Yeshasvini Health Insurance Scheme by Govt of Karnataka | Benefits & facilities | Application Pdf Download | Online Registration, Eligibility | Yeshaswini Health Insurance Card Apply Online | Hospital List
State governments around the country have worked tirelessly to offer the general public, especially economically underprivileged people, access to high-quality healthcare. Rural laborers and farmers are unable to get healthcare treatments because of the expense. As a result, several government schemes have been created to enhance public health and reduce healthcare expenses. One such scheme is the Yeshasvini Health Insurance Scheme of the Government of Karnataka. The Karnataka government uses it as one of the most popular types of health insurance for Indian farmers. To learn more about the Yeshasvini Health Insurance Scheme’s features and benefits, eligibility requirements, coverage offered, registration, a list of the medical services it covers, a list of network hospitals that are covered, and much more, please read the post below.
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Yeshasvini Health Insurance Scheme in Karnataka
A community-based medical insurance scheme called the Yeshasvini Health Insurance Scheme was established to assist workers in Karnataka’s informal sector who fell into the medium and lower-middle-income categories. In order to offer comprehensive coverage to farmers who are members of the state cooperative organizations, SM Krishna, a former Chief Minister of Karnataka, introduced the Yeshasvini Health Insurance Scheme in 2003. The Department of Cooperatives is responsible for implementing this initiative in conjunction with the Government of Karnataka. By utilizing the funds raised by cooperative societies through the Yeshasvini trust, it is able to affordably connect rural unorganized workers to the medical facilities they require. More than 30 districts of Karnataka’s Yeshasvini Cooperative Health Care Trust, which is authorized by the Indian Trust Act of 1882, are covered by the scheme.
YESHASVINI HEALTH INSURANCE SCHEME
Yeshasvini Health Insurance Scheme Administration by Govt. of Karnataka
The administration of this scheme is described in full in the table below:
Department of Cooperation
Along with keeping an eye on the entrance of beneficiaries, it reviews the total publicity needed for the scheme.
To enroll beneficiaries in the scheme
To provide all medical resources to scheme beneficiaries, with restrictions
Management Support Service Provider (IRDA licensed)
oversees the resolution of claims and other administrative matters
Yeshasvini Cooperative Farmers Health Care Trust Board
Meets once every three months to discuss key policy issues and to examine the distribution of funds under the scheme.
Features and Benefits of the Yeshasvini Health Insurance Scheme
Some of the main Features and Benefits of the Yeshasvini Health Insurance Scheme are as follows:
This scheme, which is exclusively available in Karnataka, covers the whole state.
Beneficiaries of this insurance scheme may also apply for discounted rates on a number of diagnostic tests.
To be eligible for the benefits of this insurance scheme, you must have been a member of the Karnataka Rural Co-operative Society for at least three months.
This scheme accepts enrolment from July through October each year.
You may also benefit from discounted hospital stays at several network hospitals as part of this scheme.
The maximum age for purchasing coverage for a newborn child is 75 years old.
Those who enroll during the stipulated time period may use the benefits at any time between 1 June and 31 May of the following year.
Yeshasvini Health Insurance Scheme Financing
The Yeshasvini Co-operative Farmers Health Care Scheme is one of India’s biggest independently funded healthcare schemes. Beneficiaries of the Yeshasvini Co-operative Farmers Health Care Scheme must pay nominal annual contributions, making the scheme a contributory one. For 2013–14, the fixed contribution was Rs 210 annually.
Yeshasvini Health Insurance Scheme Eligibility Criteria
The eligibility criteria for Yeshasvini Health Insurance Scheme are given in the table below:
People who are younger than 75 years old can apply for the scheme
Beginning on August 1 and ending on July 31
Before the start of the scheme’s first six months, a person can join a cooperative society. Members of rural cooperative societies Members of cooperative societies for weavers Self-help organizations addressing cooperative society Beedi Workers Cooperative Societies members Fisherman cooperative society members
Even if they are not members of the rural cooperative society, the family members of the primary recipient are nonetheless entitled to receive benefits under this scheme.
Karnataka Cities and Corporations’ rural areas are not covered.
