Quick Overview of Rashtriya Swasthya Bima Yojana (RSBY)
- Introduced in 2008, Rashtriya Swasthya Bima Yojana (RSBY) was a health insurance programme of the Government of India for the Below Poverty Line (BPL) families.
- It provided cashless hospitalisation coverage up to ₹30,000 per family per year on a floater basis.
- The plan would reimburse up to five relatives, including pre-existing illness and maternity reimbursements.
- Beneficiaries were given a biometric smart card, which allowed them to receive treatment paperlessly and without cash.
- Treatment would be made available in empanelled public and private hospitals, included in the list of hospitals under Rashtriya Swasthya Bima Yojana, and would have portability across the country.
- In 2018, RSBY was subsumed under Ayushman Bharat – PM-JAY, which now provides higher coverage of ₹5 lakh per family per year.
The cost of healthcare can cause families who are economically disadvantaged to go into immense debt. In order to overcome this problem, the Government of India launched Rashtriya Swasthya Bima Yojana (RSBY) to offer financial security against medical crises to Below Poverty Line (BPL) families. The programme was intended to provide affordable and convenient health insurance cover with a cashless, smart card-based system.
This is a complete guide to all the information about Rashtriya Swasthya Bima Yojana, such as its eligibility, coverage, benefits, exclusions, and how it performs against more recent schemes such as Ayushman Bharat.
What Is Rashtriya Swasthya Bima Yojana (RSBY)?
Overview of the RSBY Scheme
Rashtriya Swasthya Bima Yojana is a health insurance programme funded by the government that seeks to cover hospitalisation expenses of families living below the poverty line. The plan was launched to curb the amount of out-of-pocket medical payments and facilitate access to quality healthcare services.
In RSBY, hospitalisation costs are covered by providing eligible families with health insurance coverage under the empanelled public and private hospitals throughout India.
Launch of Rashtriya Swasthya Bima Yojana
The Government of India introduced Rashtriya Swasthya Bima Yojana on 1st April 2008. The scheme was first established under the Ministry of Labour and Employment and later passed to the Ministry of Health and Family Welfare as part of India’s expanding healthcare reforms.
Suggested Read: What is Aam Aadmi Bima Yojana?
Vision and Purpose of RSBY
Rashtriya Swasthya Bima Yojana was aimed at the following:
- Offer poor families financial protection.
- Provide access to quality healthcare.
- Minimise disastrous health spending.
- Encourage paperless and cashless treatment systems.
- Promote the involvement of the private healthcare providers.
Objectives of Rashtriya Swasthya Bima Yojana
- Rashtriya Swasthya Bima Yojana has the following important objectives:
- Providing health insurance to families below the Poverty Line.
- Financial coverage of hospitalisation costs.
- Empowering beneficiaries to avail services on the Rashtriya Swasthya Bima Yojana hospital list.
- Cutting down financial strain in case of unexpected illness or surgery.
- Encouraging portability across India
The scheme was modelled to enhance access to healthcare and enhance efficiency and transparency using technology.
Key Features of Rashtriya Swasthya Bima Yojana
Smart Card-Based Cashless Treatment
The introduction of a biometric smart card to the beneficiaries was one of the most innovative features of Rashtriya Swasthya Bima Yojana. Families were able to take advantage of cashless hospitalisation benefits using this card.
Paperless and Cashless Hospitalisation
RSBY offered treatment in empanelled hospitals in a cashless manner. Upon admission, the hospital would take direct claims to the insurer, which would save paperwork and avoid initial payments by individuals.
Inclusion of Private and Public Hospitals
The scheme was to empanel both government and private hospitals. In the list of official Rashtriya Swasthya Bima Yojana hospitals in their district or state, beneficiaries were allowed to select hospitals.
Coverage for the Entire Family
The scheme was used to cover a maximum of five members of a BPL family who usually consisted of the head of the household, spouse, and up to three dependents.
Affordable Premium Structure
The premium was heavily subsidised by the government:
- Central Government: 75% of the premium
- State Government: 25% of the premium
- Beneficiary contribution: A nominal registration fee (usually ₹30 per year)
Robust Monitoring and Transparency
Biometric smart cards and electronic data management were used to guarantee transparency, reduce fraud, and enhance accountability.
