Introduced on December 13, 2015, the Bhamashah Swasthya Bima Yojana (BSBY) was a health insurance program started by the State Government of Rajasthan. It was renamed to Ayushman Bharat Mahatma Gandhi Health Insurance Scheme and then Mukhyamantri Ayushman Arogya Yojana (MAAY). The scheme focuses on providing people of Rajasthan with comprehensive health coverage.

Families eligible under the National Food Security Act (NFSA) and Rashtriya Swasthya Bima Yojana (RSBY) can take advantage of this programme. The scheme provides cashless health insurance coverage, offering financial protection of up to ₹5 lakh for general medical treatments and an additional ₹5 lakh for critical illnesses.

Cashless Treatment

Beneficiaries can avail of cashless treatment at more than 3,000 empanelled government and private hospitals. This eliminates the need for upfront payments and enables timely medical care.

Quality In-Patient Care

The scheme aims to improve access to reliable and quality hospital services for rural and low-income families.

Financial Protection

This will protect families from healthcare-related financial stress and prevent families from going into debt or poverty.

Data-Driven Governance

The scheme aims to generate reliable health data that supports better planning, resource allocation and policy decisions for future initiatives.

High Sum Insured

The scheme offers coverage of up to ₹30,000 for general ailments and ₹3 lakh for critical ailments per family per year. This safeguards families against the heavy costs of major medical treatments and surgeries. With the help of this generous limit, no one has to compromise on care due to financial limitations.

Full Medical Coverage

The BSBY scheme covers more than 1400 medical and surgical procedures. This ensures beneficiaries get treatment for every issue, from common health issues to complex surgeries. The extensive coverage of the scheme provides a safety net for families facing diverse health challenges.

Daycare Procedure Coverage

The scheme includes daycare treatments such as dialysis, chemotherapy and minor surgeries that do not require overnight hospital stays.

Family Floater Policy

BSBY operates on a family floater basis, meaning the total sum insured can be used by any family member as needed. This helps ensure protection for the entire household.

No Premium for Beneficiaries

The entire premium is paid by the government, making the scheme completely free of cost for beneficiaries. This ensures accessibility for even the most economically vulnerable households.

Pre and Post-Hospitalisation Coverage

BSBY covers expenses for 7 days before hospitalisation and 15 days after hospitalisation. It includes diagnostic tests, consultations, follow-up treatments and medications.

Wide Network of Empanelled Hospitals

The scheme’s vast hospital network includes vetted public and private healthcare institutions.

Critical Illness Protection

Coverage extends to serious conditions like cancer, cardiac diseases and kidney failure, offering financial relief for treatments that typically demand long-term and costly care.

Easy and Seamless Enrollment

Registration is simple through the Bhamashah Card, which serves as a unique identifier linking individuals to their benefits.

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Registered Under NFSA

Families registered under the National Food Security Act (NFSA) are automatically eligible for the scheme. Economically weaker households receive essential health protection under this scheme.

Resident of Rajasthan

Applicants must be permanent residents of Rajasthan. The scheme is exclusive to the state’s citizens and not open to residents of other states.

Specific Social Groups

Marginalised social groups such as widows, senior citizens without support, persons with disabilities and beneficiaries of state welfare programs can get benefits from this scheme.

Bhamashah Card Holders

A valid Bhamashah Card is mandatory to access benefits. The card serves as identity proof and enables digital verification at hospitals.

Families Below Poverty Line (BPL)

Households officially identified under the BPL scheme of the government surveys can get this scheme.

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• Ration Card to establish eligibility under the National Food Security Act (NFSA).
• Aadhaar Card or Jan Aadhaar Card for identity verification.
• Proof of Income (Income Certificate) to confirm economic status.
• Recent Passport-Size Photographs of the applicant and family members.
• Proof of Residence to verify permanent residency in Rajasthan.

Since the BSBY scheme was integrated with the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY), you do not need to complete any separate registration process. Here is the step-by-step application process to apply for the scheme:

Step 1: Visit the Nearest Health Office

Go to your local district health authority or BSBY help centre, or e-mitra kiosk.

