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

RSBY COVERAGEWho is eligible?• BPL/Vulnerable households, identified by the State GovernmentWhat is covered?• Hospitalisation expensesfor medical and/orsurgical proceduresincluding maternitybenefit up to Rs 30,000per family per year on afloater basis. To accessthe benefits under RSBY,a beneficiary should behospitalized in anempanelled hospital for24 hours or more. Inaddition, beneficiariescan also access day care surgeries/procedures that do not require stay ofmore than 24 hours in an empanelled hospital.• Cashless treatment in any of the empanelled hospitals. This means thatwhen a family accesses treatment, they do not pay the hospital anything.• Day Care Surgeries/Procedures in some circumstances. For an indicativelist of covered day care surgical procedures, please refer Annex II of thisGuidebook.• Pre-existing conditions/diseases are covered from day one. Pre-existingdisease relate to a disease that was present at any time in the past(including any disease, which the insured person may not have beenaware of) and prior to the enrollment of the beneficiary under RSBY• Pre- hospitalisation up to 1 day before hospitalisation.• Post-hospitalisation up to 5 days from the date of discharge.2010 RSBY Guidebook Page 5