Bhamashah Swasthya Bima Yojana is a health insurance scheme developed by the Government of Rajasthan to provide quality healthcare for the state’s citizens. This is a cashless scheme that provides financial security against various medical threats faced by poor families in Rajasthan. This scheme is primarily designed for the benefit of people living in rural areas. This cover ensures that the overall health status of the state is improved through effective measures. Moreover, the data collected from schemes like this can be used to implement policy level changes in the government’s healthcare initiatives.
Members must meet the following eligibility criteria to avail benefits under this medical insurance scheme:
Some of the notable features of Bhamashah Swasthya Bima Yojana can be listed as follows:
|Benefits||Extent of coverage|
|General ailments||1715 disease packages|
|Secondary illness||1148 packages|
|Tertiary illness||500 packages|
|Disease packages reserved for government institutions||67|
Though the exclusions are not directly outlined under this policy cover, this scheme is limited to medical emergencies and necessary treatments. Cosmetic or aesthetic treatments are not covered under thisExclusions of Bhamashah Swasthya Bima Yojana scheme. Moreover, certain conditions may not be covered under this policy unless there is a medical emergency.
Since this is a cashless treatment scheme, all medical expenses incurred by the members are paid directly to the network hospital within the approved package limit. The insured must provide the policy card and other personal identification proof during the time of admission in a network hospital. During the time of admission, the network hospital will seek authorisation from the insurer regarding the patient’s admission.
The cashless treatment will begin after the authorisation is obtained. Once the treatment is over, the network hospital will send the medical bills, diagnostic reports, discharge summary, physical certificate, and other relevant documents to the insurer. The insurer will verify these documents and transfer the claim amount to the network facility.