Health Insurance 111 views March 12, 2021

The Government of Rajasthan launched Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana on 30th January 2021. Under this government health insurance scheme, over 1 Crore 10 Lakh families will receive health cover up to INR 5 Lakh. Earlier, this policy coverage was up to INR 3,30,000 only, but now it has been increased to INR 5 Lakh. This is a family floater plan, so your whole family will be protected financially against medical emergency expenses. Also, the Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana helps you get medical treatment at both government and private hospitals. Know further features and benefits of AB – MGRSBY below.

  1. Coverage for Common Ailments
  2. Coverage for Critical Illness
  3. Pre-and Post Hospitalization Coverage
  4. Easy to Access Hospitalization Service

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Common Ailments Covered Under Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

This Rajasthan Government Health Insurance will cover the following common ailments up to INR 50,000 –

  1. Chest Cold (Acute Bronchitis) Cough, mucus
  2. Common Cold
  3. Sneezing, runny or stuffy nose
  4. Sore throat, cough
  5. Ear Infection
  6. Ear pain
  7. Fever
  8. Flu (Influenza) Fever
  9. Body aches.
  10. Sinus Infection
  11. Skin Infections
  12. Conjunctivitis (“pink eye“)
  13. Diarrhea
  14. Headaches
  15. Mononucleosis
  16. Stomach aches

Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana Critical Illness Cover

You will get financial coverage up to INR 5 Lakh against critical illness under this government health insurance scheme. Some common critical illnesses are –

  1. Cancer of Specified Severity
  2. Heart Attack
  3. Primary Pulmonary hypertension
  4. Blindness
  5. Chronic lung disease
  6. Chronic liver disease
  7. Coma
  8. Major head Trauma

Pre-and Post Hospitalization Coverage

AB – MGRSBY shall pay for the medical expenses incurred 5 days before hospitalization, and such expenses will come under the category of pre-hospitalization medical expenses. And if your attending doctor has prescribed medicine/drugs and any tests post-discharge from the hospital, the same shall be covered up to 15 days and come under the category of post-hospitalization medical expenses.

It means you are financially covered with every medical emergency under AB – MGRSBY.

Procedure to Claim AB – MGRSBY

With the AB – MGRSBY cashless treatment, you do not need to pay money to the hospital for any type of treatment. A health card will be provided to you under this Rajasthan government healthcare scheme. And to claim the policy sum insured, you just need to show your health card in the hospital. After which, the entire cost of the medical treatment shall be borne by the Government of Rajasthan.

Note – Cashless treatment is provided only by Rajasthan government-empaneled hospitals

Exclusion Criteria of Ayushman Bharat Mahatma Gandhi Rajasthan Swasthya Bima Yojana

  1. Medical expenses for illness or injury treatment if it is due to any narcotics abuse
  2. Congenital external diseases, anomalies
  3. Suicide or attempted suicide
  4. Plastic surgery unless it is advised by the treating medical practitioner for the illness or injury treatment
  5. Vaccination
  6. Hospitalization expenses if no treatment has been performed on the insured
  7. Sex change surgery, including hormone replacement therapy
  8. Dental treatment unless it arises due to an accident
  9. Vitamins and tonics unless they are prescribed by the medical practitioner

Eligibility for AB – MGRSBY

If you want to enroll under the AB – MGRSBY, you should meet the following criteria –

  1. Permanent resident of Rajasthan
  2. Aadhaar card and Jan Aadhaar card of Rajasthan State
  3. Your family should be in the eligible families of National Food Security under Socio Economic Survey 2011

Documents Required

  1. Aadhaar card
  2. Jan Aadhaar Card
  3. Ration card
  4. Income certificate
  5. Proof of residence (electricity bill, telephone bill, etc.)
  6. Proof of age (birth certificate, copy of the passport, etc.)
  7. Passport size photograph
  8. Aadhaar registered mobile number

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