Biju Swasthya Kalyan Yojana (BSKY Odisha): Features, Coverage & More

The high costs of healthcare can c͏reate a ͏s͏ignif͏icant barri͏e͏r͏ for many individuals, especially those from economically vulnerable backgrounds. Steep medical ex͏pen͏͏ses ͏are generally associate͏d with ͏ho͏s͏p͏italisatio͏ns͏, ͏surge͏ries, ͏d͏iagno͏stic ͏test͏͏s͏, and other͏ me͏di͏cat͏ions, placing͏ seve͏͏re͏ finan͏c͏ial st͏rain on ͏many f͏a͏͏mi͏͏lies͏. They may be forced to choose between essential healthcare and other basic necessities. People from financially weaker backgrounds are often unable to access preventative care, follow-ups and even timely medical treatments. Due to the absence of cost-effective medical care, many families suffer from huge debts and social inequalities.  

This concern has prompted the Odisha Government to come up with Biju Swasthya Kalyan Yojana (BSKY) in 2018. This healthcare financing mechanism is targeted towards making health care services accessible to all citizens in Odisha especially the most vulnerable groups. BSKY intends to reduce financial barriers to healthcare by providing cashless treatment at network hospitals, including surgeries, hospitalisation, medication, and diagnostic tests.

BSKY ͏is͏ inst͏rumen͏tal ͏in ͏b͏ri͏dgin͏g the healt͏hcare gap ͏by reducin͏͏g th͏e bu͏r͏d͏en of out-o͏f͏-pocket ͏͏expenses,͏ ͏pr͏omoti͏n͏g long-ter͏m ͏heal͏th and well-bein͏g, and ulti͏m͏ately͏͏ con͏tribu͏ting to the socio-economic upliftment of ͏the eco͏͏͏nomica͏lly ͏disadvant͏͏aged͏ populations in Od͏isha.

This article scrutinises this essential project’s nitty-gritty, letting you in on everything, from its creation to its implementation, eligibility criteria and the plethora of benefits it offers.

So, let’s get started!
 

Wh͏at Is Biju Swa͏͏sthya Ka͏lyan Yoj͏an͏͏a?

The Biju Swasthya Kalyan Yojana (BSKY) was launched by the Government of Odisha in 2018. It is a special health insurance scheme known to provide accessible and cost-effective healthcare to all the people of Odisha. This scheme is especially helpful to the people belonging to the vulnerable or economically disadvantaged sections of society.

Under the Biju Swasthya Kalyan Yojana, beneficiaries can avail of cashless treatment at several empanelled hospitals. They can easily undergo treatment for different medical conditions like surgery, hospitalisation and pre and post-hospitalisation expenditures. Furthermore, BSKY provides comprehensive healthcare support by covering the entire cost of prescription medicines, diagnostic tests, and required medical supplies.   

Now, let’s get into the numerous features and benefits of the scheme below-
 

Features And Benefits Of Biju Swasthya Kalyan Yojana (BSKY)

The Biju Swasthya Kalyan Yojana has several features and benefits. Under this scheme, the state government covers all healthcare charges. It includes all diagnostic charges, drugs, cancer chemotherapy, dialysis, ICU, OT, and in-patient admission to blood bank services. This comprehensive coverage is generally covered in all governmental health institutions up to the government medical college hospital level for each person.

Families possessing a BSKY Smart Health Card can receive cashless care at any BSKY-accredited private hospital located within or outside of the state. Cardholder families can use BSKY for registration, consultation, medical tests, diagnostics, treatment, IPD, and follow-up consultation at any empanelled private hospital, with the State Government covering the cost up to the yearly coverage limit.
 

Components Of Biju Swasthya Kalyan Yojana (BSKY)

Let’s get to know the two important components of the Biju Swasthya Kalyan Yojana (BSKY) below -

• Component 1
  You will be provided with free health services, regardless of your financial situation and residence, in all State Government healthcare institutions. This includes sub-centres, PHCs, CHCs, area hospitals, SDHs, district health quarter hospitals, and all government medical college hospitals and blood banks.
  
  Furthermore, as previously said, all health services, including free medications, diagnostics, dialysis, cancer chemotherapy, OT, ICU, in-patient admission, and so on, are provided at no cost to all individuals in all government health institutions up to the government medical college hospital level. You also do not require any documents to avail of cashless treatments.
   
• Component 2
  Over 70 lakh economically disadvantaged families in the state receive additional free healthcare beyond what is offered by government hospitals at 192 empanelled private hospitals. These families must have a BKKY, BPL, or AAY card, as well as an annual income of Rs. 50,000 in rural areas and Rs. 60,000 in urban areas. The annual health coverage for each family is Rs. 5 lakh, and for women members of the family, it is Rs. 10 lakh.
  
