AB-MGRSBY: Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

The Indian state of Rajasthan, is one of the most beautiful states in the country. It is rich in folk culture and tradition with a humble population of 6 crore people. The main occupation of people here is agriculture, followed by trade and business. According to the World Bank, Rajasthan also is one of the lowest-income states of India.

People belonging to low-income groups, unfortunately, cannot avail facilities like salaried jobs or health care. However, the government is striving hard to eliminate challenges related to availing medical facilities. Schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana are being introduced for providing quality health care services.

What is Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY)?

Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana, is a health insurance scheme introduced under Chief Minister Ashok Gehlot’s government. It was announced on 30th of August 2019. The AB-MGRSBY is expected to be very helpful for the beneficiaries because it is an integration of AB-PMJAY and BSBY schemes. These two schemes were merged to include more number of eligible families into one scheme and provide quality health care services.

Key Highlights of Ayushman Bharat Mahatma Gandhi Rajasthan Health Insurance Scheme

The Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana was previously known as Bhamashah Swasthya Bima Yojana. However, this scheme was launched again in January 2021 after combining with the AB-PMJAY.

Take a look at the key highlights of the Ayushman Bharat Mahatma Gandhi Rajasthan health insuranc scheme 2021:

Scheme	Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana
Launched By	Government of Rajasthan
Beneficiaries	Citizens of Rajasthan
Launched On	30 January 2021
Health Insurance Cover	Rs 5 lakh
Coverage Type	Family Floater
Policy Tenure	1 Year
Number of Medical Packages	1576
Who is Eligible?	Families under Socio Economic Caste Census 2011 Families under National Food Security
Official Website	health.rajasthan.gov.in
Hospitals	Both government and private empanelled hospitals

Features And Benefits Of AB-MGRSBY

1. Cashless Hospitalisation:- The beneficiaries of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana can avail cashless hospitalisation in a network/empanelled hospital. This list is available in this article under the heading “List of Hospitals That Cover under AB-MGRSBY”. As the name suggests, a cashless treatment means that the beneficiary does not have to bear the cost of a medical treatment. These costs will be borne by the government.

2. Coverage For Medical Needs:- AB-MGRSBY offers holistic coverage that pays for the entire cycle of a medical emergency, including follow-up care. Here is a list of medical facilities that are covered under the scheme:

hospitalisation expense benefits
Daycare treatment benefits if applicable
Follow-up care benefits
Pre and post hospitalization expense benefits
Newborn child/children benefits

3. High Sum Insured:- AB-MGRSBY offers a very good amount of sum insured to the beneficiary family. The main sum insured is Rs. 5 lakh per year for each family covered under the scheme. It is segmented as the following:

Rs. 50,000 for secondary illnesses
Rs. 4,50,000 for tertiary illness

4. A Large Number Of Empanelled Hospitals:- More the number of hospitals empanelled under the scheme, the more it is beneficial at the time of a medical emergency. If an empanelled hospital is present in the vicinity of the beneficiary, he/she can reach there faster and treatment can begin. The AB-MGRSBY has many hospitals registered to treat patients under the scheme.

5. Health Insurance On Family Floater Basis:- A health insurance plan can be of many types. The most common types are Individual, family floater, and group health insurance plans. Among these, the AB-MGRSBY scheme is a family-floater plan where the sum insured can be used by all members of the family. This is beneficial as compared to other plans because a balance can be created while making claims. For example, individual members of a family can require treatment at different times. A family floater plan can ensure that all members can avail proper medical facilities.

What is Not Covered?

Minor conditions that do not require hospitalisation, unless mentioned in the package list.
Cost of vitamins and tonics unless part of the required treatment.
Dental treatments carried out for enhancing aesthetics.
Surgical procedures for resembling the opposite sex including hormone replacement therapy.
Vaccinations are not covered.
Plastic surgery unless required to correct an injury-related deformity.
Circumcision unless medically required due to an accidental injury.
Attempted suicide and suicide.
The persistent vegetative state as a result of brain damage.
Expenses related to medical treatments due to overuse of any intoxicating substance.
Congenital external diseases, anomalies, or defects.

Eligibility for Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

Members of the eligible beneficiary family based on SECCO that rely on economic, social and caste census. Family members falling under the National Food Security Act (NFSA)
Families must be Rajasthani natives
Beneficiaries must have Aadhaar card, Bhamashah card/Acknowledgement Slip
Members of Ayushman Bharat Scheme

Documents Required To Apply For AB-MGRSBY

Bhamashah Card (Jan Aadhaar Card) / Bhamashah Acknowledgement Slip for families falling under the National Food Security Act (NFSA)
Ration Card Number
Eligibility letter of Ayushman Bharat Scheme written by Hon’ble Prime Minister is required
23 digit HHID number
Aadhaar Card

How To Enrol in AB-MGRSBY

A family of beneficiaries do not need to carry out a separate enrolment process to enter Mahatma Gandhi Rajasthan Swasthya Bima Yojana. Since this scheme has not yet received a full-fledged launch, a specific process for registration of AB-MGRSBY has not been rolled out. However, the beneficiaries can identify themselves under the scheme by checking the relevant information from the Jan soochna portal.

FAQs

Are daycare treatments covered under Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana?

Yes, various daycare treatments as listed in the AB-MGRSBY package are covered under the scheme.

What is the meaning of secondary and tertiary diseases in terms of AB-MGRSBY?

Secondary diseases are general health ailments like extraction of a tooth, fractures, tonsillectomy, etc. while tertiary diseases could be conditions related to critical illnesses, for example, Lung Injury repair, Thyroplasty, Colonoscopy, etc.

Practice area's of B K Goyal & Co LLP

Most read resources