Rashtriya Swasthya Bima Yojana Smart Card
Benefits of the RSBY Smart Card
The Rashtriya Swasthya Bima Yojana card benefits include:
| RSBY Smart Card Benefit | Detailed Explanation |
| Cashless Hospitalisation up to the Insured Limit | The Rashtriya Swasthya Bima Yojana smart card enables beneficiaries to receive cashless inpatient treatment up to ₹30,000 per family per year on a floater basis. The hospital directly settles the bill with the insurance company, ensuring that eligible families do not have to pay upfront for covered hospitalisation expenses. |
Portability Across India |
The smart card allows beneficiaries to access treatment at any empanelled hospital across India listed under the Rashtriya Swasthya Bima Yojana hospital list. This portability feature is especially beneficial for migrant workers and families who relocate for employment. |
Biometric Identification of Beneficiaries |
Each smart card is linked with biometric data (fingerprints and photographs) of enrolled family members. This ensures accurate identification, prevents duplication or fraud, and allows secure authentication at empanelled hospitals. |
| Coverage for Pre-Existing Diseases | Unlike many private insurance plans, Rashtriya Swasthya Bima Yojana provides coverage for pre-existing illnesses from day one of enrollment. Beneficiaries do not have to undergo a waiting period to claim hospitalisation benefits related to existing medical conditions. |
| No Reimbursement Paperwork | The scheme operates on a fully paperless and cashless system. Since claims are processed electronically between the hospital and insurer, beneficiaries are not required to fill out claim forms or submit reimbursement documents. |
| Storage of Beneficiary Details | The smart card securely stores essential family information, insurance details, biometric data, and entitlement information. This facilitates quick verification during admission and ensures seamless hospital admission and discharge procedures. |
How the Smart Card Works
When a beneficiary visits an empanelled hospital:
- The smart card is verified through a biometric system.
- The treatment package is selected.
- Authorisation is obtained electronically.
- The hospital provides treatment without upfront payment.
- The claim is settled directly with the insurance company.
Eligibility Criteria for Rashtriya Swasthya Bima Yojana
The eligibility criteria under Rashtriya Swasthya Bima Yojana included:
- Families listed in the official Below Poverty Line (BPL) database
- Registered workers in the unorganised sector (in later expansions)
- Families identified by state governments
The final beneficiary list was prepared by respective state governments based on official poverty data.
Documents Required for RSBY Enrollment
To enrol under the Rashtriya Swasthya Bima Yojana, beneficiaries typically require
- Proof of inclusion in the BPL list
- Identity proof (as per state guidelines)
- Passport-sized photographs
- Biometric verification at the enrollment camp
Enrollment camps were organised at the village and block levels for easy registration.
Health Expenses Covered Under Rashtriya Swasthya Bima Yojana
RSBY provided hospitalisation coverage up to ₹30,000 per family per year on a floater basis.
Coverage included:
- Inpatient hospitalisation expenses
- Surgical procedures
- Day-care procedures
- Pre-existing diseases
- Maternity benefits
- Transportation allowance (limited amount per visit, subject to annual cap)
The scheme focused primarily on secondary-level care.
Treatments and Expenses Not Covered Under RSBY
Exclusions Under the RSBY Scheme
Some exclusions typically included:
- Outpatient (OPD) consultations
- Cosmetic surgeries
- Non-medical expenses
- Experimental treatments
- Treatment outside empanelled hospitals
Beneficiaries had to choose hospitals from the Rashtriya Swasthya Bima Yojana hospital list to avail benefits.
Benefits of Rashtriya Swasthya Bima Yojana
Key advantages include:
- Financial protection for vulnerable families
- Access to both private and government hospitals
- No waiting period for pre-existing diseases
- Paperless and cashless hospitalisation
- Technology-driven transparency
The Rashtriya Swasthya Bima Yojana card benefits significantly reduced out-of-pocket expenditure.
Suggested Read: Bhamashah Swasthya Bima Yojana
How Rashtriya Swasthya Bima Yojana (RSBY) Works
The operational structure of Rashtriya Swasthya Bima Yojana involved:
- Identification of eligible families.
- Enrollment through camps.
- Issuance of biometric smart cards.
- Empanelment of hospitals.
- Cashless treatment through approved packages.
- Direct claim settlement between the hospital and the insurer.
Insurance companies were selected through competitive bidding by state governments.
How to Register for Rashtriya Swasthya Bima Yojana
Registration was done through enrollment camps organised at the local levels.
