Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY)

Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY)

On 30th January 2021, Rajasthan Chief Minister Ashok Gehlot launched new phase of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY) to provide free treatment to the poor of the state at government as well as private hospitals.

The State Government had launched the Ayushman Bharat Scheme in Rajasthan on September 1, 2019 by combining the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) of the Center and the state’s Bhamashah Swasthya Bima Yojana (BSBY). 

The combined new scheme was named the Ayushman Bharat-Mahatma Gandhi Rajasthan Health Insurance Scheme (AB-MGRSBY).

What’s new in 2nd Phase:

  • The number of healthcare packages has been increased from 1,401 to 1,576.
  • Treatment of COVID-19 and hemodialysis has also been included in the list of packages of this scheme
  • Earlier, an eligible family was getting coverage of ₹ 3.3 lakh per year, which has now been increased to ₹ 5 lakh under AB-MGRSBY.
  • Earlier, the patients were getting a cover of Rs 20,000 for general illness and Rs 3 lakh for serious ailments but that has also been increased to Rs 50,000 and 4.5 lakh lakh, respectively.
  • Earlier, 98 lakh families were covered under the scheme, but now 1.1 crore families will be benefitted, which accounts for about two third population of the state.
  • Under this scheme, amount spent on OPD and tests before 5 days of admission to the hospital and 15 days after the discharge can also be reimbursed.
  • The AB-MGJAY will be implemented by the state health Assurance agency (SHAA), Jaipur.
  • Cashless treatment facilities at empanelled private and government-run hospitals

Cost to State

The State Government would bear 100% of the premium of NFSA beneficiaries and the Central would pay 60% of the premium pre-fixed by
the Union Government, which is Rs. 1052 per family, that too only for the families under the SECC category.

In Rajasthan, the actual premium amount paid would be Rs. 1662 per family. Thus, the state government will pay the difference of the total of pre-fixed premium of Rs. 1052 and the actual premium of Rs. 1662 for the SECC category beneficiaries as well.

The scheme is estimated to cost ₹1800 crore annually and the state government will bear 80 per cent of the cost which amounts to ₹1400 crore. The remaining ₹400 crore will be provided by the Central Government.

Identification of Beneficiaries AB-MGRSBY

There are 60 lakh families who are listed in  Socio-Economic Caste Census (SECC) 2011 in the state. Besides, there are 1 crore families covered under NFSA.

But, 80% of 60 lakh families listed in SECC 2011 are also covered under NFSA and they were already getting BSBY benefits.  Now, the remaining 20% of the families listed in SECC, which is around 10 lakh, who were not getting benefits of BSBY earlier, will now start getting the cashless insurance scheme (AB-MGRSBY).

Hence, total number of families getting benefits will be increased from 1crore to 1.1 crore.

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