Step 2: Collect and Fill Out the Form

Get the enrolment form and fill it accurately with all required details.

Step 3: Attach Supporting Document

Submit photocopies of necessary documents such as Aadhaar card, income proof and residence certificate.

Step 4: Submit to the Officials

Provide the completed form and documents to the concerned authorities for verification and processing.

Pre and Post-Hospitalisation Costs

It covers pre-hospitalisation expenses incurred up to 7 days before admission, including consultations, diagnostic tests and medications. Additionally, post-hospitalisation costs up to 15 days after discharge, such as follow-up visits, medicines and necessary investigations, are covered in this scheme.

Critical Illness Coverage

Serious conditions like cancer, cardiac ailments and kidney failure are included, covering both treatment and hospitalisation expenses.

Cashless Treatment

You can avail of cashless treatment at over 3,000 empanelled hospitals across Rajasthan, including both government and private facilities.

Daycare Procedures

Short-term treatments that do not need an overnight stay, such as cataract surgery, tonsillectomy and minor procedures, are also fully covered.

Hospitalisation Expenses

The scheme covers inpatient treatment, including costs for hospital stays, such as room charges, nursing care, ICU and doctor fees. Additionally, it covers both major and minor surgical procedures. Medical procedures include treatments like chemotherapy, dialysis and radiotherapy.

Cosmetic and Aesthetic Treatments

BSBY does not cover cosmetic or aesthetic enhancement treatments. This includes procedures such as plastic surgery, hair transplants, cosmetic dentistry, or skin treatments undertaken for appearance. However, if such procedures are medically necessary, such as reconstructive surgery after an accident or burn, they may be considered for coverage.

Pre-Existing Conditions

You have to wait for some time for certain pre-existing illnesses for the coverage to begin. Also, the waiting period may vary depending on the ailment.

Experimental Treatments

Any treatment or therapy that is not proven clinically or approved by medical authorities is excluded.

Outpatient (OPD) Services

Regular doctor visits, minor illnesses, diagnostic consultations and routine health check-ups that do not need hospitalisation are excluded from the scheme. BSBY focuses primarily on inpatient and surgical care that demands hospital admission.

Substance Abuse and Self-Inflicted Injuries

Health issues from drug or alcohol abuse, intentional self-harm, or attempted suicide are excluded from BSBY coverage.

To get the benefits under the BSBY scheme, you must have a valid Bhamashah Card. This serves as your family identification document. You can download the card easily through the Rajasthan SSO (Single Sign-On) portal or from your nearest SSO centre. Here is the step-by-step process to get your e-card:

Step 1: Log in to Your SSO Account

Visit the official Rajasthan SSO portal and log in using your SSO ID and password.

Step 2: Select the Bhamashah Option

Choose the ‘Bhamashah’ service on the new page. This will open a new page with various options related to the Bhamashah scheme.

Step 3: Download the e-Card

Click on ‘Bhamashah e-Card’ and enter the details such as your Bhamashah ID or registered mobile number and click ‘Submit’. You will get your digital Bhamashah Card on the screen. You can download this or print it for future use.

Note: Since the scheme name has changed, please select the correct scheme name to download the e-card.

The Bhamashah Swasthya Bima Yojana Scheme, or the BSBY scheme, is a lifeline to the people of Rajasthan, offering health coverage to the economically weaker sections of Rajasthan. Renamed as the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana and now Mukhyamantri Ayushman Arogya Yojana (MAAY), the scheme is a major step toward improving healthcare access and affordability.

However, if you want to extend protection for your family beyond the BSBY scheme, consider a comprehensive health insurance plan. Such health insurance plans can offer benefits such as OPD and maternity coverage, international medical protection, critical illness cover and cashless treatments at a wider hospital network throughout the country. Before availing a health policy, you must evaluate and compare features to find the plan for your family’s health needs and finances.

At TATA AIG, we offer cashless health insurance policies for individuals and families’ needs. We offer seamless claim processes, a wide hospital network and customisable coverage options with our plan.

You can visit the TATA AIG Health Insurance page online, or you can contact our customer support team for expert guidance.