Steps included:
- Verification of BPL status
- Biometric data capture
- Payment of a nominal registration fee
- Issuance of a smart card
Beneficiaries were informed about participating hospitals and scheme benefits during enrollment.
RSBY Card Renewal Process
The RSBY smart card was valid for one year. Renewal required:
- Re-verification of eligibility
- Payment of a nominal renewal fee
- Updating biometric details if required
State governments managed the renewal process annually.
Claim Process Under Rashtriya Swasthya Bima Yojana
The claim process was entirely cashless:
- The beneficiary presents a smart card
- Hospital verifies eligibility
- Pre-authorisation obtained electronically
- Treatment provided
- Claim submitted digitally to insurer
- The insurer settles the payment directly
This system minimised beneficiary involvement in paperwork.
Current Status of Rashtriya Swasthya Bima Yojana
Rashtriya Swasthya Bima Yojana has largely been subsumed under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) since 2018.
Many states transitioned RSBY beneficiaries into PM-JAY, which offers significantly higher coverage (₹5 lakh per family per year).
While RSBY laid the foundation for digital, cashless public health insurance, PM-JAY replaced it as the flagship national scheme.
Suggested Read: Ayushman Bharat Yojana Explained
Advantages and Limitations of Rashtriya Swasthya Bima Yojana
Advantages
- First large-scale technology-driven health insurance scheme
- Portable benefits across India
- Inclusion of private hospitals
- Pre-existing disease coverage
Limitations
- The coverage limit of ₹30,000 was relatively low
- Limited to hospitalisation only
- No OPD coverage
- Limited awareness in some regions
Difference Between Rashtriya Swasthya Bima Yojana and Ayushman Bharat PM-JAY
Feature |
RSBY |
PM-JAY |
Launch Year |
2008 |
2018 |
Coverage Amount |
₹30,000 per family/year |
₹5 lakh per family/year |
Target Beneficiaries |
BPL families |
Socio-Economic Caste Census (SECC) identified families |
Technology |
Smart Card |
E-card with national portability |
Status |
Subsumed |
Active |
PM-JAY expanded coverage significantly compared to Rashtriya Swasthya Bima Yojana.
Difference Between Health Insurance and Rashtriya Swasthya Bima Yojana
- Health insurance is purchased individually by paying premiums.
- Rashtriya Swasthya Bima Yojana was government-funded for BPL families.
- Private insurance offers broader coverage options.
- RSBY focused only on hospitalisation up to a fixed limit.
Rashtriya Swasthya Bima Yojana: Important Facts and Figures
- Launched in 2008
- Coverage: ₹30,000 per family per year
- Covered up to 5 family members
- Cashless hospitalization
- Biometric smart card enabled
- Implemented across multiple states
- Later merged with PM-JAY
RSBY was one of the largest health insurance initiatives for the unorganised sector at the time of its launch.
Why You Should Opt for ManipalCigna Health Insurance Along with Rashtriya Swasthya Bima Yojana
While the Rashtriya Swasthya Bima Yojana provided basic hospitalisation coverage, its coverage limit was modest. Supplementing government schemes with private health insurance can:
- Increase coverage amount
- Provide OPD and critical illness benefits
- Offer higher room rent limits
- Cover advanced treatments
- Provide wider hospital networks
Combining private insurance with government support ensures comprehensive financial protection.
FAQs on Rashtriya Swasthya Bima Yojana
What are the benefits of Rashtriya Swasthya Bima Yojana?
The scheme provides cashless hospitalisation up to ₹30,000 per family per year, covers pre-existing diseases, includes maternity benefits, and offers portability across empanelled hospitals.
What is the sum insured under RSBY?
The sum insured under Rashtriya Swasthya Bima Yojana is ₹30,000 per family per year on a floater basis.
Is AYUSH treatment covered under RSBY?
RSBY primarily focused on allopathic hospitalisation. Coverage of AYUSH treatments depended on state-level implementation and empanelment guidelines.
When was the Rashtriya Swasthya Bima Yojana launched?
The scheme was launched on 1st April 2008 by the Government of India.
How is RSBY different from Ayushman Bharat?
RSBY provided ₹30,000 coverage for BPL families, while Ayushman Bharat PM-JAY offers ₹5 lakh coverage per family per year and has a broader beneficiary base.
