Bhamashah Swasthya Bima Yojana
About the Bhamashah Swasthya Bima Yojana
The Bhamashah Swasthya Bima Yojana was designed specially by the State Government of Rajasthan. This Bhamashah Yojana was launched by the then Chief Minister, Vasundhara Raje, on 13 December 2015. This scheme was specifically designed with the aim to meet the needs and requirements of the people of Rajasthan.
Under this scheme, the insured would get a Bhamashah card that can be used by IPD patients to avail cashless treatments. Further, all families that are covered under the National Food Security Act (NFSA) and Rashtriya Swasthya Bima Yojana (RSBY) can also register for this policy.
For ease of understanding, the Bhamashah Swasthya Bima Yojana can be viewed as a cashless health insurance scheme. The policyholders and insured falling under this scheme can get treatment benefits of up to Rs.30,000 for diseases and illnesses. In the case of critical illnesses, a cover of up to Rs.3 lakh is provided.
In this policy, the family of the policyholder can also be covered on a floater basis. This would mean that the individual would be required to pay a fixed premium every year to avail of the coverage benefits of this policy. The premium value is very affordable and can easily be managed by almost all the people of Rajasthan.
According to the official reports, the insurer chosen for this scheme is the New India Assurance Company. This organization is known for providing excellent and attractive insurance plans to its customers. All of this is done with a lot of comprehensive features and at affordable premium prices.
You might find it interesting to note that for choosing the insurer of this scheme, there was a two-step bidding process. After that, an open competitive public sector insurance company was chosen.
According to the latest news reports, until September, more than 92.54 lakh families were covered under the Bhamashah Swasthya Bima Yojana. This cashless health insurance policy, which was developed by the State Government of Rajasthan, has done a lot of good.
There are also a lot of other features of this policy that you might be interested to learn. We have formulated a table filled with all of those details. And that table is mentioned below.
Name of the Scheme
Bhamashah Swasthya Bima Yojana
Launched In (Indian State)
Smt. Vasundhara Raje
Date of Implementation
13 December 2015
BPL (Below Poverty Line) Patients
There are also many other important features of this policy. These features are:
- One of the most important goals of the Bhamashah Swasthya Bima Yojana is to reduce the financial risk of excess expenditure on healthcare
- The policy is designed to support the vision of maximum governance and minimum government
- To cope with any future policy level changes, a large database was also made with the scheme so any issues or problems can be tackled later
- A mobile application has also been launched by the Rajasthan state government to provide necessary assistance to the people who wish to enroll in the policy. Through this mobile application, it will be also easier for individuals to track the application status through their mobile phones
- There is no applicable upper age limit or a lower age limit to enroll in this policy. Any individual irrespective of his or her age can enroll in this policy and enjoy its benefits
- The Bhamashah card is issued by the Government of Rajasthan. Every policyholder and insured would need the Bhamashah card to be able to avail of the policy benefits
- Before making a claim, the applicants must have an Aadhaar card. This is because an Aadhar code would be sent to the individual at the time of registration. This is necessary at the time of enrollment
- All prospective policyholders are required to submit copies of their ration cards while making submitting an enrollment application for this policy
- All prospective applicants are also required to submit their BPL cards as well during enrollment. This is a necessary step as only the people who fall in the BPL category or those who fall in the BPL category and live in a rural area will be eligible for this policy
- The scheme provides cashless treatments for all major medical illnesses and diseases
- The policyholder and insured should get the treatment done at a government hospital or private hospitals that fall under the network
- In the case of general illnesses and diseases, a cover of up to Rs.30,000 is provided for medical treatments
- In the case of critical illnesses, a maximum cover of Rs.3 lakh is provided
- Pre-hospitalization medical charges for up to 7 days before being admitted to the hospital are covered
- Post-hospitalization medical charges for up to 15 days after being discharged from the hospital are covered
A short description of treatment benefits and coverage is mentioned in the table below.
Coverage for General Illness
Up to Rs.30,000
Coverage for Critical Illness
Up to Rs.3,00,000
Government Package List
Secondary Package List
Tertiary Package List
The Bhamashah Swasthya Bima Yojana provides benefits to individuals who are enrolled in the National Food Security Scheme and beneficiaries of the Rashtriya Swasthya Bima Yojana. The scheme is only implemented through Bhamashah cards.
It should be noted that the identity related to Rashtriya Swasthya Bima Yojana and the National Food Security Scheme should also be honored until the insurance of Bhamashah cards. Other benefits associated with this scheme are mentioned below.
- For hospitals, in-house claims processing software and standardized and transparent grading criteria is available
- All medical protocols are verified and well-defined
- An excellent mobile application is also provided for the monitoring of all government officials working in a district
- Effective monitoring mechanism of the prevention of cost leakages and escalation and removal of TPA is provided
- In the case of government health institutions, an immediate reduction is provided
- This scheme would allow economically weak sections of the society to approach private health institutions for getting medical services
- Financial improvement of Medicare Relief Societies of Government Health Institutions is provided
- Pre-hospitalization expenses are covered up to seven days before being admitted to the hospital
- Post-hospitalization expenses are covered for up to 15 days after being discharged from the hospital
- Transport allowance benefits for cardiac and polytrauma cases are provided of up to Rs.100 to Rs.500
In the case of general illnesses, patients can choose between any of the 1045 packages. Further, in the case of government hospitals, the policyholder can choose from 170 packages and for critical illnesses, one can select from a total of 500 packages.
