Heritage Health Insurance TPA Pvt. Ltd.

IRDAI license No 008     CIN U85195WB1998PTC088562     An ISO 9001:2015 Company

Frequently Asked Questions [FAQs]

Q: What is RSBY?


Ans. Ministry of Labour and Employment, Government of India has launched a health insurance scheme for BPL families which is called Rashtriya Swasthya Bima Yojana (RSBY).

Q: Who is eligible?


Ans. The beneficiary is any Below Poverty Line (BPL) family, whose information is included in the district BPL list prepared by the State government. The eligible family needs to come to the enrollment station, and the identity of the household head needs to be confirmed by the authorized official.

Q: What is the insurance coverage in RSBY?


Ans. Rashtriya Swasthya Bima Yojana provides cover for hospitalization expenses upto Rs. 30,000/- for a family of five on a floater basis. Transportation charges are also covered upto a maximum of Rs. 1,000/- with Rs. 100/- per visit.

Q: What is the premium for RSBY?


Ans. The premium for RSBY is different in different set of districts. State Governments select insurance companies through open tendering process and technically qualified lowest bid is selected.

Q: Who pays the premium for RSBY?


Ans. Government pays the premium for RSBY. Central Government pays 75% of the total premium (90% in case of Jammu & Kashmir and North east States) while State Government pays the remaining premium.

Q: Will beneficiaries have to pay anything to get the policy?


Ans. Beneficiaries need to pay Rs. 30 per family at the time of enrollment.

Q: What is the time period for the enrollment and the policy period for the beneficiaries?


Ans. In case of new policy, the Scheme shall commence operation from the 1st of the succeeding month in which the smart card is issued. Thus, for example, if the initial smart cards are issued anytime during the month of April in a particular district the scheme will commence from 1st of May. The scheme will last for one year till 30th of April of next year. This would be the terminal date of the scheme in that particular district. However, in the same example, if the card is issued in the month of May, June and July then the insurance will immediately start from the next day itself for the beneficiaries and policy will be over on 30th April of next year. Thus, all cards issued in the district in May will also have the Policy start date as 1st of May (even if issued subsequent to the date) and terminal date as 30th April of the following year. The date of commencement of insurance for the cards issued during the intervening period will be as follows:
Smart card issued During Commencement of Insurance Policy period
April, 2009 1st May, 2009 30th April, 2010
May, 2009 May, 2009 30th April, 2010
June, 2009 June, 2009 30th April, 2010
July, 2009 July, 2009 30th April, 2010

Q: What is the time period for enrollment and policy period in case of renewal of the policy?


Ans. In the case of renewal, the policy will start from first of the next month in which the earlier policy will expire. Therefore, for example, if the earlier policy is getting over on 30th April and card is renewed in the month of April then the new policy will start only from the 1st May and will finish on 30th April of next year. However, in the same example, if the card is issued in the month of May, June and July then the insurance will immediately start from the next day itself for the beneficiaries and policy will be over on 30th April of next year. The date of commencement of insurance for the cards issued during the intervening period will be as follows:
Smart card issued During Commencement of Insurance Policy period
April, 2009 1st May, 2009 30th April, 2010
May, 2009 May, 2009 30th April, 2010
June, 2009 June, 2009 30th April, 2010
July, 2009 July, 2009 30th April, 2010