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Bhamashah Swasthya Bima Yojana

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Bhamashah Swasthya Bima Yojana: Eligibility, Coverage, Benefits

Overview of BMSY or the Bhamashah Swasthya Bima Yojana

The Bhamashah Swasthya Bima Yojana is a health insurance scheme that has been introduced by the Rajasthan Government. It was launched in 2015, with the initiative to give healthcare access and financial security to the state’s economically disadvantaged population.

Under this particular scheme, eligible beneficiaries receive a health insurance card known as the Bhamashah Swasthya Bima Card. The Bhamashah Swasthya Bima Yojana has undoubtedly made a substantial impact in Rajasthan, as it bridges the gap in healthcare accessibility and affordability, particularly for those who need it the most.

What is the Bhamashah Swasthya Bima Yojana?

BSBY or The Bhamashah Swasthya Bima Yojana, is a health insurance programme launched by the Rajasthan government. Families who satisfy the requirements for eligibility can receive health services without needing to pay anything upfront. They can receive max Rs. 30,000 for general health issues and a substantial Rs. 3 lakhs for critical illnesses.

BSBY is available to those insured under the NFSA or the National Food Security Act as well as the RSBY or the RSBY or the Rashtriya Swasthya Bima Yojana. To provide this cashless health insurance to economically disadvantaged persons, the Rajasthan government has teamed together with the New India Assurance Company financially disadvantaged people. This insurance provider offers attractive coverage options with reasonable premiums, making it accessible to those in need.

Purpose of BMSY or the Bhamashah Swasthya Bima Yojana

The primary purpose of the Bhamashah Swasthya Bima Yojana is to provide financial protection and improved access to healthcare services for economically disadvantaged families in Rajasthan, India. This health insurance scheme aims to:

General and Critical Illnesses: The scheme distinguishes between general and critical illnesses, offering higher coverage for critical conditions, which is crucial for vulnerable families facing life-threatening health issues.
Healthcare Access: By providing a Bhamashah Swasthya Bima Card, the scheme allows eligible families to receive medical treatment in government and designated private hospitals without the need for immediate payment.
Financial Security: The scheme offers the benefit of cashless insurance, which helps reduce the financial burden on the insured.
Coverage for Vulnerable Populations: It extends coverage to those covered under the Rashtriya Swasthya Bima Yojana (RSBY) and the National Food Security Act (NFSA), ensuring that the most economically deprived individuals are protected.

Medical packages and hospitalisation process in Bhamashah Swasthya Bima Yojana

The following are the packages that are covered under the BSBY scheme:

Doctor consultation fees
Medicines
Bed charges
Blood
Nursing charges
Boarding fees
Implants
Transportation allowance while hospitalised
Food expenses

You can find the official, in-depth package list on the official BSBY page, which is divided into three sections.

Secondary Packages
Tertiary Packages
GOVT Packages

Hospitalisation Process in Bhamashah Swasthya Bima Yojana:

In the event of a medical emergency or planned treatment, head to a network hospital, ensuring you bring along your Bhamashah card and identification.
The hospital will reach out to the insurance provider to secure authorisation for cashless treatment.
Once the insurer greenlights the treatment, you can access the required medical care without the need for upfront payments.
Post-treatment, the hospital will gather all the pertinent documents, including bills, receipts, and medical records linked to the hospitalisation.
Subsequently, the hospital will forward these documents to the insurance company for claim processing.
Following a thorough review of the submitted documents, the insurance company will directly settle the claim with the hospital, streamlining the payment process.

How does the Bhamashah Swasthya Bima Yojana work?

Bhamashah Swasthya Bima Yojana works towards women’s empowerment and inclusivity. It plans to uplift the condition of women in our state. Through this health insurance scheme, the eligible individuals are given financial and no financial services for economic upliftment, through their respective banks in a transparent method.

List of Diseases and Treatments Covered under Bhamashah Swasthya Bima Yojana

The list of Diseases and Treatments covered under the Bhamashah Swasthya Bima Yojana is ever-changing. You can find the official list through their portal or you can go through the official link which will lead you to an Excel sheet with all the details you may need.

Things to consider when applying for the BSBY or the Bhamashah Swasthya Bima Yojana

Here are the things to consider when applying for the Swasthya Bima Yojana Scheme:

Ensure that you meet the specific eligibility requirements for the scheme, such as income levels, family status, and any other criteria outlined by the program.
Make sure you understand the application process, whether it’s online or offline.
Understand the extent of the health coverage provided under the scheme.
Be aware of the hospitals and healthcare facilities that are part of the scheme’s network.
Be aware of any deadlines or timeframes for application submission, renewal, or claim filing.
Stay informed about the renewal process and any updates or changes to the scheme’s terms and conditions.
Check if there are any premium payments or contributions required.

