Yashasvini Health Insurance Scheme:-
State governments around the country have been working nonstop to give the general public, particularly the population’s economically disadvantaged group, access to high-quality healthcare. Farmers and rural laborers are unable to obtain healthcare treatments because of the expense. To promote citizen health and reduce medical expenses, the government has created several projects.
One such scheme is the Yeshasvini Health Insurance Scheme of the Government of Karnataka. The Karnataka government offers it as one of the most popular options for health insurance for Indian farmers. To know all the important details about the ಯಶಸ್ವಿನಿ ಆರೋಗ್ಯ ವಿಮಾ ಯೋಜನೆ, including its features and benefits, eligibility requirements, coverage offered, registration requirements, list of medical services covered, network hospitals included, and much more, read this article till the end.
Yashasvini Health Insurance Scheme 2024
For informal sector workers in Karnataka who earn between middle-class and lower-middle-class salaries, Yashaswini Health Insurance Scheme is a community-based medical insurance program. To provide comprehensive coverage to farmers who are members of State Cooperative Groups, S.M. Former Chief Minister of Karnataka Krishna launched the Yashaswini Health Insurance Scheme in 2003. The Cooperation Department is working with the Government of Karnataka to implement this scheme. It uses the funds the cooperative societies receive from the Yashaswini Trust to provide rural unorganized workers affordable access to the health facilities they need.
In more than 30 districts of Karnataka, the Yeshasvini Cooperative Health Care Trust, formed under the Indian Trust Act of 1882, is in charge of the program.
Features and Benefits
- This program is available exclusively in Karnataka and covers the entire state.
- Beneficiaries of this insurance plan may also take advantage of lower prices on several diagnostic tests.
- To be eligible for the benefits of this insurance plan, you have to be a member of the Karnataka Rural Co-operative Society for a minimum of three months. At that point, you will become the key player.
- This program accepts enrollment from July through October of each year.
- You may also benefit from discounted rate hospital stays at several network hospitals under this scheme.
- The maximum age at which someone may obtain a newborn child coverage is 75 years old.
- Individuals who register during the designated period are eligible to utilize the benefits at any time between June 1 and May 31, of the following year.
Scheme Provide Coverage
Under the Yeshasvini Health Insurance Scheme, farmers can obtain coverage up to Rs 2.5 lakh for an annual subscription of at least Rs 250. This program provides coverage for family members’ medical emergencies for farmers who take part.
List of Medical Services Covered
General Surgery | Gynecology Surgery |
Orthopedic, Pediatric, cardiothoracic Surgery | Cardiac Arrest |
Vascular Surgery | Obstetrics |
Neurological Surgery | Neonatal Intensive Care |
Normal Delivery | Dog bite |
Ophthalmology Surgery | Drowning |
Genito-urinary Surgery | Snakebite |
Surgical Oncology | Accidents during operation of agricultural implements |
List of Medical Services Not-Covered
Kidney transplant | Heart transplant |
Diagnostic investigations | Road accidents |
Burns | Vaccination or inoculation |
Dialysis | Skin treatment or grafting |
Cosmetic surgery | Cost of vitamins, or sanitary items |
Implants, prosthesis | Chemotherapy |
Dental surgery | Joint replacement surgery |
Post-surgery follow-up treatment | Inpatient medical treatment |
Network hospitals included in Yashaswini Health Insurance Scheme
There are about 572 network hospitals, according to the Yeshasvini Co-operative Farmers Health Care Scheme. yeshasvini health insurance scheme network hospital list is given below:-
District Name | Number of network hospitals |
Hassan | 20 |
Dakshina Kannada | 26 |
Belgaum | 49 |
Haveri | 16 |
Raichur | 11 |
Bangalore Rural | 7 |
Davanagere | 21 |
Chitradurga | 12 |
Ramanagar | 11 |
Bellary | 8 |
Chikkaballapura | 8 |
Dharwad | 19 |
Bangalore Urban | 61 |
Mysore | 22 |
Gulbarga | 16 |
Bidar | 11 |
Gadag | 6 |
Bijapur | 23 |
Mandya | 25 |
Kolar | 11 |
Koppal | 8 |
Udupi | 22 |
Chamrajnagar | 4 |
Bagalkote | 44 |
Chikkamagalur | 7 |
Kodagu | 5 |
Shimoga | 22 |
Uttara Kannada | 18 |
Tumkur | 27 |
Yeshasvini Health Insurance Scheme Administration
Feature | Particulars |
