Complete Guide for Rajasthan Government Health Scheme

Healthcare costs in India are rising at an alarming rate. Access to quality medical care is a priority for every family. The Rajasthan government health scheme aims to solve this.

It offers financial protection to millions of residents. This blog breaks down the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY). You will learn about its benefits, eligibility, and application process. Let’s dive in.

What is Ayushman Bharat MGRSBY?

The Government of Rajasthan launched this initiative in 2015 to provide free medical treatment to vulnerable sections of society. The scheme was known as Bhamashah Swasthya Bima Yojana.

In 2021, the government merged the central Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) with the state's own Bhamashah Swasthya Bima Yojana. The goal was simple: No family should suffer due to a lack of funds for medical treatment.

The scheme focuses on lower-income families and covers both government and private empanelled hospitals. It offers a sum insured amount of ₹5 lakh. Its key features are as follows:

Cashless Treatment: With MGRSBY, you don't have to pay cash at the hospital counter. The government will directly settle the bill with the hospital.

Family Floater Basis: Your whole family will receive the coverage amount. Therefore, even if one member falls sick, they can use the amount for treatment.

No Cap on Family Size: Many private plans put restrictions on the number of insured members under family floater plans. However, with the Rajasthan health scheme, you don’t have to worry.

Extensive Network: You can access quality care at a vast network of government and private hospitals across the state.

Wide Coverage: This health insurance scheme lets you get coverage for inpatient, outpatient, and daycare treatments.         

Rajasthan Government Health Scheme Coverage Benefits and Sum Insured

Understanding the financial coverage is vital. The Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana offers substantial support:

General Illnesses: You will get ₹50,000 per year for secondary care. You can utilise this for common ailments and standard hospitalisations for your entire family.

Critical Illnesses: Ayushman Bharat Rajasthan provides a dedicated coverage of ₹4.5 lakh per family per year for tertiary care. This covers serious conditions like heart disease, cancer, and kidney issues.

Total Coverage: With the ₹4.5 lakh and ₹50,000, your total coverage amount comes to ₹5 lakh.

Medical Packages: In addition to the general coverage, you can also access over 1,576 medical packages. These cover important surgeries, diagnostics, and doctor fees.

Rajasthan Government Health Scheme Eligibility Criteria: Who Can Apply?

To avail the benefits of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana, you must fall among the following groups:

SECC 2011 Data: Families listed in the Socio-Economic Caste Census (SECC) 2011 are eligible for this scheme.

NFSA Beneficiaries: If your family falls under the National Food Security Act (NFSA), then you are eligible.

Antyodaya Families: Households classified as the poorest under state records.

Citizen of Rajasthan: You must be living in Rajasthan to avail this health insurance scheme.

PMJAY Scheme: If you are already benefitting from the central scheme, you can avail the benefits of MGRSBY as well.

You can check your eligibility on the official departmental website or at a local e-Mitra kiosk.

What Documents are Required for Ayushman Bharat Rajasthan?

To avail of the benefits, you must present valid identification at the hospital. Keep these ready:

Jan Aadhaar Card: This is the primary identification document in Rajasthan. You can also use the Bhamashah acknowledgement slip for identification.

Aadhaar Card: This card is an important personal identification which contains biometric information and a 12-digit number.

Ration Card: This serves as the proof of NFSA status.

HHID Number: HHID or Household Identification Number is a 23-digit unique number which you need to verify your eligibility.

How to Avail Services Under the Rajasthan Government Health Scheme?

Visit the Hospital: Go to any empanelled hospital with your Jan Aadhaar card. This could be a government or private hospital.

Identification: The Swasthya Marg Darshak (health guide) at the help desk will verify your documents.

Authentication: Next, they will authenticate your identity using biometrics or an OTP on your registered mobile number.

Treatment: Once verified, doctors will admit you. Then the hospital will start the cashless treatment process.

Discharge: After recovery, the hospital files the claim. You can leave without paying medical bills out of pocket.

Why You Might Need Additional Private Insurance in Rajasthan?

Government schemes provide a great safety net. However, they have their own limits. For example, the ₹5 Lakh limit might fall short for advanced treatments or in metro cities outside Rajasthan. Also, room rent caps in government schemes often limit you to general wards, which may not be enough.

For higher coverage, premium rooms, and faster access to top-tier private hospitals nationwide, consider a private plan. A comprehensive policy from Bajaj General Insurance works as a perfect top-up to your government cover. It ensures you never compromise on comfort or quality of care.

Download the Bajaj General app and purchase health insurance within a few clicks. No lengthy paperwork needed!

Final Thoughts

The Rajasthan government health scheme is a lifeline for millions of people. It removes the fear of medical debt and safeguards families. Check your eligibility today and secure your future. For enhanced protection beyond the basics, explore private options from Bajaj General Insurance.

FAQs About  Rajasthan Government Health Scheme

Who is eligible for the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana?

Families included in the SECC 2011 list and beneficiaries under the National Food Security Act (NFSA) in Rajasthan are eligible for the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana.

Is there a waiting period for pre-existing diseases in the Ayushman Bharat MGRSBY Rajasthan Health Scheme?

No, the Ayushman Bharat MGRSBY Rajasthan Health Scheme covers all pre-existing diseases from day one. There is no waiting period for beneficiaries.

What documents do I need to carry to the hospital?

You must carry your Jan Aadhaar Card and Aadhaar Card. The hospital help desk uses these to verify your eligibility.

Can I use this card for treatment in private hospitals?

Yes, you can avail cashless treatment at any private hospital that is empanelled under the Ayushman Bharat MGRSBY Rajasthan Health Scheme.

What is the total sum insured provided per family?

The Ayushman Bharat MGRSBY Rajasthan Health Scheme provides a total annual cover of ₹5 lakhs per family. This includes ₹50,000 for general illnesses and ₹4.5 Lakhs for critical illnesses.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet and is subject to changes. Please consult an expert before making any related decisions.

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.