The Government of Odisha’s vision is to ensure access to quality healthcare for all residents of the State, particularly focusing on the economically vulnerable segments. To achieve this goal, it has introduced the Biju Swasthya Kalyan Yojana (BSKY), a groundbreaking initiative aimed at offering universal health coverage with a special focus on safeguarding the health of vulnerable families and women. In this article, we will talk about the Biju Swasthya Kalyan Yojana in detail. I hope by the end of the article, you will not have any doubt regarding the scheme. You can comment down below in case of any queries left after the exam.
What is Biju Swasthya Kalyan Yojana?
BSKY popularly known as Biju Swasthya Kalyan Yojana is a health insurance scheme for the permanent residents of Odisha. The scheme mainly focuses on safeguarding the health of vulnerable families and women. Under this scheme, anyone with the domicile of Odisha can avail the free or cashless health care in any state government hospital. However, to avail the cashless health care in private empanelled hospitals, one need to be identified as economically vulnerable families in the State.
Every life is precious. BSKY is a paradigm shift in India’s healthcare service system
– Naveen Pattnaik
As an identified economically vulnerable family in the State, the state government will bear an annual health coverage of Rs. 5 lakh per family and additional Rs.5 lakh for the women members of the family after exhaustion of the initial limit. Let’s talk about the Biju Swasthya Kalyan Yojana key highlights in detail.
| Biju Swasthya Kalyan Yojana (BSKY) 2023 Key Highlights | |
| Biju Swasthya Kalyan Yojana launch date | August 15,2018 |
| Biju Swasthya Kalyan Yojana Official Website | Click Here |
| Biju Swasthya Kalyan Yojana Objective | To provide healthcare service to every citizen of Odisha (with a special focus on safeguarding the health of vulnerable families and women.) |
| Biju Swasthya Kalyan Yojana Eligibility | All Citizen of India – For Government Hospitals BSKY Smart Health Card/ National Food Security Act (NFSA)/ State Food Security Scheme (SFSS) card – For empanelled private hospitals. |
| Biju Swasthya Kalyan Yojana Enrollment Process | For Health Coverage upto 5 lakh in eligible private hospitals one must have a BSKY Health Card. |
| Biju Swasthya Kalyan Yojana Health Coverage Amount | Rs 5 Lakh for BSKY Health Card Holders Rs 10 lakh for Women having BSKY Health Card |
| Biju Swasthya Kalyan Yojana BSKY Health Card Validity | The validity of the BSKY Smart Health Card is linked to the presence of the family members’ names in the NFSA/SFSS database. It does not require renewal. The annual amount available for the beneficiary family is renewed automatically each year. |
| Biju Swasthya Kalyan Yojana Family Size Limit | No limit. The family members included in BSKY are also listed in the updated database of NFSA/SFSS. |
| Biju Swasthya Kalyan Yojana Helpline Number | 104 (Toll Free Number)E & IT Department Number-155369 (for any BSKY Smart Health Card related issues) |
| BSKY Dashboard | Click Here for BSKY Dashboard |
Biju Swasthya Kalyan Yojana Objective
- The primary objective of the Biju Swasthya Kalyan Yojana 2023 is to provide cashless health care to the permanent residents of the state.
- Any permanent citizen of the state can go and avail of cashless health care. The State Government will bear the full cost of all health services delivered to all patients.
- For Identifying economically vulnerable families in the State, the state government will bear an annual health coverage of Rs. 5 lakh per family (Rs 10 lakh for the women members of the family) after the exhaustion of the initial limit.
- This will make every citizen of the state independent and empowered so that they can avail of cashless healthcare services.
- The services that are provided under Universal Health care up to MCH level are:
- All services are free of cost including OPD registration fees.
- Free drugs
- Free Diagnostic (Pathology, Radiology, Biochemistry, Ultrasonology, Histopathology charges)
- Free Cancer Chemotherapy.
- Free Dialysis charges.
- Free OT charges
- Free ICU charges
- Free IPD accommodation, etc,
Biju Swasthya Kalyan Yojana Eligibility Criteria
Before you try to avail the benefit of Biju Swasthya Kalyan Yojana, it is imperative to check the full Biju Swasthya Kalyan Yojana Eligibility Criteria. Here is the Biju Swasthya Kalyan Yojana eligibility in the list below.
- All citizens of Odisha are eligible for cashless health care services at all State Government health care institutions. You don’t need to have any card or application to avail these services.
- Please note that the State Government will bear the full cost of the healthcare service.
