Bhamashah Swasthya Bima Yojana: A Comprehensive Review

Healthcare costs can push families into financial distress, especially when dealing with hospitalizations or critical illnesses. In Rajasthan, where several households often struggle with out-of-pocket medical expenses, the government introduced the Bhamashah Swasthya Bima Yojana (BSBY) in 2015 to ensure access to cashless treatment.

At Ditto, we’ve seen firsthand how government-backed health schemes impact families and advised thousands of customers navigating state schemes and private policies.

In this guide, we’ll help you know exactly what BSBY covered, who qualified for it, and whether you should complement its successor schemes with private health insurance for better protection.

Which Scheme has Replaced Bhamashah Swasthya Bima Yojana?

The BSBY scheme in Rajasthan was merged with the Central Ayushman Bharat (PMJAY) and Rajasthan’s own health insurance program to form Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY) in 2019. This merged scheme offered ₹5 lakh of cashless treatment per family under the unified system.

Starting May 1, 2021, the state’s government relaunched an expanded health scheme called the Mukhyamantri Chiranjeevi Swasthya Bima Yojana. Currently called the Mukhyamantri Ayushman Arogya Yojana, it offers cashless treatment of up to ₹25 lakh to all families in the state. This marks a significant increase from the ₹5 lakh provided under the central Ayushman Bharat scheme alone.

What Did the Bhamashah Swasthya Bima Yojana Cover?

The Bhamashah Swasthya Bima Yojana covered: 

• Cashless treatment for up to ₹30,000 per year for general illnesses and up to ₹3 lakh annually for critical illnesses at government and empaneled private hospitals. 
• Hospitalization costs, pre-hospitalization expenses for 7 days, post-hospitalization expenses for 15 days, consultation fees, diagnostics, medicines, implants, nursing charges, room rent, and miscellaneous hospital expenses. 
• A family floater benefit, as a part of which all registered family members shared coverage under a single policy. 
• Pre-existing conditions and daycare procedures

Eligibility Criteria for Bhamashah Swasthya Bima Yojana

Since BSBY is no longer active, here’s the eligibility criteria for its alternate scheme, Mukhyamantri Ayushman Arogya Yojana: 

• Below Poverty Line (BPL) families registered under SECC 2011
• NFSA cash holders
• EWS families
• Small farmers
• Jan Aadhar Card Holder
• Families on the COVID-19 Ex-Gatia list
• Contractual/contractual employees of all departments
• Beneficiary families of Ayushman Bharat 
• Rajasthan Health Insurance Scheme

Note: Families who are not eligible can also register by paying ₹850 annually. 

Exclusions Under Bhamashah Swasthya Bima Yojana

• Non-medical expenses such as items of personal comfort (e.g., telephone charges, toiletries).
• Treatment taken in non-empanelled hospitals or outside Rajasthan.
• Cosmetic or plastic surgeries, unless required due to an accident or illness covered under the scheme.
• Treatments related to self-inflicted injuries or substance abuse.
• Experimental or investigational treatments.
• Conditions or diseases explicitly excluded in the policy wording.

Bottom Line: These exclusions were structured to ensure quality healthcare coverage with financial protection while maintaining focus on medically necessary and approved treatments.

Steps to Apply for Bhamashah Swasthya Bima Yojana

Since the scheme is not live, you may consider applying to the Mukhyamantri Ayushman Arogya Yojana. The steps include:

• Visit sso.rajasthan.gov.in and create your SSO ID.
• Log in with your SSO ID and click on Online Registration for the scheme.
• Choose between Free or Paid categories based on your eligibility.
• Under Free, select your category (SMF for small/marginal farmers, Contractual for contract workers, or COVID-19 ex-Gratia for eligible families).
• Enter your Jan Aadhar number or registration receipt number and search.
• Review family details, complete e-signature using OTP from your Aadhaar-linked mobile, and submit.
• For the paid category, pay the ₹850 premium online and print your policy document after successful payment.

Documents Required for Bhamashah Swasthya Bima Yojana

• Aadhar card
• Jan Aadhar Card
• Ration card
• Income certificate
• Proof of residence
• Proof of age
• Passport-sized photograph
• Mobile number

Quick Note: Currently, the same documents are required for Mukhyamantri Ayushman Arogya Yojana. 

How to Apply For a Claim Under Bhamashah Swasthya Bima Yojana?

Applicants were required to show their insurance (Bhamashah) card and ID proof to the network hospital. Then, the insurance provider authorized the amount. Finally, the hospital shared the bills and receipts with the insurance company post which the latter settled the claims directly. 

Ditto’s Take on the Bhamashah Swasthya Bima Yojana

Mukhyamantri Ayushman Arogya Yojana, a far more comprehensive health insurance initiative, has replaced BSBY. However, like most government-backed schemes, it comes with certain limitations, such as a restricted hospital network, limited choice of doctors, and potential wait times. While these schemes may serve as excellent baseline coverage, they are package-based and dependent on empanelled hospitals. 

If you have the financial capacity and prefer greater flexibility, such as choosing your own doctor, accessing private rooms, and receiving faster, personalized treatment, a private comprehensive health plan is worth considering.

At Ditto, our IRDAI-certified advisors can also help you compare options at your own pace, without any spam.

Why Choose Ditto for Health Insurance?

At Ditto, we’ve assisted over 8,00,000 customers with choosing the right insurance policy. Why customers like Pallavi below love us:

• No-Spam & No Salesmen
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Confused about the right insurance? Speak to Ditto’s certified advisors for free, unbiased guidance. Book your call or chat on WhatsApp with us now!

Conclusion

Rajasthan has always been at the forefront of social security schemes like the Mukhyamantri Ayushman Arogya Yojana or the Bhamashah Swasthya Bima Yojana (discontinued). These government initiatives aim to provide cashless medical services to families, especially those belonging to weaker sections of society.

Even if you are not covered under any of these schemes, opting for a health insurance plan ensures financial protection and access to quality healthcare for you and your family.