Rashtriya Swasthya Bima Yojna: 2010 Guidebook - Health Systems ...

• Maternity and NewbornChildren covered, subjectto conditions. See box.• Transportation costs arecovered with a maximumof Rs. 100 per visit andan annual limit ofRs.1,000.• Family size: up to fivemembers of a householdcan be covered. If thereare more than threechildren, the head of thehousehold must decidewhich three to beinsured. Extended familycannot be included in thefamily even if thebeneficiary familyconsists of less than fivepersons. Enrollment ofthe head of thehousehold and thespouse is compulsory.Maternity & Child Coverage under RSBY• All expenses related to the delivery ofthe baby (normal or cesarean) in thehospital/nursing home are covered• Coverage up to Rs 2,500 for normaldelivery• Coverage up to Rs 4,500 for caesareansection or complicated delivery• Involuntary termination of pregnancy orother medical emergency• Newborn coverage from day one up tothe end of the policy, even if thenewborn is the sixth member of theenrolled family. (Upon renewal, thehead of household must decide whichdependents are to be enrolled; only 5family members are covered)• Normal hospitalisation period for bothmother and child should not be lessthan 48 hours post delivery• Benefit is on a familyfloater basis, whichmeans that the totalbenefit amount (Rs.30,000) can be used byone person or jointly withother members of thefamily.• Age Limit: There is nolower or upper age limitfor coverage.• Maximum benefit for maternity coverageis Rs. 4.500/- including transportationcharge of Rs. 100/- per hospitalisationExclusions under Maternity Benefit• Abortion: Voluntary termination ofpregnancy, except for medicalemergency to save the life of themother• Hospitalisation Period: If less than 48hours from the time ofdelivery/operation• Payment by beneficiaries: Beneficiaries are required to pay Rs. 30 perfamily as registration charge, at the time of enrollment and upon renewal.Page 6