Biju Swasthya Kalyan Yojana (BSKY Odisha): Features, Coverage & How to Apply

The Biju Swasthya Kalyan Yojana (BSKY) is a comprehensive healthcare scheme launched by the Government of Odisha to provide cashless healthcare services to the state's residents. Introduced in 2018, this scheme aims to ensure that every individual in Odisha can access essential medical care without worrying about financial constraints.

Biju Swasthya Kalyan Yojana (BSKY) Overview

What is Biju Swasthya Kalyan Yojana?

BSKY stands for Biju Swasthya Kalyan Yojana. Launched on August 15, 2018, by Chief Minister Naveen Patnaik, the Biju Swasthya Kalyan Yojana aims to provide financial assistance to Odisha residents for medical treatments. The scheme covers a wide range of healthcare services, from basic to advanced treatments, ensuring that no one is denied medical care due to financial difficulties.

Objectives of Biju Swasthya Kalyan Yojana

The primary objective of this scheme is to provide cashless treatment facilities to residents of Odisha, focusing on the economically weaker sections of society. It aims to reduce the financial burden on families and ensure they have access to quality healthcare services.

Eligibility Criteria for Biju Swasthya Kalyan Yojana (BSKY)

Residents must meet specific eligibility criteria to benefit from the Biju Swasthya Kalyan Yojana. Understanding these criteria is essential for successfully utilising the scheme.

Who is Eligible for BSKY?

Resident of Odisha:

The applicant must be a permanent resident of Odisha. This is a fundamental requirement for receiving benefits under BSKY.

BPL and APL Families:

Both Below-Poverty Line (BPL) and Above-Poverty Line (APL) families in Odisha are eligible for the scheme. This inclusivity ensures that a broad population can benefit from healthcare services.

No Age Restrictions:

BSKY is available to individuals of all ages, from newborns to seniors. This universal age eligibility ensures that the scheme covers the entire population.

Valid Identification:

Residents must possess a valid identification document, such as an Aadhaar card, voter ID, or PAN card, to receive the BSKY card online.

How to Apply for Biju Swasthya Kalyan Yojana Online?

Currently, there is no online registration process for the BSKY application. Families covered under the State Food Security Scheme (SFSS) and the National Food Security Act (NFSA) are automatically eligible, and the government issues BSKY health cards to these eligible families.

Documents Required for Biju Swasthya Kalyan Yojana

Certain documents are required to establish eligibility for Biju Swasthya Kalyana Yojana benefits. These documents ensure that the scheme benefits the correct individuals and that the process remains transparent.

1. Proof of Identity: Aadhaar card, voter ID, or PAN card is necessary to verify the applicant’s identity.
2. Proof of Residence: Aadhaar card, voter ID, or a utility bill such as electricity or water can serve as proof of residence.
3. Proof of Income: An income certificate or BPL card is required to determine the applicant's financial eligibility.
4. Photographs: Recent passport-sized photographs for verification purposes.

These documents help streamline the process and ensure that all eligible residents can access the benefits of BSKY. Also Read: Types and Benefits of Health Insurance Policies in India

Benefits of Biju Swasthya Kalyan Yojana

The Biju Swasthya Kalyan Yojana offers a range of benefits designed to make healthcare accessible and affordable for the residents of Odisha. Understanding these benefits can help you make the most of the scheme.

Cashless Treatment

One of the most significant benefits of BSKY is the cashless treatment facility available at network hospitals across the state. This ensures that patients do not have to worry about out-of-pocket expenses during medical emergencies.

Wide Range of Coverage

The scheme covers various medical services, including hospitalisation, surgeries, consultations, and diagnostic tests, ensuring comprehensive healthcare for all beneficiaries.

High Coverage Limits

BSKY offers substantial financial coverage, with families receiving up to Rs. 5 lakh per annum for medical expenses. This limit extends to Rs. 10 lakh per annum for women beneficiaries.

No Room Rent Capping

BSKY does not impose any room rent capping, allowing beneficiaries to choose a room based on availability and comfort. Also Read: Benefits of Health Insurance

Treatments Covered Under BSKY (Biju Swasthya Kalyan Yojana)

The Biju Swasthya Kalyan Yojana (BSKY) is a government-funded health insurance scheme in Odisha, providing comprehensive healthcare coverage for residents. The following treatments and services are covered under BSKY:

1. Hospitalisation Costs: BSKY covers the costs of hospitalisation, including room charges, doctor's fees, and nursing charges during medical treatment.
2. Surgical Procedures: The plan includes coverage for major and minor surgeries, both inpatient and outpatient, depending on the severity of the condition.
3. Maternity and Newborn Care: Maternity-related treatment and care for newborn babies are covered, including hospitalisation and surgery costs.
4. Critical Illnesses: BSKY covers the treatment of critical illnesses such as cancer, kidney failure, heart attack, stroke, and more.
5. Pre and Post-Hospitalisation: Coverage is available for medical expenses incurred before and after hospitalisation, including diagnostics, medication, and follow-up treatments.
6. Ambulance Services: Emergency ambulance transportation charges to and from the hospital are included.
7. Organ Transplants: Coverage for organ transplants such as kidney and liver transplants is available, ensuring comprehensive healthcare for patients.
8. Ayush Treatments: Alternative treatments such as Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH) are also covered under the scheme.

How to Make a Claim Under BSKY?

Understanding the claims settlement process is essential for beneficiaries to fully utilize the benefits of BSKY. Here’s how the process works:

Document Submission

To make a claim, the necessary documents must be uploaded to the BSKY app within seven days of the patient’s discharge. This includes the claim form, a valid BSKY card, and medical documents.

Electronic Payment

Once the claim is raised, payment is made electronically through the Public Financial Management System (PFMS) within four weeks.

Multiple Procedures

If multiple surgeries are performed during the same session, the claim for the primary procedure is reimbursed at 100% of the package rate. Subsequent procedures are reimbursed at reduced rates.

Document Verification

If the minimum required documents are not provided at the time of claim submission, the hospital is asked to upload the missing documents within seven days. The Biju Swasthya Kalyan Yojana is a groundbreaking initiative by the Odisha government to provide cashless healthcare services to its residents. By understanding the Biju Swasthya Kalyan Yojana eligibility, registration process, and benefits, you can protect your family against medical expenses. If you're eligible and want to know how to apply for a BSKY card or need to check your Biju health card eligibility, the process is simple and accessible through the official BSKY online portal.

Conclusion

The Biju Swasthya Kalyan Yojana (BSKY) is a groundbreaking initiative by the Odisha government to provide cashless healthcare services to its residents. By understanding the eligibility criteria, registration process, and benefits of the Biju Swasthya Kalyan Yojana, you can safeguard your family against the financial burden of medical expenses. If you are eligible and wish to know how to apply for a BSKY card or need to check your Biju health card eligibility, the process is simple and accessible through the official BSKY online portal. *Standard T&C Apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale. Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet and is subject to changes. Please consult an expert before making any related decisions. Claims are subject to terms and conditions set forth under the health insurance policy.