  Patients with illnesses related to cancer, hearts, or kidneys are eligible for the aforementioned services even if their yearly income is less than Rs. 3 lakhs. BSKY covers all government hospitals and prestigious medical facilities, even those located outside the state.
   

What Is Covered Under Biju Swasthya Kalyan Yojana (BSKY)?

Here’s what is covered under the Biju Swasthya Kalyan Yojana (BSKY) -

• Inpatient Treatment
  The Biju Swasthya Kalyan Yojana (BSKY) pays for all medical expenses incurred while hospitalised, including the cost of the room, nursing care, and any required medical care.
   
• Outpatient Treatment
  BSKY additionally covers medical expenses incurred during outpatient visits to hospitals or health centres, including consultation fees, diagnostic tests, and prescriptions.
   
• Maternity Expenses
  BSKY covers the entire cost of delivery and post-delivery care under maternity expenses. It also covers postpartum care for the mother for a few weeks following discharge. This provides relief to financially constrained families by offering adequate healthcare for new moms without financial stress.
   
• Homoeopathic And Ayurvedic Treatment
  In addition to allopathic (modern) treatment, BSKY includes Ayurvedic and homoeopathic remedies. This incorporates coverage for competent in-patient Ayurveda, Unani and Homoeopathy treatments, as well as diagnostic tests, drugs, Panchkarma therapies, and recognised procedures that acknowledge the value of traditional medical forms.
   
• Organ Transplant
  BSKY covers organ transplant procedures, including the cost of the surgery and follow-up care. This includes expenditures for donor screening, organ harvesting, hospitalisation for engraftment operations, and immunosuppressive drugs required for long-term post-transplant recovery, providing new hope for patients suffering from chronic organ failure.
  
  BSKY covers a range of treatments and diseases. Let’s get to know what all diseases are covered under the scheme-
   

Treatments And Diseases Covered Under BSKY

The current BSKY Health Benefit Package (HBP), which was revised in 2022, contains the Unspecified Package among its 2066 procedures spread across 30 specialisations. Let’s look at the diseases covered under the BSKY below-

• Burns Management
• Cardiology
• Covid-19
• Cardiothoracic Vascular Surgery
• Emergency Room Packages
• ENT
• General Medicine
• General Surgery
• High-End Diagnostics
• High-End Procedures
• Infectious Diseases
• Interventional Radiology
• Medical Oncology
• Mental Disorders
• Neonatal Care
• Neurosurgery
• Obstetrics and Gynecology
• Ophthalmology
• Oral and Maxillofacial Surgery
• Organ and Tissue Transplant
• Orthopaedics
• Palliative Medicine
• Paediatric Medical Management
• Paediatric Surgery
• Plastic and Reconstructive Surgery
• Polytrauma
• Radiation Oncology
• Surgical Oncology
• Unspecified Package
• Urology

Note - All the Health Benefit Package (HBP) procedures are regularly updated and are made available on the BSKY website.
 

What Is A BSKY Card?

The BSKY Smart Health Card is a Smart Card Operating System for Transport Applications (SCOSTA) card with a 64 KB chip that is printed with the name of the household head and the card number. The chip has information on the family, including the names, ages, genders, and demographics of each beneficiary as well as their unique smart card number and relationship to the head of the home. 

Now, let’s explore the registration process for the Biju Swasthya Kalyan Yojana (BSKY)!
 

Biju Swasthya Kalyan Yojana (BSKY) Registration Process

There is no online application procedure available for the Biju Swasthya Kalyan Yojana (BSKY) to receive a health card. Instead, a BSKY Smart Health Card is automatically granted to any family in Odisha that is covered by the State Food Security Scheme (SFSS) or the National Food Security Act (NFSA). Every qualified household receives a BSKY Smart Health Card from the government, and the BSKY database is updated often and synchronised with the NFSA/SFSS databases in real-time.
 

How To Check The Biju Swasthya Kalyan Yojana Beneficiary List?

Here is the step-by-step guide for you to check the beneficiary list for the Biju Swasthya Kalyan Yojana (BSKY) -

Step 1: Head over to the official website- nhmodisha.gov.in.

Step 2: Proceed to the homepage and click on the BSKY Beneficiary List link to view the beneficiary list.

Step 3: Make sure to search for your name. After that, you will be taken to a page with the full list of BSKY beneficiaries. To swiftly locate your name in the list, hit the keyboard shortcut Ctrl+F and type it.

All residents of Odisha are entitled to cashless healthcare services at all State Government healthcare institutes.

