Bhamashah Swasthya Bima Yojana

  What is Bhamashah Swasthya Bima Yojana?

It is a scheme to provide cashless facility to the IPD patients.
For the identified families covered under National Food Security Act (NFSA) and Rashtriya Swasthya Bima Yojana (RSBY).
By the Government (Medical and Health Department)
Through an Insurance Company “New India Assurance Company”
On a fixed premium per family per year on floater basis

Aims of the Scheme

To Hedge Govt. moneys
To provide quality health care that avoids large out of pocket expenditure
To provide financial security against illness
To Improve health status of the State.
To create a data base which could be used to make policy level changes in Healthcare.
To bring a revolution in healthcare in rural area – by providing stimulus to Private Sector to open hospitals in rural areas and reducing the increasing burden on Government facilities .

Salient features of the scheme

Cashless for beneficiary

Only for IPD procedures.

1715 disease packages are covered under the scheme which includes 1045 packages for Secondary illness, 500 for Tertiary illnesses.

170 disease packages are reserved for Govt. Institutions.  (these includes 65)

For the families covered under NFSA  or RSBY.

To be coupled with Bhamashah Scheme.

Treatment through Govt. and accredited private hospitals.

Coverage of Rs. 30,000 for general illnesses and Rs. 3 lakh for serious ailments.

Provision for fund enhancement.

MNDY ,MNJY  and MMBPLJRK to continue as usual.

—Beneficiaries will be covered for secondary and tertiary illness according to the pre decided package rates.

—Pre-existing conditions or diseases will be covered from beginning of the scheme.

—Transportation allowance of INR 100 in cash to be given during discharge of the beneficiary with an annual ceiling of INR 500 and shall be a given only for Cardiac & Polytrauma cases.

—Transportation allowance is included in the package cost.

—Pre hospitalization of 7 days and post hospitalization of 15 days to be covered under the scheme.

 

BHAMASHAH YOJANA HEALTH CARD (Rajasthan Govt.)

          The state government has included 1,715 diseases under the ambitious Bhamashah Health Insurance Scheme (BHIS). The diseases have been categorised under three heads like secondary illnesses (1,045), tertiary (500) and others (170). Under the scheme, people suffering from these illnesses will be treated at government hospitals.

As per the guidelines issued by the government on Friday, the insurance cover for secondary illness is Rs30,000, while for the tertiary illness, it will be Rs3 lakh.

Under the tertiary illness, the health department has kept those illnesses which are related to burns, cardiology, including coronary balloon angioplasty, aorta-aorta bypass with graft, refractory cardiac failure and renal angioplasty with stent (non-medicated). The surgeries for valve replacement and chest surgeries, including lobectomy, pneumonectomy, pleurectomy, pulmonary AV fistula surgery, lung cyst will be covered. Under secondary illnesses, the health department has included dental problems, ear, nose, eye, endocrine, throat, various illnesses requiring general surgery, obstetrics and gynaecology and neurology.

The insurance will be applicable in private hospitals which will be empanelled by the health department.