Bhamashah Swasthya Bima Yojana is a scheme aimed at offering IPD patients with access to cashless facility. It is a budget declaration for the financial year 2014-15 and is only open to people from Rajasthan. All families covered under the RSBY (Rashtriya Swasthya Bima Yojana) and NFSA (National Food Security Act) can avail this scheme. The premium payments for each family are fixed and must be made on an annual basis on floater policy.
The insurer for the scheme are chosen via open competitive public sector insurance company and a two-stage bidding process. The insurer chosen by the scheme is the New India Assurance Company as it offers the most attractive rates across the country for a scheme possessing the most comprehensive features.
Features of Bhamashah Swasthya Bima Yojana:
- The main objective of the scheme is to improve health indicators.
- The scheme offered reduction in additional expenses whilst offering financial cover to customers against illnesses.
- Bhamashah Swasthya Bima Yojana aims to reduce the financial risk of surplus expenditure on healthcare by making use of insurance as a solution.
- The scheme aims at squashing the government’s vision of minimum government and maximum governance.
- The scheme aims at creating a large health database that can be used in the future during policy level decisions / changes.
- The scheme aims at bringing about a revolution in healthcare in rural regions by encouraging the private sector to start providing hospitalisation services whilst lowering the rising concerns on government facilities.
Benefits of Bhamashah Health Insurance:
Bhamashah Swasthya Bima Yojana offers benefits to beneficiaries of the National Food Security Scheme and beneficiaries of the Rashtriya Swasthya Bima Yojana. The scheme is expected to be implemented via Bhamashah Cards. However, identity related to Rashtriya Swasthya Bima Yojana and the National Food Security Scheme must also be honoured until the issuance of Bhamashah cards. Following are the key benefits offered by Bhamashah Swasthya Bima Yojana:
- In-house claims processing software and standardised and transparent grading criteria for hospitals.
- Verified and well-defined medical protocols.
- Mobile application for the monitoring of all government officials in the district.
- Removal of TPA and effective monitoring mechanism for the prevention of cost escalation and leakages.
- Immediate reduction on government health institutions.
- Opportunity for poor people to approach private health institutions for health services.
- Financial improvement of Medicare Relief Societies of Government Health Institutions.
|Health Insurance Cover for general illnesses||Rs.30,000|
|Critical Illness Cover||Rs.3 lacs|
|Pre-hospitalisation expenses||Cover for seven days|
|Post-hospitalisation expenses||Cover for 15 days|
|Transport allowance for polytrauma and cardiac cases||Rs.100 to Rs.500|
Patients will also receive 1045 packages to choose from under General Illnesses, 170 packages for government hospitals, and 500 packages under Critical Illnesses. These cashless benefits and services will be provided via empanelled private health institutions and public health institutions.
The package costs include bed charges, consultant fees such as surgeons’ and anaesthetists’ charges, boarding and nursing charges, blood, consumables, implants, anaesthesia, medicines, implants, cost of pathological diagnostic and radiological tests such as x-ray, urine and blood, transportation allowance for cardiac and polytrauma cases, and food for beneficiary during hospital admission.
How to Apply for Bhamashah Swasthya Bima Yojana?
The authority issuing Bhamashah Swasthya Bima Yojana selects applicants based on a two-stage bidding process. The Qualification Stage is the first stage of the process and includes prequalification of interested individuals according to the provisions of the Request for Quotation (RFQ). Once the Qualification Stage is complete, the applicants short-listed by the issuing authority will gain eligibility to participating in the Bid Stage, which is the next stage of the bidding process involving the Request for Proposal.
Guidelines have been issued by the Indian government regarding the qualification of bidders interested in acquiring stakes in companies or firms from the public sector via disinvestment. The issuing authority reserves the right to disqualify any applicant if they do not comply with the guidelines at any step of the Bidding Process.
Should an applicant satisfy all guidelines and qualify to bid, he / she must provide the issuing authority with an undertaking regarding the same in the Appendix-I form. During the second stage, the short-listed applicants will be requested to furnish their bids (financial offers) based on the terms and conditions specified within the Bidding Documents. The validity of the bid will extend to a minimum period of 120 days from the Bid Due Date.
The proposal and bidding documents furnished by the applicant shall be part of the scheme’s draft insurance agreement. Any other documents issued after the RFP documents shall also be part of the bidding documents.
At the second stage, bidders can carefully scrutinise the scheme if they wish to carry out any studies prior to the submission of bids to acquire the insurance. The coverage mentioned in the bid document will be provided by Public Sector Insurance Companies for the premium amount according to which bids are invited. In this RFP, “Highest Bidder” refers to the applicant offering the lowest premium. The terms and conditions of the scheme, such as tenure and other details, will be pre-determined and mentioned in the draft insurance agreement.
Bidders who have any requests or queries for additional information regarding the RFP must submit the same in writing and sent it by special messenger / courier / speed post or e-mail to get in touch with the Additional Mission Director, NHM. The communication / envelops must have the following title / identification: Queries / Request for Additional Information: RFP for implementation of Health Insurance in Rajasthan Scheme.
GST rate of 18% applicable for all financial services effective July 1, 2017.
Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.