- In order to take the cashless health care benefit at empanelled private hospitals within and outside Odisha, one needs to have a BSKY Smart Health Card/ National Food Security Act (NFSA)/ State Food Security Scheme (SFSS) card.
- Through these cards, the holders are eligible to avail cashless health coverage of Rs. 5 lakh per annum per family and additional Rs. 5 lakh for women members of the family after exhaustion of initial limit.
Also, to determine the eligibility of a beneficiary under BSKY, a two-way authentication process is followed:
- The beneficiary’s name is cross-verified with the information stored in either the BSKY Smart Health card or the NFSA/SFSS card. This validation is carried out using the BSKY application or a POS machine, which connects to the NFSA/SFSS server. If the beneficiary’s details are found in the NFSA/SFSS database, they are considered eligible. Otherwise, they are deemed ineligible.
- Once the validation from the NFSA/SFSS database is established, a second authentication step takes place using Aadhaar-based verification. This can be done through either the IRIS biometric technology or a POS device.
What is a BSKY Health Card? | Biju Swasthya Kalyan Yojana Card
The BSKY Smart Health Card is a chip-based SCOSTA card with a storage capacity of 64 KB. It is personalized with the cardholder’s name and card number, representing the head of the household.
Inside the chip, it securely holds essential family information, including the names, ages, genders, demographic details, and Aadhaar numbers of all beneficiaries. Each family member is assigned a unique smart card number, along with their relationship to the head of the household.
Check your BSKY Card Balance Here
Biju Swasthya Kalyan Yojana Documentation Required
In order to avail the Cashless Health Care service under BSKY, one needs to have a BSKY Health Card which will be sanctioned or distributed by the Odisha Government.
In case you don’t have the BSKY Health Card, you can avail one by visiting the designated Mo Seva Kendra by producing your valid NFSA/ SFSS Card.
To avail the cashless health care service in the government hospitals within Odisha, you don’t need to produce any health card.
Biju Swasthya Kalyan Yojana 2023 Empanelled Hospitals List
For the BSKY Smart Health Card holders, there is a list of Empanelled Hospitals published by the Odisha Government. The patient can be referred to transfer to any of these hospitals within or out of Odisha. Here is the complete Biju Swasthya Kalyan Yojana Hospitals list provided below.
Download the Complete List of Empanelled Hospitals under BSKY [PDF]
For more details on this, please visit this link of updated empanelled list under BSKY.
Biju Swasthya Kalyan Yojana How to Apply Online? | Biju Swasthya Kalyan Yojana Enrollment Process
- You don’t have to enroll anywhere for the scheme as there is no direct enrolment process under Biju Swasthya Kalyan Yojana.
- If you belong to vulnerable families and are covered under NFSA / SFSS within Odisha are eligible beneficiaries.
- You will receive the BSKY Smart Health Card distributed by the Government.
- If you are one of the vulnerable families and are covered under NFSA / SFSS within Odisha, you can collect your BSKY Smart Health Card at designated Mo Seva Kendra by producing your valid NFSA/ SFSS Card.
Please Note: The BSKY database is updated and synchronized with the NFSA/ SFSS database in a real time manner.
Biju Swasthya Kalyan Yojana Health Package
Under BSKY Health Package, the detailed list of packages is available on the website. Please note that this list is subject to periodic updates. There are three types of package under BSKY Health Package
- Reserved Package
- Referral Package
- Open Package
Reserved Package
Around 3% of the total packages are reserved exclusively for treatment in Government health institutions. These packages cover treatment for minor ailments and diseases under National Health Programs, as well as specific surgical procedures, and are only available in Government facilities.
Referral Package
- Around 10% of the packages fall under the referral category, which can only be availed on a referral from the appropriate authority. The updated list of referral packages is also available on the website.
- Referral to impanelled private hospitals is allowed under certain conditions, such as when the required package or procedure is not available at a Government facility in the district when there is a long waiting time at a Government facility, or in cases of emergencies requiring immediate referral.
- The referral process is decentralized up to the Sub-Divisional Hospital level, with designated medical officers responsible for issuing referrals to beneficiaries under BSKY.
Download the Referral Application form under BSKY [PDF]
Open Package
The remaining packages are categorized as “Open packages,” which means any beneficiary can directly seek treatment at any empanelled private hospital. The treating doctor at the empanelled hospital will assess the beneficiary’s suitability for the package before proceeding with the treatment.
