Yeshasvini Health Insurance Scheme | karnataka.gov.in | yeshasvini health insurance scheme application form | yeshasvini health insurance scheme in karnataka |
Yeshasvini Health Insurance Scheme was launched by the Karnataka State Government on 1st June 2003 with an aim to provide comprehensive affordable medical facilities in the state. The scheme is implemented by the Cooperative Department and it harnesses the funds of cooperatives through the Yashaswini Trust.
It offers medical insurance coverage along with coverage of 823 different surgical procedures. Only those persons who are members of the cooperative society can avail the benefits of this health insurance scheme.
In this article we will share all the important information related to the Yeshasvini Health Bima Yojana like Features and Benefits, Eligibility Criteria, Coverage provided, Registration, List of Medical Services Covered, Network Hospitals Included, and much more.
Yeshasvini Health Insurance Scheme
Yashaswini Swasthya Insurance Scheme by govt of Karnataka is a community-based medical insurance program to assist workers in the informal economy of Karnataka who falls in the middle and lower-middle income groups. Former Chief Minister of Karnataka “SM Krishna” launched the Yashaswini Swasthya Bima Yojana in 2003 to provide complete coverage to farmers who are members of state cooperative organizations.
It uses funds earned by cooperatives through the Yashaswini Trust to provide affordable access to essential healthcare facilities to rural unorganized workers. The Yashaswini Cooperative Health Care Trust, registered under the Indian Trusts Act of 1882, oversees the program providing coverage to people in over 30 districts of Karnataka.
|Scheme’s Name||Yeshasvini Health Card Scheme|
|Launched By||Karnataka Government|
|Beneficiaries||Farmers of the State|
Implementing Steps for the Yeshasvini Health Insurance Scheme
Yeshaswini Swasthya Bima Yojana is being implemented by 730 network hospitals affiliated with the trust. Both government and private hospitals are included. The Trust authorizes network hospitals to provide medical services under the standards of the panel.
Management Support Service Provider (MSP) arranges cashless hospitalization through these 730 network hospitals. Following are the steps involved in implementing Yeshaswini Swasthya Bima Yojana:
- A network hospital that the trust identifies and authorizes is visited by the Yashaswini beneficiary.
- A network hospital coordinating officer will verify the UHID card of the beneficiary.
- The nominating party is required to pay the fee.
- The patient should then undergo a preliminary diagnosis and some basic medical tests
- The network hospital will submit an online pre-authorization request to the MSP along with supporting documentation based on the initial diagnosis.
- The request will be examined by the doctors selected by the MSP and approval will be issued the next day.
- The network hospital will offer cashless treatment to the beneficiary keeping in mind the restrictions mentioned in the program.
- The network hospital will send the original invoice, discharge summary, and other medical records to the MSP for settlement of the claim after the patient is discharged.
- Within 45 days of receipt of the document, the trust will settle the claim with the network hospital through MSP.
Benefits Of the Yeshasvini Health Insurance Scheme
There are many benefits provided by the Yeshasvini Health Card Scheme such as:-
- The member contribution is as follows:-
- For rural schemes- Rs.300 per year
- For urban schemes- Rs.710 per year.
- A subsidy of up to Rs.600 will be provided to SC/ST members.
- Many people such as:-
- Members of all cooperative societies including self-help group members
- Members having a transaction with a cooperative society
- Members of fishermen cooperative societies
- Beedi workers can avail of the benefit of the scheme.
- Over 730 network hospitals are included in the scheme.
- The cashless manner has opted for the scheme.
Network Hospitals Included in Yeshasvini Health Insurance Scheme
As per Yeshasvini Sahakari Farmers Health Care Scheme, there are around 572 network hospitals. The number of network hospitals in Karnataka is displayed in the table below:-
|District’s Name||Number of The Network Hospitals|
List of Medical Services Covered by Yeshasvini Health Insurance Program
The Yeshasvini health program was put in place for members of urban and rural cooperatives, and covers the following charges for surgery and treatment:-
- Accidents during the operation of agricultural implements
- Cardiac Arrest
- Dog bite
- General Surgery
- Gynecology Surgery
- Genito-urinary Surgery
- Neurological Surgery
- Neonatal Intensive Care
- Normal Delivery
- Orthopedic, Pediatric, cardiothoracic Surgery
- Ophthalmology Surgery
- Surgical Oncology
- Vascular Surgery
List of Exclusions Medical Services
- Cosmetic surgery
- Cost of vitamins, or sanitary items
- Diagnostic investigations
- Dental surgery
- Heart transplant
- Implants, prosthesis
- Inpatient medical treatment
- Joint replacement surgery
- Kidney transplant
- Post-surgery follow-up treatment
- Road accidents
- Skin treatment or grafting
- Vaccination or inoculation
Coverage Provided by the Scheme
Farmers can get coverage up to 2.5 lakhs for an annual premium payment of less than Rs 250 under the Yashaswini Swasthya Bima Yojana. Farmers participating in this program are covered for medical emergencies of family members.
Given below are the eligibility criteria for Yashaswini Health Card Scheme:-
- The applicant must be a resident of Karnataka state.
- The applicant must be a member of the Rural Cooperative Society of Karnataka.
- No age limit is available to apply for the scheme.
The documents required for the Yeshasvini Health Insurance Scheme are as follows:-
- Age proof
- Address Proof
- A document attesting to a person’s membership in rural or urban cooperative societies.
How to Register for Yeshasvini Health Insurance Scheme?
- The applicant must have been a member of the cooperative societies for at least three months to register for this program.
- Every year, from May to June, new enrollment for the Karnataka Yeshasvini plan is completed at all relevant corporative organizations.
How the Yeshasvini Health Insurance Scheme Beneficiaries will get the benefits?
- When the patient is admitted to the hospital, the applicant has to provide an identity card.
- In addition, the need for surgical intervention is determined.
- The network hospital will send the pre-authorization requirement to Yashaswini Trust for approval.
- Verification is done by the Trust within 24 hours.
- After obtaining pre-authorization for the medical treatment, the doctors and surgeons at the network hospital can proceed with the medical treatment.
- Post-treatment, the network hospital will send all the medical bills and discharge summaries of the patient to the MSP.
- After verification of the claim, the trust will automatically send the payment to the network hospital on behalf of the patient.
Some Important FAQs Answer
Who can avail of the Yeshasvini Health Insurance Scheme benefits?
Anyone who is a member of the rural cooperative society for a minimum of 3 months can avail of the benefits of the Yeshasvini Scheme.
What is covered under the Government of Karnataka’s Yeshasvini Health Insurance Scheme?
Neonatal Intensive Care
Dog bites, snake bites, and drowning
What is the age limit to avail of the Yeshasvini Health Insurance Scheme?
There is no age limit to avail of the benefits of the Yeshasvini Scheme.