Regarding enrolment in this scheme, the following details are provided: The Department of Cooperation of the Government of Karnataka publishes enrolment and renewal regulations each year. The Deputy Registrar of Cooperative Societies and Cooperative Development Officers, among others, help in the enrolment of beneficiaries and premium collection. After being collected, the money is transferred from District Central Cooperative Banks to Apex Bank in Bangalore. The district registrar of cooperatives issued a letter during the first year. During the second year, photo ID cards were provided. A Unique Health Identification enrollment form has been sent to principal members since 2008. The registration form contains information about the principal beneficiary, his or her family, relationships, and other facts.
Yeshasvini Health Insurance Scheme Documents Required
The documents required for the Yeshasvini Health Insurance Scheme are as follows:
A document attesting to a person’s membership in rural or urban cooperative societies
Coverage Provided by the Yeshasvini Health Insurance Scheme Karnataka
Under the Yeshasvini Health Insurance Scheme, farmers can obtain coverage up to Rs. 2.5 lakh for an annual premium payment of at least Rs. 250. Farmers who take part in this scheme are protected for medical emergencies involving family members.
List of Medical Services Covered by Yeshasvini Health Insurance Scheme
The Yeshasvini health scheme was put into place for the members of Urban & Rural Co-operative Societies, and it covers the following fees for surgery and treatment:
Orthopedic, Pediatric, Cardiothoracic Surgery
Neonatal Intensive Care
Accidents during the operation of agricultural implements
Yeshasvini Health Insurance Scheme Exclusions – What are the medical services not included in Yeshasvini Health Insurance Scheme?
Any of the following medical procedures are not covered by the Yeshasvini Health Insurance Scheme.
Vaccination or inoculation
Skin treatment or grafting
Cost of vitamins, or sanitary items
Joint replacement surgery
Post-surgery follow-up treatment
Inpatient medical treatment
List of Network Hospitals Included in Yeshasvini Health Insurance Scheme
According to the Yeshasvini Co-operative Farmers Health Care Scheme, there are around 572 network hospitals. The number of network hospitals in Karnataka is displayed in the table below.
Number of network hospitals
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 scheme.
Every year, from May to June, new enrollment for the Karnataka Yeshasvini scheme is completed at all relevant corporate organizations.
Implementation Strategy for the Yeshasvini Health Insurance Scheme
When a patient enters one of the Network Hospitals, a coordinator looks through the patient’s UHID card, pays the enrollment fee, and authorizes the first diagnosis. If surgery is required, a pre-authorization request is sent to MSP. Experts evaluate the request. The recipient may get cashless care for any procedure, within the stated restrictions. The patient’s signed bill summary and other documents required are sent by the network hospitals to the MSP for claims processing. The Yeshasvini Health Insurance Scheme Trust pays the network hospitals via MSP after 45 days of receiving the bills.
Implementing Steps for the Yeshasvini Health Insurance Scheme
730 network hospitals with affiliations to the trust are implementing the Yeshasvini Health Insurance Scheme. There are both public and private hospitals. In accordance with the empanelment rules, the trust grants the network hospitals permission to offer medical services. The Management Support Service Provider (MSP) arranges for cashless healthcare through these 730 network facilities. The Yeshasvini Health Insurance Scheme must be implemented in the manner described below:
The beneficiary of the Yeshasvini Trust visits a network hospital that the trust recognizes and approves.
The beneficiary’s UHID card will be examined by a network hospital coordination officer.
A fee must be paid by the enrolling party.
The patient must next undergo a preliminary diagnostic and a few standard medical examinations.
Based on the first diagnosis, the network hospital will send an online pre-authorization request to the MSP with accompanying evidence.
The request will be reviewed by doctors the MSP has selected, and a decision will be made the following day.
The network hospital will provide cashless care to the recipient while taking into consideration the limitations stated in the scheme.
After the patient is discharged, the network hospital will submit the MSP the original bills, discharge summary, and other medical information in order to pay the claim.
The trust will settle the claim with the network hospital through the MSP within 45 days of receiving the supporting documents.
Frequently Asked Questions – FAQs
Who is eligible for the Yeshasvini card?
Farmers who are members of the state cooperative society at least for 3 months are the key beneficiaries under this scheme. The policy offers insurance coverage for any kind of listed illnesses. The policy can be availed for a newborn baby to a person with a maximum age of below 75 years.
What is the use of the Yeshasvini card?
The scheme aims at providing hassle-free cashless treatment to the members at impanelled hospitals both private and government identified by Yeshasvini Trust for more than 1,650 diseases and health issues.