Below is the basic eligibility criteria for BSKY-
 

Eligibility Criteria Of The Biju Swasthya Kalyan Yojana (BSKY)

Candidates should meet certain eligibility criteria to qualify to buy insurance coverage under the Biju Swasthya Kalyan Yojana (BSKY) in Odisha. Let’s look at the eligibility criteria below -

• Residency: Should be a resident of Odisha.
• Income Limit: In rural areas, a family's income cannot exceed ₹5 lakh, and in urban areas, it cannot exceed ₹6 lakh.
• Card Holders:
  • Holders of Biju Krushak Kalyan Yojana (BKKY) cards.
  • Holders of Below Poverty Line (BPL) cards.
  • Holders of Antyodaya Anna Yojana (AAY) cards.
  • Holders of Rashtriya Swasthya Bima Yojana (RSBY) cards.
     

Documents Required For Biju Swasthya Kalyan Yojana (BSKY)

The Biju Swasthya Kalyan Yojana (BSKY) requires the following papers for verification -

1. Residential Proof: Documents indicating residency in Odisha.
2. Aadhaar Card: While Aadhaar is required, exceptions are given upon enrollment if applicants obtain it within one year of the project's start.
3. Below Poverty Line (BPL) Certificate: Proof that you are a BPL cardholder.
4. Income Certificate: Documentation that proves the family's income.
5. Profession-Related Certificate: Proof of the applicant's profession, if applicable.

Important Note- These documents are required to prove residency and financial status to be eligible for the plan.

Now, let’s get to know the detailed process for claim settlement for BSKY.
 

Claims Settlement Process Of BSKY

Here is the detailed process for claim settlement under BSKY  -

• Submission Of Documents
  The necessary documentation for claim settlement, as defined in the package master, should be uploaded to the BSKY app within seven days of the patient's discharge. Claims submitted after this deadline may be denied.
   
• Electronic Payment
  After submitting e-swasthya claims via the BSKY programme, payment is processed electronically via the Public Financial Management System (PFMS) within four weeks.
   
• Multiple Surgical Procedures
• If a beneficiary undergoes numerous surgical procedures during a single OT session, reimbursement is arranged as per the following -
  • The primary procedure or the highest rate is reimbursed at 100% of the entire package rate.
  • The second procedure is typically reimbursed at 50% of the package rate.
  • The third and subsequent procedures are reimbursed at 25% of the total package rate.
     
• Missing Documents
  If the hospital does not provide the minimum number of required documents when a claim is raised, they should upload the missing papers within seven days. The BSKY application will automatically obtain the claims if these documents are uploaded.
   

Documents Necessary For Making A Claim Against BSKY

You will require the below documents if you want to make a claim under the Biju Swasthya Kalyan Yojana (BSKY) -

1. Claim Form: Duly filled claim form.
2. Valid BSKY Card: Evidence of enrollment in the BSKY programme.
3. Medical Documents: All of the essential medical records, such as prescriptions, records of treatment, and diagnosis reports.
4. Proof of Identity: Identification paperwork, like an Aadhar card or voter ID.
5. Receipts for Medical Expenses: Original receipts for all medical costs incurred.

Note-  Make sure you procure all these documents, as they are crucial for verifying and processing your claim.

Now, let’s look at the contact information for Swasthya Mitras at private empanelled hospitals below!
 

Contact Details Required For Swasthya Mitras At Empanelled Private Hospitals

Below are some of the important hospital names, along with their contact information. You can look at the detailed list of the empanelled private hospitals here.

Address And Toll-Free Number For BSKY

Address: A1 Block, 2nd Floor Toshali Bhawan, Satyanagar, Unit - 9, Bhubaneswar, Pincode - 751007, Odisha.

Contact Number: 0674-2620500

Mail: snaodisha@gmail.com , bsky@odisha.gov.in

The Bottom Line

Th͏e ͏Bi͏͏ju Swast͏hya Ka͏lyan Yojana (B͏͏SKY͏) sta͏nds as͏ a true͏ testament to the Odisha Gover͏nment’s͏ ͏commitmen͏t ͏in providing accessible and hig͏h-q͏ual͏i͏ty͏ hea͏͏l͏thcare͏ to eco͏nomic͏ally vulnerable popu͏lat͏ion of Odisha. ͏In a world where ͏high costs of healthcar͏e are͏ a͏͏ s͏ignificant ba͏r͏rier t͏o acce͏ssing necessary medical services, BSKY sh͏ines as a beacon͏ o͏f hope ͏and guid͏anc͏e, offering a r͏ol͏e mo͏del fo͏r ot͏her r͏eg͏ions to emulate. Thu͏s, BSKY embod͏ies ͏the p͏rinciple tha͏t healthcare is not a pr͏ivi͏lege but a fu͏ndamental h͏um͏an͏͏ ͏r͏ight͏, ensuring ͏a ͏hol͏ist͏ic͏ ͏a͏pproach to health͏͏ and well-being.

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