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Department of Community Medicine
       JN Medical College
         AMU, Aligarh


                     TEAM JNMC
RASHTRIYA SWASTHYA
 BIMA YOJANA (RSBY) –
HEALTH INSURANCE FOR
        POOR
Before 11th five
year plan health
insurance was
only available to                  Only 16%
                                   population
 government                        covered
 employees
organised sector
private health
 insurance


   RSBY started rolling from 1st April 2008.
WHAT IS RSBY
 ‘cash-less’
 smart card based
 health insurance
  cover of Rs
  30,000 per
  annum
 each enrolled
  family, comprisin
  g up to five
  individuals.
BENEFICIARIES
Originally limited to Below Poverty
 Line (BPL) families




building and other construction workers,
 MGNREGA beneficiaries, street
 vendors, beedi workers, and domestic
 workers.
        Registration/renewal fee – Rs 30/annum per family

        Premium – centre and state in 75:25 ratio.
INSURERS    HOSPITALS          INTERMEDIARIES      GOVERNMENT



                                       BUSINESS
                                      MODEL FOR
                                      ALL STAKE
                                       HOLDERS
                  INFORMATION                      SAFE AND
                  TECHNOLOGY
                    INTENSIVE                     FOOLPROOF



 PUBLIC                               UNIQUE
HOSPITALS                            FEATURES
                EMPOWERING
                    THE                                PORTABILITY
                 BENEFICIARY

 PRIVATE
HOSPITALS                 ROBUST
                                             CASH LESS AND
                        MONITORING
                                               PAPER LESS
                           AND               TRANSACTIONS
                        EVALUATION
SHORTCOMINGS
• Unnecessary treatment
• lack of coverage for primary health and out patient
  care
• upward escalation towards the secondary level of
  patients
• does not take into account state specific variations in
  disease profiles and health needs


Intensified Information, Education & Communication
(IEC) activities
Coverage of all the beneficiaries

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Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
 

RSBY

  • 1. Department of Community Medicine JN Medical College AMU, Aligarh TEAM JNMC
  • 2. RASHTRIYA SWASTHYA BIMA YOJANA (RSBY) – HEALTH INSURANCE FOR POOR
  • 3. Before 11th five year plan health insurance was only available to Only 16% population  government covered employees organised sector private health insurance RSBY started rolling from 1st April 2008.
  • 4. WHAT IS RSBY  ‘cash-less’  smart card based  health insurance cover of Rs 30,000 per annum  each enrolled family, comprisin g up to five individuals.
  • 5. BENEFICIARIES Originally limited to Below Poverty Line (BPL) families building and other construction workers, MGNREGA beneficiaries, street vendors, beedi workers, and domestic workers. Registration/renewal fee – Rs 30/annum per family Premium – centre and state in 75:25 ratio.
  • 6. INSURERS HOSPITALS INTERMEDIARIES GOVERNMENT BUSINESS MODEL FOR ALL STAKE HOLDERS INFORMATION SAFE AND TECHNOLOGY INTENSIVE FOOLPROOF PUBLIC UNIQUE HOSPITALS FEATURES EMPOWERING THE PORTABILITY BENEFICIARY PRIVATE HOSPITALS ROBUST CASH LESS AND MONITORING PAPER LESS AND TRANSACTIONS EVALUATION
  • 7. SHORTCOMINGS • Unnecessary treatment • lack of coverage for primary health and out patient care • upward escalation towards the secondary level of patients • does not take into account state specific variations in disease profiles and health needs Intensified Information, Education & Communication (IEC) activities Coverage of all the beneficiaries