The Indian state of Rajasthan is one of the most beautiful states in the country. With a population of only 6 crore people, it is rich in folk culture and heritage. Agriculture is the most common occupation here, followed by trade and business. Rajasthan is also one of India’s poorest states, according to the World Bank. Low-income people, sadly, are unable to access services such as salaried jobs or health care. The government, on the other hand, is working hard to eradicate barriers to medical care. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana are two schemes that have been created to provide quality health care.

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

Mahatma Gandhi’s Ayushman Bharat  Rajasthan Swasthya Bima Yojana is a health-insurance program launched by Chief Minister Ashok Gehlot’s administration. It was announced on August 30th, 2019. Because it combines the AB-PMJAY and BSBY schemes, the AB-MGRSBY is predicted to be particularly beneficial to the beneficiaries.

AB-MGRSBY Features and Benefits:

The AB-MGRSBY health insurance plan has the following features and benefits:

1. Cashless Hospitalization: Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana beneficiaries can use a network/impaneled hospital to receive cashless treatment. This list may be found under the heading “List of Hospitals That Cover Under AB-MGRSBY” in this article. A cashless treatment, as the term implies, means that the beneficiary is not responsible for the expense of medical treatment. The government will cover these expenses.

2. Medical Needs Coverage: AB-MGRSBY provides comprehensive coverage that covers the complete cycle of a medical emergency, including follow-up treatment. A list of medical facilities covered by the plan is as follows:

  • Benefits from hospitalization expenses
  • If applicable, daycare treatment benefits
  • Benefits of follow-up care
  • Benefits for pre-and post-hospitalization expenses
  • Benefits for a newborn child or children

3. High Sum Insured: AB-MGRSBY provides the beneficiary family with a substantial sum insured. For each household covered by the scheme, the principal sum insured is Rs. 5 lakh per year. It is divided into the following sections:

  • For secondary ailments, Rs. 50,000 is available.
  • For tertiary disease, Rs. 4,50,000

4. A Large Number Of Empanelled Hospitals: The more hospitals that are enrolled in the plan, the better it is in the event of a medical emergency. If the beneficiary lives near an empanelled hospital, he or she will be able to get there quickly and begin treatment. Many hospitals have signed up to treat patients under the AB-MGRSBY.

5. Health Insurance on a Family Floater Basis: There are many different types of health insurance plans. Individual, family floater, and group health insurance policies are the most frequent. The AB-MGRSBY scheme is a family-floater plan in which the money covered can be utilised by all family members. When compared to other plans, this is advantageous because a balance can be created while filing claims. Individual members of a family, for example, may require treatment at various times. A family floater plan helps ensure that all family members have access to adequate medical care.

What is Not Covered?

The things that aren’t covered by an insurance policy are referred to as policy exclusions. A claim brought against a policy exclusion will not be settled by the insurance company. The following items are not covered by AB-MGRSBY:

  • Minor illnesses that do not necessitate hospitalization, unless otherwise specified in the package list.
  • Vitamins and tonics, unless they are part of the prescribed treatment.
  • Dental procedures are performed to improve appearance.
  • Surgical methods to make one look like the other sex, such as hormone replacement therapy.
  • Vaccinations are not included in the plan.
  • Plastic surgery is not recommended unless it is necessary to repair an injury-related deformity.
  • Circumcision, unless it is medically necessary due to an accident.
  • Suicide attempts and suicides
  • As a result of brain damage, a person can remain in a vegetative state for a long time
  • Medical expenses incurred as a result of excessive use of any intoxicating substance
  • External congenital illnesses, abnormalities, or deficiencies

Eligibility for Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

The program is designed for low-income families who do not have access to high-quality health care. As a result, the eligibility of AB-MGRSBY is limited to select Rajasthan-based families. The Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana has the following qualifying criteria:

  • Based on SECCO’s economic, social, and caste census, members of the qualified beneficiary family. Members of a family that are covered by the National Food Security Act (NFSA)
  • Rajasthani families are necessary.
  • Aadhaar card, Bhamashah card/Acknowledgement Slip are required for beneficiaries.

How to Enroll in AB-MGRSBY: 

To participate in the Mahatma Gandhi Rajasthan Swasthya Bima Yojana, a family of beneficiaries does not need to go through a separate enrolment process. Because the scheme has not yet been fully launched, a special registration process for AB-MGRSBY has not been implemented. Beneficiaries can, however, check the appropriate information on the Jan soochna webpage to see if they are covered by the scheme.

Documents Required for AB-MGRSBY Application:

The benefit of this scheme, like the Bhamashah Health Insurance Scheme, would be provided through the Bhamashah Card (Jan Aadhaar Card) in all registered hospitals. The following documents are necessary for the recipient family’s identification in order to participate in the scheme:

  • For families covered by the National Food Security Act, a Bhamashah Card (Jan Aadhaar Card) / Bhamashah Acknowledgement Slip is required (NFSA)
  • Number on the Ration Card
  • Ayushman Bharat Yojana eligibility letter signed by the Hon’ble Prime Minister is necessary.
  • HHID number with 23 digits
  • Aadhaar Card is a unique identification card issued by the government of India.

Registration Process for Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

Enrollment in AB-MGRSBY does not require separate registration. In the event of a medical emergency, the beneficiary’s family must utilise the documentation specified under “How To Enroll in AB-MGRSBY” in this page. This is how the family can benefit from AB-cashless MGRSBY’s medical treatment.

How To Claim Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana?

During medical treatment, beneficiaries of the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana must bring a few documents with them. These documents will aid them in obtaining secondary or tertiary care packages. Following the verification of documentation, the claim will be resolved between the hospital and the insurance carrier. The following are the documentation needed to file a claim under the Mahatma Gandhi Rajasthan Swasthya Bima Yojana:

  • Card of Bhamashah (Jan Aadhaar Card)
  • Slip of Enrollment
  • The patient’s Aadhaar card

The patient’s Bhamashah Card should also be linked to his or her Aadhaar card. At the time of claim, the family’s HHID number may also be required. The patient or other beneficiaries do not have to worry about claim settlement after verification. There isn’t anything further that has to be done. The beneficiary’s primary focus should be on obtaining appropriate medical care and improving their health.

Also, read

Best Family Floater Health Insurance Plans in India
Family Health Insurance vs Family Floater Plan