICES? Both public. ECG. and private health providers could offer services  The service providers should possess specified basic facilities.e. Pathological test.  X-Ray. . including ESI.

FUNDING Contribution by GOI : 75% of the estimated annual premium of Rs 750. 565 per family.  . 30 per annum as Registration Fee/ Renewal Fee  Administrative cost to be borne by the State Government will come from Rs 30 received from beneficiary  Cost of Smart Card to be borne by the Central Government.60 per beneficiary would be available for this purpose. subject to a maximum of Rs.  Beneficiary to pay Rs.  Contribution by the State Governments: 25% of the annual premium and any additional premium beyond Rs 750. An additional amount of Rs.

SMART CARD .

Photograp h of the Head of the Family KFO Confirmation Thumb Impressio n of all members .

SMART CARD REGISTRATION PROCESS RSBY CARD RSBY CARD .

KEY MANAGEMENT SYSTEM Cryptographic keys for encryption of Data  Provided by Government – National Informatics Center   To  prevent generation & issuance of fake cards  To implement & Address PKI On Smart Card Transactions  On Network Data exchange  To ensure security & authenticity of Data .

Go To Hospital Patient Show s Card Go To Docto r After Treatment Again Thumb Impression is Taken and updated in System Advise Hospitalization RSBY COUNTER Verifies Thumb Impression Check Limit and issue Slip Process Card .

Process Overview .

Rajnandgoan and Sarguja . Oriental Insurance company has been selected for implementation in First phase 6 districts  17 . Bilaspur. July  Tenders floated for remaining districts  Nodal Agency being set up  Process for identification of Insurance agency completed.  Smart Card Enrollment has commenced in Durg and Rajnandgoan .Progress so far Scheme being implemented in 6 districts viz. scheduled in Sarguja from 16th July and in Bilaspur around 20th. Bastar ( including Narayanpur). Durg. Raipur.

LET US MAKE IT WORK .………..