Eligibility criteria for Bhamashah Swasthya Bima Yojana

The eligibility criteria for Bhamashah Swasthya Bima Yojana is as follows:

Children and students seeking support for educational coaching under this specific scheme should be enrolled in government schools and colleges.
There’s no age limit and family members can access this scheme as well.
You need to fall under the National Food Security Act and be covered under the Rashtriya Swasthya Bima Yojana.

Benefits of the Chiranjeevi Yojana Health Scheme

The following are the benefits of Chiranjeevi Yojana Health Scheme:

You are offered up to 5 lakh rupees in accidental coverage.
You are provided with up to 10 lakh for health coverage.
If you’re planning to apply for this as a family, you are only required to pay 850 rupees.
You can avail of treatment at any hospital, as it also covers pre and post-hospitalisation.
You are eligible for cashless medical treatment.

Key Features of BMSY or the Bhamashah Swasthya Bima Yojana

Here are the key features of BMSY or the Bhamashah Swasthya Bima Yojana:

Insurance Benefits: BSBY provides insurance coverage, with up to ₹30,000 for general illnesses and ₹3 lakhs for critical ailments.
Hospitalisation Costs: The Bhamashah Health Insurance Scheme caters to all hospitalisation expenses that has been incurred.
Age Flexibility: Bhamashah Yojana extends its benefits to individuals without any upper or lower age restrictions.
Comprehensive Coverage: The Bhamashah Yojana includes pre and post-hospitalisation costs to ensure comprehensive coverage.
Extensive Hospital Network: Beneficiaries have the flexibility to seek treatment at both private and government healthcare facilities.
Bhamashah Card: Policyholders are issued a Bhamashah card by the Government of Rajasthan to access healthcare benefits.

Coverage Highlights:

General Ailments: Coverage up to ₹30,000.
Critical Diseases: Coverage up to ₹3 lakhs.
Pre-Hospitalisation: Expenses covered for a period of 7 days prior to admission.
Post-Hospitalisation: Expenses covered for a period of 15 days after discharge.

Inclusions Under Bhamashah Swasthya Bima Yojana

The Bhamashah Swasthya Bima Yojana encompasses various medical expenses, offering comprehensive coverage:

It provides coverage for generic illnesses up to Rs. 30,000 and up to Rs. 3 lakh for critical illnesses.
This program facilitates hassle-free hospitalisation, covering all expenses incurred during the insured’s stay.
The scheme caters to pre-hospitalisation expenses, covering up to 7 days prior to hospital admission.
Medical treatments can be obtained at both government and approved private hospitals.
For cardiac cases and polytrauma, it includes transport allowances ranging from Rs. 100 to Rs. 500.
It also extends post-hospitalisation coverage for up to 15 days after discharge.
The plan even covers pre-existing illnesses.
In addition to secondary and tertiary care, beneficiaries can access cashless treatment for outpatient cases (OPD).
These packages cover a range of expenses, including bed charges, consultant fees, medications, implants, blood transfusions, nursing and boarding costs, consumables, transportation allowances, and food expenses for the insured during hospitalisation.
Beneficiaries can choose from 1045 general illness packages, 500 critical illness packages, and 170 government hospital packages.

Exclusions Under Bhamashah Swasthya Bima Yojana

The Bhamashah Swasthya Bima Yojana excludes coverage for:

Cosmetic procedures.
Non-allopathic treatments.
Congenital conditions.
Infertility treatments.
Dental and optical care.
Injuries from hazardous activities.
Self-inflicted injuries.
War or terrorism-related injuries.
Drug and alcohol abuse treatment.
Preventive care.

These medical expenses are typically not covered by the scheme.

How to register for the Bima Yojana Scheme of Bhamashah Swasthya?

Here’s how to register for Bhamashah Swasthya Bima Yojana online:

First, you need to visit the official website of BMSY or the Bhamashah Swasthya Bima Yojana.
On the main page, you’ll find the “Bhamashah Citizen Registration” option.
Fill up and complete all the required details.
Do a double-check after adding all the details required on the application forms.
Once you’re done filling out the form, and attaching the documents, hit submit to get the Bhamashah enrollment registration number.

Required documents to register

In order ro register for Bima Yojana Scheme of Bhamashah Swasthya, these are the documents required:

Caste certificate
Birth certificate
Aadhar or Ration Card
Letter of experience for business

How to apply online for Bhamashah Swasthya Bima Yojana?

