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RSBY scheme, panacea for BPL
Published on 17 Jun. 2011 12:44 AM IST
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Recognizing the diversity with regard to public health infrastructure, socio-economic conditions and administrative network, the state labour department, by introducing Rashtriya Swasthya Bima Yojana (RSBY) scheme in Nagaland, aims to facilitate health insurance in all the districts in phase wise manner, below poverty line households. One of the major insecurities for workers in the un-recognized sector is absence of health cover for such workers and their family members.
Insecurity relating to absence of health cover, heavy expenditure on medical care and hospitalisation is not only a social and psychological burden borne by these workers but there are significant economic cost resulting from lose of earning and progressive deterioration of health.
Despite the expansion in health facilities, illness remains one of the most prevalent causes of human deprivation in the country.
It has been clearly recognized that the health insurance is one way of providing protection to poor households, against the risk of health spending leading to poverty.
Thus, with a view to providing health insurance cover to BPL workers in unorganized sectors and families, the central Government has announced the ‘Rashtriya swasthya Bima Yojana’ (RSBY).
The entire country will be covered by 2012-13. In districts where the Scheme is introduced, it would supersede the Universal Health Insurance Scheme (UHIS), DIPR reports said.
According to Planning Commission of India, the first phase has to cover 10000 BPL households during 2010. In Nagaland some of the district like Kohima, Peren, had already been covered in 2009 and Phek and Mokokchung was covered in 2010. The rest of the remaining districts will be covered during 2011.
Following are the benefits under the RSBY
Financing for the scheme would be contributed by the Government of India 90% of the estimated annual premium of Rs 750, subject to a maximum of Rs 565 per family per annum. The cost of smart card will be borne by the central Government @Rs 60/ per card. -- Respective state Government contribution is 10% of the annual premium, as well as any additional premium.
The beneficiary would pay per annum as registration / renewal fee.
The administrative and other related cost of administrating the scheme would be borne by the respective state government.
Unorganised sector workers belonging to BPL category and their family members (a family unit of five) shall be the beneficiaries under the scheme. A family would thus comprise the Household Head, Spouse and up to three dependent children.
The beneficiaries will be issued smart cards for the purpose of identification.
Health Services Benefits package for the un-recognized sector workers and his family (unit of five) will be covered. Total sum insured would be Rs 30,000/- per family floater The beneficiary shall be eligible for coverage of the financial costs of such in-patient health care services as negotiated by the respective state government with the insurer, as well as agreed day-care procedures not requiring hospitalisation.
Cashless attendance to all covered ailments.
All pre-existing diseases to be covered.
Provision for a smart card based system of beneficiary identification/verification and point of service processing of client transaction.
Transportation cost (actual with limit of Rs. 100 per visit) but subject to an annual limit of Rs. 1000.
To uplift the BPL households, NGOs and Villages authorities, etc. has to play a vital role and keep in close contact with the Assistant Labour Commissioner and officials of the concerned department from time to time to achieve their goals. Officers from the labour department organises seminars/workshops for the beneficiaries and BPL households will be able to learn more and be benefited by attending the awareness programmes.

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