You might also wish to know that cashless benefits and services will be provided through impaneled private health institutions and public health institutions. All of these packages include the cost of the following factors.
- Bed charges
- Consultant fees
- Surgeon’s charges
- Anesthetist’s charges
- Boarding charges
- Nursing charges
- Blood transfusion costs
- Consumables charges
- Implant expenses
- Anesthesia expenses
- Cost of Medicines
- Radiological tests, including x-ray
- Cost of pathological diagnostic tests, including blood and urine
- Transport allowance for polytrauma cases
- Transport allowance for cardiac cases
- Food for the beneficiary during the hospital stay
There are several features that are provided under the Bhamashah Swasthya Bima Yojana. These key features are:
- All medical expenses are covered by the insured for cashless hospitalization and treatment
- One can enjoy coverage benefits between Rs.30,000 to Rs.3 lakh. The exact amount will depend on the type of illness or disease that one is suffering from
- Policyholders can get treatments done at both government and private hospitals that fall under the network of the scheme
- Any pre-existing illnesses are also covered under the scheme
- Policyholders and insured can get cashless treatments for OPD cases as well. This excludes secondary and tertiary medical treatments
There are some restrictions and exclusion factors that fall under this policy. You can go through those restrictions and exclusion factors by referring to the list mentioned below.
- There are strict eligibility criteria for availing of the benefits under this medical insurance policy, including that one should be covered under the National Food Security Act (NFSA) and Rashtriya Swasthya Bima Yojana (RSBY)
- Only family members of the policyholder are covered under this scheme
It was a commendable move made by the Government of Rajasthan to introduce Bhamashah Swasthya Bima Yojana to help the economically weaker sections of the society. This scheme has been responsible for saving so many families across the state. This is also quite obvious when you see and hear the reviews left by policyholders. You can go through some of those reviews below.
- Excellent Policy, says Jay Rashim: I purchased this policy a few months back and since then I have been completely free of all worries related to the health of my family. I was always worried about the prices of medical services but I’m not anymore. I’m very thankful to the Government of Rajasthan for rolling out this policy.
- Love the Mobile App, says Shriti Pathakar: I have been a policyholder of the Bhamashah Swasthya Bima Yojana for the last two years. And I have not had a single problem till now. I have got cashless treatments done at private hospitals multiple times. I will be renewing this policy for a long time to come.
- This Policy Changed My Life, says Jatin Shankar: I was looking to purchase a health insurance policy that could cater to my medical needs. But I couldn’t afford most of the policies in the market. Thankfully, that changed when Bhamashah Swasthya Bima Yojana came into the picture. Since then, I haven’t spent a day worrying about my medical security at all.
Bhamashah Swasthya Bima Yojana FAQs
What documents do I need to make a claim request under my Bhamashah Swasthya Bima Yojana?
The documents required to make a claim request under Bhamashah Swasthya Bima Yojana are:
Prescription is written by the doctor
A valid photo ID of the patient
Photograph of the patient at the time of admission into the hospital
A copy of the investigation report
A copy of the ration card
For RSBY beneficiaries, a copy of the RSBY card
How can I place a claim request for my Bhamashah Swasthya Bima Yojana?
Bhamashah Swasthya Bima Yojana is a cashless treatment scheme in which all medical expenses are borne by the insurance company. The bills are also directly settled at the network hospital within an approved package limit.
After providing the necessary documents, the policyholder or the insured will have to wait for the approval. This authorization would allow the insured to get admission into the hospital. One will be able to avail of cashless treatments after that authorization from the insurance company.
Once the treatment is done, then the network hospital will forward all the medical bills, physical certificates, medical reports, discharge summary, and other documents to the insurer. The insurance company will verify the documents and transfer the claim amount to the network hospital subject to verification of all bills and reports.
What is a Bhamashah card?
A Bhamashah card is a new initiative that would help make women get more important role in a family. This initiative has been taken by the Government of Rajasthan. This card is made in the name of the eldest woman in a household. The eldest woman would also get a bank account in her name after the issuance of the Bhamashah card.
The main idea behind this entire initiative is to pave the way for the empowerment of women. In this manner, the state government can also directly transfer grants to the official bank accounts of the beneficiaries.
The Bhamashah card will further ensure that all financial grants reach as soon as possible to the account holder. This card is also linked to the mobile number of the holder. This will allow one to receive updates of all transactions done through SMS.
How can I apply for the Bhamashah Swasthya Bima Yojana?
It should be noted that the application process for the Bhamashah Swasthya Bima Yojana is not held online. This is mainly due to the fact that this policy is designed for economically weaker sections of the society and they might not have easy access to the internet.
Only manual enrollment is required to enjoy the benefits of this policy. All interested applicants can approach any hospital within the policy network. In those hospitals, there will be one individual who will be responsible for handling applications related to the Bhamashah Swasthya Bima Yojana. You can bring your documents and directly approach that individual to fill the form and enroll in this policy.