Here’s how to apply for online under the Bhamashah Swasthya Bima Yojana after the initial registration process:

Once you’re done filling out the form, and attaching the documents, hit submit to get the Bhamashah enrollment registration number.
Click on the enrollment link and input your registration to access the Enrollment form of the Bhamashah Citizen.
Furnish details about the applicant (typically the woman who is the head of your family) and include information about family nominees.
Applicants will be issued a Receipt Number, which is used to upload the required supporting documents.

How to Download Bhamashah Swasthya Bima Yojana Application Form?

There is no online download option for the application form of Bima Yojana of Bhamashah Swasthya, as the BSBY application process is based on the software page. You can however get an application form at Municipal Corporations and Village Panchayats of Rajasthan across all the urban and rural areas, where they coordinate specific camps across all wards.

How to Claim the Bhamashah Swasthya Bima Yojana?

Since the Bhamashah Swasthya Bima Yojana operates as a cashless scheme of health insurance, the medical costs will be promptly handled by the insurance provider. In situations of medical emergencies or scheduled treatments, it is essential to present your Bhamashah card and identification at a network hospital. Once the insurer approves the cashless treatment, the policyholder can proceed with their medical care. Subsequently, the hospital will forward the hospitalisation bills and receipts to the insurance company, and the claim will be efficiently settled directly.

You’ll need the following documents for the process:

Patient’s valid photo ID
Doctor’s prescription
Indoor slip
Patient’s photos at admission and discharge
Valid ID of BSBY beneficiaries (a copy of ration card/RSBY card)
Copies of investigation reports
Discharge ticket

Empanelled Hospitals Listed Under Bhamashah Swasthya Bima Yojana

The list of Empanelled Hospitals under the Bhamashah Swasthya Bima Yojana is updated work every day. You can find the list of them devised by departments through the official website. All you need to do is choose the department you need to visit and it’ll show you the empanelled hospitals that provide the facilities.

Bhamashah Swasthya Bima Yojana Helpline Number

The following are the different types of Helpline numbers for Bhamashah Swasthya Bima Yojana:

Claim Queries:

Manager, Jaipur Regional Office, The New India Assurance Agency, Ph. 0141-2643842
Helpline No.NIA Office (BSBY) Jaipur Regional Office, The New India Assurance Agency Ph. 0141-2609947, Ph. 0141-2609838, Ph. 0141-2617965
Email Id: bsbynia@gmail.com

Lalit Kumar Jain Account Officer Ph. 9829123223 niait. Email Id: bsby@gmail.com

Scheme Queries:

Ms. Aachu Agrawal, Programme Officer, BSBY,
Email Id: bsbyraj@yahoo.com
Ph. 8764848541
Ms. Priyanka Kapoor, SNO(P), BSBY,
Email Id: bsbyraj@yahoo.com
Ph. 9414063905
Sh. M.P Jain, SNO(M), BSBY,
Email Id: bsbyraj@yahoo.com
Ph. 9414057269,
Sh. Buddhi Vardhan, Programme Officer-BSBY,
Email Id: bsbyraj@yahoo.com
Ph. 8146545515,
Dr. Vikram Singh, Consultant -BSBY,
Email Id: bsbyraj@yahoo.com
Ph. 9529963867.

How can I check the Bhamashah Swasthya Bima Yojana status online?

Here’s how to check the status of the Swasthya Bima Yojana Scheme status using the ‘Case Status Tracker’:

To get started, go to the left side of the screen and find the ‘Case Status Tracker’ link under ‘Quick Links.’
You have several options for searching a TID (Transaction ID) in the Case Status Tracker:
• Search using a specific TID.
• Search by the type of package – Secondary, Tertiary, or All.
• Search by Case Status – to check the status of different TIDs.
The Case Status Tracker screen is initially set to display 20 TIDs per page by default. If you prefer to see more TIDs on a single page, scroll down on the screen, and locate the box marked ’20’ along with a dropdown arrow. Select the number of TIDs you’d like to view on one page. Click on that number and give the system some time to load the data – you will then see the selected number of TIDs on a single page.

Frequently Asked Questions (FAQs)

After successfully opening an account at any scheduled bank, it usually takes approximately 2 to 3 months to receive your Bhamashah Card. Thus, all applicants will receive a notification on their registered phone number once the card is ready.

The insurance provider offers a transportation allowance of up to Rs. 500 for individuals with cardiac and polytrauma diseases.

No, the Bhamashah Swasthya Bima Yojana is exclusively available for the residents of Rajasthan.

Yes, the Chiranjeevi Yojana provides coverage for childbirth. Women from "below-poverty-line" (BPL) households can access health insurance benefits for childbirth at government and specific private hospitals through the Chiranjeevi Yojana.