Bhamashah Swasthya Bima Yojana

According to the latest news reports, until September, more than 92.54 lakh families were covered under the Bhamashah Swasthya Bima Yojana. This cashless health insurance policy, which was developed by the State Government of Rajasthan, has done a lot of good.

There are also a lot of other features of this policy that you might be interested to learn. We have formulated a table filled with all of those details. And that table is mentioned below.

There are also many other important features of this policy. These features are:

• One of the most important goals of the Bhamashah Swasthya Bima Yojana is to reduce the financial risk of excess expenditure on healthcare
• The policy is designed to support the vision of maximum governance and minimum government
• To cope with any future policy level changes, a large database was also made with the scheme so any issues or problems can be tackled later
• A mobile application has also been launched by the Rajasthan state government to provide necessary assistance to the people who wish to enroll in the policy. Through this mobile application, it will be also easier for individuals to track the application status through their mobile phones
• There is no applicable upper age limit or a lower age limit to enroll in this policy. Any individual irrespective of his or her age can enroll in this policy and enjoy its benefits
• The Bhamashah card is issued by the Government of Rajasthan. Every policyholder and insured would need the Bhamashah card to be able to avail of the policy benefits
• Before making a claim, the applicants must have an Aadhaar card. This is because an Aadhar code would be sent to the individual at the time of registration. This is necessary at the time of enrollment
• All prospective policyholders are required to submit copies of their ration cards while making submitting an enrollment application for this policy
• All prospective applicants are also required to submit their BPL cards as well during enrollment. This is a necessary step as only the people who fall in the BPL category or those who fall in the BPL category and live in a rural area will be eligible for this policy
• The scheme provides cashless treatments for all major medical illnesses and diseases
• The policyholder and insured should get the treatment done at a government hospital or private hospitals that fall under the network
• In the case of general illnesses and diseases, a cover of up to Rs.30,000 is provided for medical treatments
• In the case of critical illnesses, a maximum cover of Rs.3 lakh is provided
• Pre-hospitalization medical charges for up to 7 days before being admitted to the hospital are covered
• Post-hospitalization medical charges for up to 15 days after being discharged from the hospital are covered

A short description of treatment benefits and coverage is mentioned in the table below.

The Bhamashah Swasthya Bima Yojana provides benefits to individuals who are enrolled in the National Food Security Scheme and beneficiaries of the Rashtriya Swasthya Bima Yojana. The scheme is only implemented through Bhamashah cards.

It should be noted that the identity related to Rashtriya Swasthya Bima Yojana and the National Food Security Scheme should also be honored until the insurance of Bhamashah cards. Other benefits associated with this scheme are mentioned below.

• For hospitals, in-house claims processing software and standardized and transparent grading criteria is available
• All medical protocols are verified and well-defined
• An excellent mobile application is also provided for the monitoring of all government officials working in a district
• Effective monitoring mechanism of the prevention of cost leakages and escalation and removal of TPA is provided
• In the case of government health institutions, an immediate reduction is provided
• This scheme would allow economically weak sections of the society to approach private health institutions for getting medical services
• Financial improvement of Medicare Relief Societies of Government Health Institutions is provided
• Pre-hospitalization expenses are covered up to seven days before being admitted to the hospital
• Post-hospitalization expenses are covered for up to 15 days after being discharged from the hospital
• Transport allowance benefits for cardiac and polytrauma cases are provided of up to Rs.100 to Rs.500

In the case of general illnesses, patients can choose between any of the 1045 packages. Further, in the case of government hospitals, the policyholder can choose from 170 packages and for critical illnesses, one can select from a total of 500 packages.

You might also wish to know that cashless benefits and services will be provided through impaneled private health institutions and public health institutions. All of these packages include the cost of the following factors.

• Bed charges
• Consultant fees
• Surgeon’s charges
• Anesthetist’s charges
• Boarding charges
• Nursing charges
• Blood transfusion costs
• Consumables charges
• Implant expenses
• Anesthesia expenses
• Cost of Medicines
• Radiological tests, including x-ray
• Cost of pathological diagnostic tests, including blood and urine
• Transport allowance for polytrauma cases
• Transport allowance for cardiac cases
• Food for the beneficiary during the hospital stay

There are several features that are provided under the Bhamashah Swasthya Bima Yojana. These key features are:

• All medical expenses are covered by the insured for cashless hospitalization and treatment
• One can enjoy coverage benefits between Rs.30,000 to Rs.3 lakh. The exact amount will depend on the type of illness or disease that one is suffering from
• Policyholders can get treatments done at both government and private hospitals that fall under the network of the scheme
• Any pre-existing illnesses are also covered under the scheme
• Policyholders and insured can get cashless treatments for OPD cases as well. This excludes secondary and tertiary medical treatments

There are some restrictions and exclusion factors that fall under this policy. You can go through those restrictions and exclusion factors by referring to the list mentioned below.

• There are strict eligibility criteria for availing of the benefits under this medical insurance policy, including that one should be covered under the National Food Security Act (NFSA) and Rashtriya Swasthya Bima Yojana (RSBY)
• Only family members of the policyholder are covered under this scheme