Last updated: 24/11/2020
Programme objectives

To provide beneficiaries with financial protection against catastrophic health expenditures and to improve access to quality health care

References
Rashtriya Swasthya Bima Yojana. n.d. “About RSBY”. RSBY website. <http://www.rsby.gov.in/about_rsby.aspx>. Accessed 11 May 2018.
Country
Geographic area
Previous programme name (if any)
The Rashtriya Swasthya Bima Yojana (RSBY) programme, which was under the purview of the Ministry of Labour and Employment, was shifted to the Ministry of Health and Family Welfare and renamed as Rashtriya Swasthya Suraksha Yojana (RSSY), and later was renamed again as National Health Protection Scheme in the 2017-18 budget
Institutions and agencies involved
Start date
2008
References
German Cooperation. 2017. Mainstreaming Gender and Targeting Women in Inclusive Insurance: Perspectives and Emerging Lessons. Eschborn: Deutsche Gesellschaft für Internationale Zusammenarbeit. <http://www.ifc.org/wps/wcm/connect/da895c64-2bc0-4a64-8206-9f9057b2dbd2/Full+Women+%26+Inclusive+Insurance+BMZ_Web.pdf?MOD=AJPERES>. Accessed 11 May 2018.
Programme components
The programme provides coverage for hospitalisation expenses and transportation charges
References
Rashtriya Swasthya Bima Yojana. n.d. “FAQs”. RSBY website. <http://www.rsby.gov.in/faq_scheme.aspx>. Accessed 11 May 2018.
Conditionalities (if any)
 
Contribution type and amount
 
Targeting methods
poverty/vulnerability assessments
Targeted areas
Nationwide
Target groups
People living below the poverty line
Eligibility criteria
The benefits extend to a maximum of five members (including the head of household, spouse and three dependents) of any household below the poverty line. There are no age limits and pre-existing conditions are covered
References
Rashtriya Swasthya Bima Yojana. n.d. “FAQs”. RSBY website. <http://www.rsby.gov.in/faq_scheme.aspx>. Accessed 11 May 2018.
Eligibility reassessment (if any)
 
Type of benefits
Health care services
Amount of benefits
Hospitalisation coverage of up to INR30,000 per year on a family floater basis for diseases defined in package list. Transportation charges are also covered at the rate of INR100 per visit, up to a maximum of INR1.000 per year
References
Rashtriya Swasthya Bima Yojana. n.d. “FAQs”. RSBY website. <http://www.rsby.gov.in/faq_scheme.aspx>. Accessed 11 May 2018.
Payment/delivery frequency
After receiving the smart card, beneficiaries can seek treatment whenever they want or need
References
German Cooperation. 2017. Mainstreaming Gender and Targeting Women in Inclusive Insurance: Perspectives and Emerging Lessons. Eschborn: Deutsche Gesellschaft für Internationale Zusammenarbeit. <http://www.ifc.org/wps/wcm/connect/da895c64-2bc0-4a64-8206-9f9057b2dbd2/Full+Women+%26+Inclusive+Insurance+BMZ_Web.pdf?MOD=AJPERES>. Accessed 11 May 2018.
Benefit delivery mechanism
Selected insurance companies enroll households directly in villages and issue a biometric smart card to beneficiaries, which can be used to access cashless treatment at any public or private hospital across India which is registered with the scheme
References
German Cooperation. 2017. Mainstreaming Gender and Targeting Women in Inclusive Insurance: Perspectives and Emerging Lessons. Eschborn: Deutsche Gesellschaft für Internationale Zusammenarbeit. <http://www.ifc.org/wps/wcm/connect/da895c64-2bc0-4a64-8206-9f9057b2dbd2/Full+Women+%26+Inclusive+Insurance+BMZ_Web.pdf?MOD=AJPERES>. Accessed 11 May 2018.
Benefit recipients
The card is given to the head of the household. In some states like West Bengal, the RSBY smart card is issued in the women's name
References
German Cooperation. 2017. Mainstreaming Gender and Targeting Women in Inclusive Insurance: Perspectives and Emerging Lessons. Eschborn: Deutsche Gesellschaft für Internationale Zusammenarbeit. <http://www.ifc.org/wps/wcm/connect/da895c64-2bc0-4a64-8206-9f9057b2dbd2/Full+Women+%26+Inclusive+Insurance+BMZ_Web.pdf?MOD=AJPERES>. Accessed 11 May 2018.
Minimum and maximum duration of benefits (if any)
 
Coverage
130 million beneficiaries in more than 41 million households (2017) are currently covered by RSBY, but coverage is expected to be expanded under the NHPS
References
German Cooperation. 2017. Mainstreaming Gender and Targeting Women in Inclusive Insurance: Perspectives and Emerging Lessons. Eschborn: Deutsche Gesellschaft für Internationale Zusammenarbeit. <http://www.ifc.org/wps/wcm/connect/da895c64-2bc0-4a64-8206-9f9057b2dbd2/Full+Women+%26+Inclusive+Insurance+BMZ_Web.pdf?MOD=AJPERES>. Accessed 11 May 2018. US Aid. 2017. “Pathways to Universal Health Coverage: Lessons from Government-Sponsored and Community-Based Health Insurance Schemes in India”. North Bethesda, MD: Abt Associates. <https://www.hfgproject.org/pathways-universal-health-coverage-lessons-government-sponsored-community-based-health-insurance-schemes-india/>. Accessed 11 May 2018.
Programme expenditure
INR1,000 crore (1 crore = 10 million) (budget estimates for the 2017-18 fiscal year)
References
Centre for Budget and Governance Accountability. 2017. “National Health Protection Scheme(NHPS)”. <http://unionbudget2017.cbgaindia.org/health/national_health_protection_scheme.html>. Accessed 11 May 2018.
Monitoring and evaluation mechanisms and frequency
State Nodal Agencies (SNA) oversee monitoring the scheme, in coordination with insurance company, hospital, and district authorities, as well as other local stakeholders. Furthermore, the programme will rely on a back-end data management system to track all transactions and provide analytical reports
References
Rashtriya Swasthya Bima Yojana. n.d. “About RSBY”. RSBY website. <http://www.rsby.gov.in/about_rsby.aspx>. Accessed 11 May 2018.
Legal Framework
 
MIS
 
Population Group