Department of Cooperation | It also monitors the beneficiaries’ entry and evaluates all necessary publicity for the program. |
Cooperative societies | To register recipients in the program |
Network hospitals | To provide program beneficiaries with all available medical resources, subject to limitations |
Management Support Service Provider (IRDA licensed) | oversees the resolution of claims and other administrative problems |
Yeshasvini Cooperative Farmers Health Care Trust Board | Meets once every three months to review the allocation of funding under the plan and talk about important policy matters. |
Financing
The Yeshasvini Co-operative Farmers Health Care Scheme is one of the biggest self-funded healthcare initiatives in India. The Yeshasvini Co-operative Farmers Health Care Scheme is a contributory scheme, meaning that beneficiaries must pay small yearly contributions to benefit from it. For 2013–14, the fixed contribution was Rs 210 annually.
Eligibility Criteria
Eligible members | A person can become a member of a cooperative organization before six months the start of the plan. Participants in rural cooperative societies Participants in cooperative weavers’ associations Self-help groups focusing on a cooperative society Members of Beedi Workers Cooperative Societies Members of the Fisherman’s Cooperative Society |
Availability | The principal recipient’s family members are eligible to get benefits under this program even if they are not members of the rural cooperative organization. |
Enrolment | Regarding enrollment in this program, the following details are given: The Department of Cooperation of the Government of Karnataka issues enrollment and renewal guidelines annually. Among others, Cooperative Development Officers and the Deputy Registrar of Cooperative Societies help with beneficiary enrollment and premium collection. District Central Cooperative Banks collect the monies and then send them to Apex Bank in Bangalore. The district registrar of cooperatives sent out a letter in the first year. The second year saw the distribution of photo ID cards. The primary members have been receiving enrollment documents for Unique Health Identification since 2008. The registration form contains information about the principal beneficiary’s family, relatives, and other details. |
Coverage | Karnataka Cities and Corporations’ rural areas are not covered. |
Period | Beginning on August 1 and ending on July 31 |
Age Limit | People who are younger than 75 years old can apply for the program |
Documents Required
- Address Proof
- Age proof
- A document attesting to a person’s membership in rural or urban cooperative societies
Yeshasvini Health Insurance Scheme Registration Process
- To register for this program, the applicant must have been a member of the cooperative societies for a minimum of three months.
- Annually, all pertinent corporative groups complete the new registration for the Karnataka Yeshasvini plan from May to June.
Yashasvini Health Insurance Scheme Implementing process
730 network hospitals associated with the trust are implementing the Yashaswini Health Insurance Scheme. This includes both private and government hospitals. The trust network allows hospitals to provide healthcare services as per the empaneled guidelines. Management Support Service Providers (MSPs) provide cashless healthcare through these 730 network facilities. Following are the steps involved in implementing Yashaswini Health Insurance Scheme:
- The Yeshasvini beneficiary visits a network hospital that the trust approves and acknowledges.
- An officer responsible for coordinating network hospitals will verify the beneficiary’s UHID card.
- The enrolling party is required to pay a charge.
- After that, the patient has to undergo a preliminary diagnostic and a few basic medical tests.
- Based on the first diagnosis, the network hospital will send the MSP an online request for pre-authorization along with any necessary supporting paperwork.
- The doctors selected by the MSP will review the request, and the following day, permission will be given.
- The network hospital will honor the program’s limitations while providing the recipient with cashless care.
- To settle the claim, the network hospital will submit the MSP the original bills, discharge summary, and other medical data following the patient’s release.
- The trust will settle the claim with the network hospital through the MSP within 45 days of receiving the documentation.