Arogya Karnataka Scheme (AB-ArK)

Arogya Karnataka Scheme – Key Highlights

A quick overview of everything you need to know about the Arogya Karnataka health cardscheme before you apply online.

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Why Was Arogya Karnataka Needed?

As a result of hospital admissions, BPL families in Karnataka were sliding into extreme poverty. In fact, it was found that out-of-pocket spending was one of the biggest contributors to poverty in the state. A World Bank study reported that mortality rates were far higher amongst BPL families requiring hospital treatment pre-AB-ArK simply because families were too poor to receive it. Karnataka had several disconnected schemes, including a number of cards, a number of procedures and a number of hospitals and Arogya Karnataka was aiming to have one scheme, one card and the whole state covered.

Eligibility

Category A – BPL Households (Free Treatment):

Who can avail:

• Permanent residents of Karnataka.
• An eligible household according to the National Food Security Act (NFSA) 2013 such as the BPL families, PHH card holders, and AAY families.
• Farmers, unorganized sector workers, SC/ST families and co-operative society members.
• free cashless treatment is for 5 lakh per family annually.

Category B – APL Households (Subsidised Treatment):

• A domicile of Karnataka.
• Do not have any NFSA card in the name of family.
• Gets 30% of the government package rates and the family pays 70%.
• 1.5 lakh cover up to per family per year on co payment.
• 19 lakh families have been covered under APL group.

No age restriction as all members fall in the same family floater amount.

Arogya Karnataka Card Online Registration- How to Apply

For Arogya Karnataka card online registration or Arogya Karnataka apply online, enrollment is done at the point of care, meaning you register when you first go for treatment. No prior registration or government office visit is needed.

At a Government PHI (Primary Health Institution):

• Go to the closest PHI with your Aadhaar card and PDS ration card.
• Staff at the centers enroll you on the Arogya Karnataka Enrollment Portal.
• Biometric data taken and verified using Aadhaar.
• In case of failure of biometric, OTP verification or QR code scanning is done as an alternative.
• A unique Arogya Karnataka ID (ArKID) is created and updated with your PDS (Ration) card.
• A Universal Health Card is issued (with photo/with ArKID), ₹10 (A4) or ₹35 (plastic card).

After your ArKID is registered, your ArKID will be valid for all further visits at any empanelled hospital in Karnataka.

Also available at:

• KarnatakaOne centres across districts
• Common Service Centres (CSCs)
• Empanelled private hospitals with dedicated enrollment staff

Arogya Karnataka Card Benefits And Coverage

For BPL Families (Category A):

• Free Cashless Treatment- Family of 5 lakh per year. 100% free at all Empaneled Hospitals.
• Treatment Packages- 1650+ procedures covering Cardiology, Oncology, Neurosurgery, Orthopedics, Pediatrics, Burns and Emergency treatment.
• Disease pre-existing- Covered from first day in the hospital. No waiting time.
• Follow up procedures- Around 60 procedures, which can be performed annually, after treatment of patients in empaneled hospitals.
• Emergency treatment- walk into any empanelled hospital without referral.

For APL Families (Category B):

• Up to 30,000 p.a. for complicated secondary care.
• Up to 1.5 lakh p.a. for tertiary care.
• Additional 50,000 for emergency tertiary care beyond the annual limit of 1.5 lakh.
• The family pays 70% of the cost of treatment and the state contributes 30%.

Janani Suraksha Yojana (JSY) and Pradhan Mantri Matru Vandana Yojana (PMMVY) are available for maternity benefits to be availed simultaneously by the pregnant women. The Nikshay Poshan Yojana also provides extra Rs 1000 p.m. to TB patients. For expenses exceeding Rs 5 lakhs, the BPL families can avail of one-time assistance of 15 lakhs from Rashtriya Arogya Nidhi (RAN) at government super-specialty hospitals.

What is NOT Covered:

• Doctors' office visits that do not result in hospitalization.Visits to doctors’ offices that are not followed by hospitalization.
• Any cosmetic or elective procedure that is not listed on the approved procedures list.
• Treatment at non-empanelled private hospitals
• Conditions not listed in the approved package list

Documents Required

• Aadhaar card: It is compulsory for biometric authentication.
• The ration card issued by PDS is used to decide the entitlement of Category A or B.
• Self declaration consent form- provided and signed at the PHI

AB-ArK Card Download

To download AB-ArK Card or Arogya Karnataka health card:

• Go to arogya.karnataka.gov.in, log in with your ArKID or registered ID, and click on the card download section, enter your Aadhaar or ArKID and download as PDF.
• You can also pick up the card in person at your PHI enrollment site, where it will cost you ₹10 (A4) or ₹35 (plastic).

Claim Process

1. Visit any empanelled hospital with your AB-ArK card and Aadhaar
2. The Aarogya Mitra at the help desk verifies your identity and card
3. The hospital sends a pre-authorisation request online to SAST in non-emergency situations.
4. After approval, treatment starts, it is fully cashless in Category A; co-payment in Category B.
5. In emergencies, treatment begins immediately without a referral
6. Post-discharge, e-health records are updated on the portal

Helpline Details

• Toll-Free Helpline: 1800-425-8330
• Health Helpline: 104
• Official Portal: arogya.karnataka.gov.in
• Post Office Address:Department of Health and Family Welfare Services, Arogya Soudha, Madagi Road, Bengaluru – 560023

Any hospital that denies cashless treatment to a Category A beneficiary must be reported on the helpline immediately.

Why Arogya Karnataka Matters

Arogya Karnataka was the first all-inclusive health insurance scheme in India which covered not only the poor, but all inhabitants of the state. Today, if a daily wage laborer in Mysore requires a bypass surgery, or if a farmer family from Dharwad requires that their child be operated for cancer, the benefit to them is access to quality care without bankruptcy because of Arogya Karnataka scheme. While there are many loopholes and gaps such as the APL families still bear 70% cost of care and the remote parts of the state lack awareness, yet as a universal health care project, AB-ArK continues to be one of the most successful health schemes of state in India.