Biju Swasthya Kalyan Yojana Pre- Authorization Process
1. Pre-authorization is required for procedures with a package cost of Rs 10,000 or higher, as well as for all cases falling under the “Unspecified” category.
2. Settlement of Pre-authorization necessitates the submission of the minimum documents specified in the package master.
3. If the hospital fails to provide the required minimum documents, they will be requested to furnish the missing documents. Failure to upload the requested documents within 7 days will result in auto-rejection of the Pre-authorization request by the BSKY application.
4. The Turnaround Time (TAT) for Pre-authorization is 24 hours for package costs of Rs. 10,000 or more. If no decision is made within this timeframe, the Pre-authorization is automatically approved by the BSKY application. However, for “Unspecified” package Pre-authorization, auto-approval occurs after 48 hours if no decision is made in the interim.
5. Hospitals are prohibited from booking medical and surgical packages together. Exceptions can be made in rare cases with proper justification and prior pre-authorization.
Download BSKY Pre -Authorization Process [PDF]
Biju Swasthya Kalyan Yojana Claim Settlement (Under BSKY Health Card)
The BSKY application requires the minimum necessary documents for claim settlement to be uploaded within 7 days of the patient’s discharge. If these documents are uploaded after the 7-day period, they will be rejected by the application.
Payment for approved claims is made through electronic transfer via the Public Financial Management System (PFMS) within four weeks of raising the claims in the SKY application.
In cases where a beneficiary undergoes multiple surgical procedures during one operation session, the procedure with the highest rate is considered the primary package and reimbursed at 100% of the package rate. The second surgical procedure is reimbursed at 50% of the package rate, while the third and subsequent surgical procedures are reimbursed at 25% of the package rate.
If the minimum required documents for claim settlement are not provided when raising the claim in the BSKY application, the hospital is requested to upload the missing documents. Failure to share these documents within 7 days results in automatic rejection of the claims by the BSKY application.
Biju Swasthya Kalyan Yojana Grievances
The Government of Odisha has set up a grievances panel under which you can ask your doubt regarding the scheme.
| Biju Swasthya Kalyan Yojana Grievances Number | |
| BSKY Helpline (Toll Free) | 104 |
| BSKY Smart Card Helpline | 155369 |
| Mo Sarkar Call Center | 14545 |
The State Government collects feedback from beneficiary patients about treatment quality, service providers’ behavior, and out-of-pocket expenses. Citizens can register their feedback or grievances by calling the Mo Sarkar Call center.
Biju Swasthya Kalyan Yojana FAQs
How many members in a family are eligible to benefit from BSKY at empanelled private hospitals?
All the registered family members under NFSA/ SFSA who are issued with BSKY Smart Card are eligible to avail the benefit at any empanelled private hospitals under BSKY
My original BSKY Health card is lost/ damaged. How to get a duplicate BSKY card?
In case a beneficiary loses or damages their card, they can obtain a new one from the nearest Mo Seva Kendra by presenting their NFSA/SFSA card as proof.
In case of multiple surgeries, will I get 100% reimbursement under BSKY?
Unfortunately, No. In case of multiple surgeries, the following percentage of reimbursement will be done
100% – In case of 1st surgery
50% – In case of 2nd surgery
25% – In case of 3rd and subsequent surgeries.
Who are Swasthya Mitras under BSKY?
Swasthya Mitras, appointed by State Health Assurance Society (SHAS), Odisha, serve as frontline facilitators at private empaneled hospitals. They act as a bridge between SHAS and the hospitals, being the primary point of contact for the beneficiaries.
I am a male and I spent 3 lakh from the BSKY Health Card. Now my wife needs surgery. What limit is left in the Health Card now?
If male member falls sick and exhausts Rs 3 Lakh from BSKY Smart Health card and then the women member falls sick, she can avail up to Rs 7 lakh under the BSKY Health Card.
How to do Biju Swasthya Kalyan Yojana card renewal online?
You don’t need to renew the BSKY card. It will be auto renewed by the government every year.
How to check BSKY Card member details?
You can check the BSKY Card member details through BSKY application or a POS machine. You can visit your nearest Mo-Seva Kendra to check your BSKY Card member details.
How to check the BSKY Health Card Balance under BSKY Scheme?
Under BSKY, you can do the Biju Swasthya Kalyan Yojana balance check by entering your BSKY/ Ration Card Number. All these information is available in BSKY dashboard
What is the BSKY Card limit under Biju Swasthya Kalyan Yojana?
Under the BSKY scheme, a total limit of Rs 5 lakh per family is given. An additional 5 lakh is for the women of the family.
