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AB-MGRSBY: Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

Introduced under Chief Minister Ashok Gehlot’s government, Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana on 30th August 2019, is an integration of AB-PMJAY and BSBY schemes. It is a very helpful scheme that provides eligible families quality healthcare services such as daycare treatments, hospitalisation expenses, follow-up care pre-hospitalisation and post-hospitalisation, newborn baby expenses, etc.

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AB-MGRSBY: Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY) is a health insurance scheme under Chief Minister Ashok Gehlot’s government introduced to provide quality healthcare services to the people. Announced on 30th August, 2019, the scheme is expected to be very useful for the beneficiaries as it is an integration of AB-PMJAY and BSBY schemes. These schemes have been merged so that more eligible families can be benefited under the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana or AB-MGRSBY.

Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY) benefits the policyholders by offering the following features:

  • Cashless Hospitalisation: The policyholders of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana can avail cashless treatment at any network hospital. Cashless treatment allows the insured to avail of treatment without paying at the hospital for medical expenses that are covered under the policy. These expenses are borne by the government.
  • Wide Sum Insured Range: AB-MGRSBY comes with a wide sum insured range. The main sum insured for every family covered is Rs. 5 lakh per year, which is segmented as Rs. 50,000 for secondary illnesses and Rs. 4,50,000 for tertiary illnesses.
  • Huge Network of Hospitals: Greater number of network hospitals makes it easy for the insured to avail treatment at the time of medical emergency. It will be easier for the insured to reach the network hospital if it is located in the vicinity of the insured. The AB-MGRSBY has many network hospitals where the insured can avail of cashless treatment.
  • Health Insurance on Family Floater Basis: AB-MGRSBY is a family-floater health insurance policy where all the family members insured can use the sum insured under the policy. Family floater health insurance policy is beneficial as it allows all the insured family members to avail the of medical facilities. One can also create a balance when making health insurance claims when availing treatment at different times.

Inclusions Under Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY) covers the insured against the following healthcare expenses:

  • Follow-up care benefits
  • Hospitalisation expenses
  • Daycare treatments if applicable
  • Newborn child/children benefits
  • Pre-hospitalisation and post-hospitalisation expenses

Exclusions Under Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY) does not cover the insured for the following:

  • Vaccinations
  • Minor conditions that do not require hospitalisation, unless stated in the policy
  • Change of gender treatments
  • Vitamins and tonics unless necessitated due to the treatment
  • Dental treatments required to enhance aesthetics
  • Plastic surgery unless required due to an injury
  • Any act of self-harm including suicide
  • Congenital diseases, defects, or anomalies
  • Treatment required due to overuse of any intoxicating substance

Eligibility for Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

Rajasthan is one of the lowest-income states of India. That is why the scheme AB-MGRSBY is launched in Rajasthan aiming towards benefiting the lower-income group families who do not have access to quality healthcare. Given below is the eligibility criteria for AB-MGRSBY:

  • Families must be Rajasthani natives
  • Members of the Ayushman Bharat Scheme
  • Members of the eligible beneficiary family based on SECCO depend on social, caste, and economic census. Family members under National Food Security Act (NFSA)
  • Rajasthani native families
  • Beneficiaries having Aadhaar card, Bhamashah card/acknowledgment slip

Enrolment For Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

There is no requirement to carry out a separate enrolment process to enter AB-MGRSBY. This is because the scheme has not received a complete launch yet, so a specific process for registration for the scheme is not rolled out. But the beneficiaries can check the relevant information related to the scheme and get themselves identified by checking the relevant information from the Jan soochna portal.

Documents Required to Apply for Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

The benefits of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana are provided through the Jan Aadhaar card or the Bhamashah card in all the registered hospitals. Given below are the documents required for the identification of beneficiary families to avail of the scheme.

  • Bhamashah card/Bhamashah acknowledgment slip for families under NFSA (National Food Security Act)
  • Ration card number
  • Eligibility letter for Ayushman Bharat Scheme written by Hon’ble Prime Minister
  • Aadhaar card
  • 23 digit HHID number

Note: It is mandatory to get the Aadhaar card and ration card number connected to Bhamashah car by going to the nearest e-Mitra centre.

Registration for Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

There is no requirement to enroll separately under Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana. The eligible families are required to use the documents mentioned under ‘Enrolment For Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY)’ above, in case of an emergency. The family can thereby avail cashless treatment at the network hospital under the AB-MGRSBY.

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FAQ About AB-MGRSBY: Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

  • What are the toll-free numbers of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY)?

    The toll-free numbers of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana are 1800-111-565 and 1800-180-6127. 

  • Does Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana cover me for daycare procedures?

    Yes, under Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY), you are covered for various daycare procedures as listed under the scheme. 

  • What are the eligibility criteria for availing of the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana Scheme?

    The eligibility criteria for availing Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana Scheme is as follows:

    • Members of the Ayushman Bharat Scheme
    • Families must be Rajasthani natives
    • Members of eligible beneficiaries on the basis of SECCO that depend on caste, economic, and social census. 
    • Family members under National Food Security Act 
    • Beneficiaries with Aadhaar card, acknowledgement slip or Bhamashah card.
  • What is the meaning of secondary and tertiary diseases in terms of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana?

    Secondary diseases in Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana are general health ailments such as extraction of a tooth, tonsillectomy, fractures, and so on. Whereas, tertiary diseases in the scheme are the conditions that are related to critical illnesses such as colonoscopy, lung injury repair, thyroplasty, etc. 

  • What is the policy term of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana (AB-MGRSBY)?

    The policy term for Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana is 12 months from the date of commencement or any time period as stipulated by the RSHAA.