Rashtriya Swasthya Bima Yojana: Benefits and Eligibility Criteria

Healthcare affordability continues to be a major concern for low-income families across India. To address this challenge, the Government of India introduced Rashtriya Swasthya Bima Yojana (RSBY), a health insurance scheme designed to provide financial protection to economically vulnerable groups. Launched in 2008, the program enables eligible families to access quality healthcare services without the burden of high out-of-pocket expenses. This blog explores the key benefits of RSBY, outlines the eligibility criteria, and explains the step-by-step enrolment process, while also highlighting how structured insurance coverage plays an important role in long-term financial security, much like SBI Life Insurance.

What is Rashtriya Swasthya Bima Yojana (RSBY)?

The Government of India created Rashtriya Swasthya Bima Yojana (RSBY) as a health insurance program for Below Poverty Line families and other specified risk groups. In support of family healthcare needs there exist cashless hospitalization benefits covering families for ₹30,000 annually through empanelled health service providers.

Benefits of Rashtriya Swasthya Bima Yojana

✔ Protection up to ₹30,000 per household yearly for hospitalization expenses 

✔ Cashless hospitalization at government and private empanelled hospitals 

✔ Pre-existing medical conditions are covered since day one 

✔ Covers hospitalizations, transport expenses, and medicines 

✔ Able to include up to 5 beneficiaries, covering head, spouse and dependent beneficiaries

✔ Beneficiaries will receive a biometric smart card for convenient access to healthcare services. 

✔The premium is low since most of the premium is covered by the government.

Criteria for Eligible Enrolment into Rashtriya Swasthya Bima Yojana (RSBY)

Eligibility Criteria for Enrolment into Rashtriya Swasthya Bima Yojana (RSBY) The enrolment criteria for Rashtriya Swasthya Bima Yojana (RSBY) is as follows: 

✅The applicant must be a member of a family identified by the government as Below Poverty Line (BPL).

✅ Workers in the unorganized sector as well as their families can avail of this scheme. 

✅Other specific group such as street vendors, domestic workers, construction workers, and MNREGA beneficiaries may avail of this scheme. 

✅ Families must be enrolled in the SECC (Socio-Economic Caste Census) database. 

Steps to Apply for Rashtriya Swasthya Bima Yojana?

Step 1: Check Eligibility

You have to visit your nearest government office or you can check online if you qualify for Rashtriya Swasthya Bima Yojana.

Step 2: Enrol into the scheme

The registration will take place at the enrolment camps being held in villages or towns. You need to bring all required documents — Aadhaar Card, BPL Certificate, and Ration Card. 

Step 3: Biometric Smart Card Issuance

The family will receive a smart card, which is a biometric smart card with details of the insurance after registration. 

Step 4: To Avail of Healthcare Services 

Then you will be able to use the smart card to avail of cashless treatment at any of the empanelled hospitals.

In-Depth Impact of RSBY

Case Study: How RSBY Prevented a Family from Debt

Rajesh is daily wage earners in a tiny village. He faced an emergency medical situation that required his wife to undergo surgery. With no savings, he was worried about the worst. Fortunately, because his family is enrolled in Rashtriya Swasthya Bima Yojana, the full cost of ₹25,000, the surgery, was covered by RSBY. As a result of RSBY, Rajesh’s wife was able to receive quality care without the stressful burden of debt.