On 72nd Independence day, the Hon’ble Chief Minister, Odisha, Shri Naveen Pattnaik
has launched the BijuSwasthyaKalyanYojana (BSKY) which has two components viz:
a)Universal Health Care (Free healthcare) to all people of Odisha in all Government
health institutions upto DHH levels. All persons, irrespective of income status
or residence, can avail all procedures provided in Government health facilities,
including in-patient beds, surgeries, OT facility, ICU facility etc., without any
charge.
b) Annual Cashless health coverage of 5 Lakh per family (7 Lakh to women members
of family) to 70 lakhs families that belong to the lower socio-economic section
of the society of the State in all Government and 208 empanelled Private health
institutions (through the existing RastriyaSwasthyaBimaYojana(RSBY), BijuKrushakKalyanYojana(BKKY)
and Odisha State Treatment Fund (OSTF) schemes.
69,69,672 RSBY (BPL, MGNREGA & B&OCW
families), BKKY Stream-I (Farmer families) & BKKY Stream-II (RSBY families) Card
holder families are getting Rs.1,00,000/- cashless health benefit under RSBY & BKKY
insurance schemes. OSTF scheme provides top-up of additional Rs.4,00,000/- (Rs.6,00,000/-
to women members of families) cashless health benefit to these RSBY/ BKKY Card holder
families. Further, families who not covered either under the BKKY or the RSBY but
have annual income within Rs.60,000 in urban areas and Rs.50,000 in rural areas
will be eligible for Rs.5,00,000 (Rs.7,00,000/- to women members of families) per
annum health protection under OSTF in assurance mode, on production of income certificate/
BPL Card/ Antodaya Anna Yojana Card. For Cardiac, Renal and Cancer patients annual
income is relaxed upto Rs.3,00,000/-.
To facilitate this, BSKY Helpdesks have operational in all District Headquarter Hospitals and First Referral Units in the State.
Since its inception on 15.08.2018, the BSKY has launched a new era in Universal Health
Coverage, by providing cashless treatment to over 45 Lakh people each month. Under
the scheme, SwasthyaMitras have been deployed in BSKY Helpdesks of all empanelled
hospitals to facilitate the beneficiaries.
Empanelment: Besides Public hospitals,208 Private hospitals have been empanelled under BSKY. Every hospital has a nodal
officer & helpdesk for seamless provision of treatment to the beneficiaries. Under
the scheme, more hospitals are proposed to be empanelled within & outside the State.
Details of currently empanelled hospitals can be obtained from H&FW Department,
NHM, Odisha & district websites.
Currently, Insurance Companies are empanelling
hospitals after due approval of State Nodal Agencies under RSBY & BKKY. Under OSTF,
hospitals are being empanelled directly under H & FW Department after verification.
Hospital empanelled under RSBY & BKKY are auto-empanelled under OSTF. Hospital empanelment
process under OSTFis being further streamlined and in future it will be undertaken
in online mode.
Packages:A total of 4036 packages have been finalized under BSKY.
Package rates have been rationalised keeping current cost of treatment in view.
Most rates are above CGHS package rates. This aims at better acceptance of beneficiaries
by the empanelled hospitals & attract more numbers of hospitals for empanelment
under BSKY.
Claim Settlement Process: Claim settlement under RSBY & BKKY is undertaken
through Insurance Companies. Under OSTF claim settlement is currently processed
in manual mode and it is proposed to undertake online settlement of claims under
OSTF in the near future.