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Wednesday, 16 March 2016

UP SACHI Government Scheme for Free Medical Service and Treatment rsby

State agency for comprehensive health insurance: SACHI | स्टेट एजेंसी फॉर कॉम्प्रिहेंसिव हेल्थ इन्श्योरेन्स
 State government of uttar pradesh launched state agency for comprehensive health insurance which is also known as SACHI. Government establishes the agency for providing free Medical facility to eligible beneficiary poor people because an illness not only represents a permanent threat to their income but also lack of resources. UP Government has started it specially for helping the BPL (Billow Poverty Line) families. According to this Scheme, only by paying Rs 30/- as a registration fee/ amount eligible candidates, on the basis of floater,  5 members of a family (including head of the family), will get free medical facility of Rs 30,000/- per year in the selected government and private hospital or in other words provides cover for hospitalization expenses.  According to SACHI scheme not only free food will be provided for patients but also at the time of discharging 5 days medicine will be given. Beneficiary after getting discharged, are able to get Rs 100/- for going, from the hospital. For which maximum limit is Rs 1000/-annually. And new born baby will get auto insurance security if he /she takes birth in the period of insurance policy.

Main Achievements of the scheme

There was Inauguration ceremony for the website ( of  this scheme on 10th March 2015 under the chairmanship of  chief Secretary, ministry of medical health and Family Welfare, department. The website of SACHI scheme is the only website in India related to “health sector” by which common people and beneficiaries can get complete information about the plan and other things, only in one place, such as details of the service providers and all the information regarding hospital and district coordinator etc.

Features and Highlights of the scheme
In UP Rashtriya Swasthya Bima Yojana (RSBY),  is running by the “SACHI” (State agency for comprehensive health insurance), based on PPP (Public Private Partnership) modal,  This is the state government’s only scheme by which, direct contact is possible with the beneficiary during and after providing the medical facility. Now a days there are 734 private hospitals and 599 government hospitals are running for helping poor people in UP.
Smart Card Status
Smart Card is must for getting the facility given by the scheme SACHI and RSBY, and before hospitalization it is must to show the smart card to the hospital.  
Till the 5th stage government provided medical facility to 1,08,421 eligible beneficiaries under the government’s scheme SACHI. Beneficiaries can check themselves on website about validity of the smart card and left amount in smart card. And also other information like Hospitals at the level of district and state, companies which are providing insurance service, complains given by the beneficiaries and their solutions all will be available on SACHI website.   
List of Empanelled Hospitals
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Hospitals on Map
All the private and government hospitals have been mapped with Google, due to which needed person can access/reach hospitals very easily and also all the information about hospitals  are available on the website such as beneficiaries Treatment profile, Location,  illness, disease profile and Hospital treatment profile means, and all about beneficiaries treatment.

कॉल सेंटर (1800-1800-4444)
 For the successful implementation of the scheme a call center has been set up, by which Anyone can call on the toll-free no. 180018004444 and able to get information related to scheme and limited description and details.

Disposal of all complaints will be done at a specific time, and related details available on the SACHI Website.
कौल सेन्टर पर आयी हुई सभी शिकायतों का निस्तारण सम्बन्धित बीमा सेवा प्रदाता कम्पनी, सहायक परियोजना अधिकारी एवं नोडल अधिकारी के स्तर पर एक निर्धारित समय में किया जाता है तथा उसकी सूचना साची के वेबसाईट पर भी देखी जा सकती है।

Beneficiaries can inform their relatives with the help of Call Centers regarding getting health benefit details, like they are getting right treatment by the hospitals or not, after treatment rent allowance (किराया भत्ता) received or not, during Hospitalization five days drug and meals were provided by the hospitals or not and beneficiaries are satisfied with the treatment or not etc. Beneficiary’s Health-related information can be obtained through the call center after a week of discharging from the hospital.

 Aims of Rashtriya Swasthya Bima Yojana (RSBY) program
UP Government has introduced RSBY yojana for waning/removing the threat of poor people at State level and National level.
RSBY aims to provide consistent quality policy and improvement, applicable throughout the state, in private and public hospitals. This program is for accessing the “Quality health care” to its beneficiaries. And Ensuring Safe, Effective and Timely Health Care Services.  Website of RSBY Scheme is
And in case, if needed person not be able to hospitalize then free medical advises will be provided for that person. And for redress of the errors related to smart card candidates can consult to the district kiosk, which is situated medical officer’s office.

Right to information (RTI)

Public Information Officer    
Dr. AK Singh (Nodal Officer, RSBY) 
Appellant Authority    
Mr. Alok Kumar Mitra (CEO, RSBY)

Important Faq
 1. What is RSBY?
Ministry of Labour and Employment, Government of India has launched a health insurance scheme for BPL families which is called Rashtriya Swasthya Bima Yojana (RSBY).

2. Who is eligible?
The beneficiary is any Below Poverty Line (BPL) family, whose information is included in the district BPL list prepared by the State government. The eligible family needs to come to the enrollment station, and the identity of the household head needs to be confirmed by the authorized official.
3. What is the insurance coverage in RSBY?
Rashtriya Swasthya Bima Yojana provides cover for hospitalization expenses upto Rs. 30,000/- for a family of five on a floater basis. Transportation charges are also covered upto a maximum of Rs. 1,000/- with Rs. 100/- per visit.

4.What is the premium for RSBY?
The premium for RSBY is different in different set of districts. State Governments select insurance companies through open tendering process and technically qualified lowest bid is selected.
5.Who pays the premium for RSBY?
Government pays the premium for RSBY. Central Government pays 75% of the total premium (90% in case of Jammu & Kashmir and North east States) while State Government pays the remaining premium.

6.Will beneficiaries have to pay anything to get the policy?
Beneficiaries need to pay Rs. 30 per family at the time of enrollment.

7.What is the time period for the enrollment and the policy period for the beneficiaries?
    In case of new policy, the Scheme shall commence operation from the 1st of the succeeding month in which the smart card is issued. Thus, for example, if the initial smart cards are issued anytime during the month of April in a particular district the scheme will commence from 1st of May. The scheme will last for one year till 30th of April of next year. This would be the terminal date of the scheme in that particular district. However, in the same example, if the card is issued in the month of May, June and July then the insurance will immediately start from the next day itself for the beneficiaries and policy will be over on 30th April of next year. Thus, all cards issued in the district in May will also have the Policy start date as 1st of May (even if issued subsequent to the date) and terminal date as 30th April of the following year.

8. What is the time period for enrollment and policy period in case of renewal of the policy?
In the case of renewal, the policy will start from first of the next month in which the earlier policy will expire. Therefore, for example, if the earlier policy is getting over on 30th April and card is renewed in the month of April then the new policy will start only from the 1st May and will finish on 30th April of next year. However, in the same example, if the card is issued in the month of May, June and July then the insurance will immediately start from the next day itself for the beneficiaries and policy will be over on 30th April of next year.

Rashtriya Swasthya Bima yojana  RSBY 

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