Yashasvini Health Insurance Scheme by Karnataka Government

State governments across the country have been in constant effort to supply good healthcare to the common people especially the economically deprived section of the society. Plenty of government schemes have been launched and are working towards the betterment of their health and medical expenditures. One such scheme is Yeshasvini Health Insurance Scheme by the Govt. of Karnataka. It is among the popular types of health insurance for farmers in India.

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    What’s Yeshasvini Health Insurance Scheme?

    Yeshasvini Health Insurance Scheme was launched on June 1, 2003 under the leadership of the former Chief Minister of Karnataka S.M. Krishna. Precisely designed for the farmers who are members of the state co-operative societies, the Yeshasvini Co-operative Farmers Health Care Scheme offers comprehensive health insurance protection with 823 surgical procedures coverage. 

    The scheme covers 30 districts in the State of Karnataka. The functioning of the scheme is solely managed by the Yeshasvini Cooperative Farmers Health Care Trust that is registered under the Indian Trust Act 1882.

    Karnataka Yeshasvini Health Insurance Scheme: Scope of Coverage

    Under the Yeshasvini Health Scheme by Karnataka Govt., the policy benefits are extended to 30 lakh beneficiaries. With a minimum premium of Rs 250 annually, farmers in Karnataka can get insurance coverage for their families for medical emergencies. The scope of coverage under this rural healthcare scheme majorly includes surgical procedures with a sum insured up to Rs 2.50 lakh.

    Yeshasvini Health Insurance Scheme: Features & Benefits

    Listed below are some of the key features and benefits to be availed under this rural healthcare scheme in Karnataka:

    • Farmers who are the members of the state co-operative 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 new born baby to a person with the maximum age of below 75 years.
    • A rural Yeshasvini member can avail free medical surgery costing up to Rs 1.25 lakh and Rs 2 lakh, while an urban member can claim for treatment cost up to Rs 1.75 lakh for single admission and Rs 2.50 lakh for multiple hospitalisations. 
    • Yeshasvini Health Insurance Scheme covers 823 surgical procedures under three categories: normal delivery, Neonatal Care and Angioplasty procedure.

    List of Treatments Covered Under Yeshasvini Health Insurance Scheme

    Implemented for the members of Urban & Rural Co-operative Societies, the following surgery & treatment expenses are covered under the Yeshasvini health scheme:

    • Cardiac Arrest
    • Orthopedic, Pediatric, cardiothoracic Surgery
    • General Surgery
    • Gynecology Surgery
    • Neonatal Intensive Care
    • Obstetrics
    • Ophthalmology Surgery
    • Genito-urinary Surgery
    • Surgical Oncology
    • Vascular Surgery
    • Neurological Surgery
    • Dog bite
    • Drowning
    • Snake bite
    • Accidents during operation of agricultural implements 
    • Normal Delivery

    Karnataka Yeshasvini Scheme: Exclusions

    Some of the medical procedures are excluded under this scheme such as:

    • Diagnostic investigations
    • Regular follow-up treatment and medico legal Cases
    • Kidney Transplant
    • Heart Transplant
    • Burns
    • Cosmetic surgery
    • Implants, prosthesis
    • Skin treatment or grafting 
    • Dental Surgery
    • Nasal Septum
    • Inpatient medical treatment
    • Chemotherapy
    • Autoimmune diseases 
    • Joint replacement surgery
    • Dialysis 
    • Road accidents

    YCFHS Eligibility Criteria

    In India, anyone who fulfills the eligibility conditions can avail Yeshasvini Co-operative Farmers Health Care Scheme. Let’s consider the below eligibility conditions under this government health scheme:

    Entry Age

    Individual who are below 75 years of age can apply for the scheme

    Eligible Member

    An applicant must be a member of a cooperative society at least for 3 months to be eligible for this scheme.

    The family members of the scheme holder can avail the policy benefits, even if they are not a part of the co-operative society.

    Members Covered

    Self, spouse, dependent children and parents

    Scheme Tenure

    August 1st to July 31st of the successive year

    How to Claim Yeshasvini Health Scheme?

    To avail the scheme benefits, the beneficiary can approach any of the network hospitals listed under the scheme. Below is the detailed process of how to avail healthcare under Yeshasvini scheme:

    Claim Steps

    • The beneficiary can check for the nearest authorized network hospital to get treatment.
    • Initially, a medial coordinating officer will examine the required documents or health card.
    • An enrollment fee has to be submitted for pre-diagnosis and other medical tests.
    • Depending on the tests, if a surgery is required, a pre-authorisation request is sent to the MSP (Management Support Service Provider).
    • After verifying the request by the MSP, cashless approval is given as per the terms of the scheme.
    • Cashless treatment will be provided up to the Yeshasvini health scheme limit. 
    • After discharge, the hospital authority will send the bills, discharge summary and other related documents to the MSP for settlement.
    • The Yeshasvini Health Insurance Scheme Trust will settle the claim accordingly.

    How to Register for Karnataka Yeshasvini Health Scheme?

    In order to register for this scheme, the applicant must be a member of the Cooperative societies at least for 3 months. The new enrolment for the Karnataka Yeshasvini scheme is done at all respective corporative societies from May to June every year.

    Documents Required for Yeshasvini Health Insurance Scheme

    The following documents are required for availing Yeshasvini card in Karnataka:

    • A certificate proving that the person is a member of Rural or Urban Co-operative Societies
    • Age proof
    • Address Proof

    How to Get Yeshasvini Health Card?

    Yeshasvini health card is an essential ID that enables one to avail the healthcare facility. By showing this card in a hospital, the scheme holder can process the necessary treatment under cashless category. This card is provided at the time of buying the scheme and also renewable at all corporative societies. The Yeshasvini card apply online registration can be initiated through http://yeshasvini.kar.nic.in 

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    Written By: PolicyBazaar - Updated: 29 July 2021

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