State governments around the country have worked tirelessly to offer the general public, especially the economically underprivileged population, access to high-quality healthcare. Rural workers and farmers are unable to get healthcare treatments because of the expense. Therefore, several government efforts have been devised to promote citizens’ health and cut medical costs. The Department of Cooperatives is in charge of putting the programme into action, and it makes use of cooperative society money via the Yeshasvini Trust. It offers 823 various surgical procedures covered in addition to medical insurance. Only those who are cooperative society members are eligible to use this health insurance plan’s advantages. To learn more about the Yeshasvini Health Insurance Scheme 2023 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, see the post below.
What Is Yeshasvini Health Insurance Scheme 2023?
A community-based medical insurance scheme called the Yashasvini Health Insurance Scheme was created to help workers in Karnataka’s informal economy who fell into the middle and lower-middle income ranges. The Yeshasvini Health Insurance Scheme was launched in 2003 by S.M. Krishna, a former chief minister of Karnataka, to give farmers who belong to state cooperative organisations full coverage. The Department of Cooperatives is responsible for implementing this initiative in conjunction with the Government of Karnataka. By utilising the funds raised by cooperative societies through the Yeshasvini trust, it is able to affordably connect rural unorganised workers to the medical facilities they require. More than 30 districts of Karnataka’s Yeshasvini Cooperative Health Care Trust, which is authorised by the Indian Trust Act of 1882, are covered by the programme.
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Key Highlights of Scheme
|Launched By||Government of Karnataka|
|Name of Scheme||Yeshasvini Health Insurance Scheme 2023|
|Objective||To provide medical facilities|
|Benefits||Get many diagnostic tests at affordable prices|
|Eligibility Criteria||Residents of Karnataka|
Objective of Yeshasvini Health Insurance Scheme
The Yeshasvini Health Care Scheme’s primary goal is to offer Karnataka residents who belong to cooperative societies registered with the Department of Cooperation access to affordable, high-quality healthcare. Farmers who fall under the economically disadvantaged category are denied access to different government-funded healthcare services. The Department of Cooperatives is responsible for implementing this initiative in conjunction with the Government of Karnataka. By utilising the funds raised by cooperative societies through the Yeshasvini trust, it is able to affordably connect rural unorganised workers to the medical facilities they require.
Benefits and Features of Yeshasvini Health Insurance Scheme
The Yashasvini Health Insurance Scheme’s primary features and advantages include the following:
- This programme, which is only provided in Karnataka, covers the entire state.
- Beneficiaries of this insurance programme may also qualify for reduced prices on a number of diagnostic tests.
- To be eligible for the advantages of this insurance programme, you must have been a member of the Karnataka Rural Co-operative Society for at least three months. The focus will shift to you at that point.
- This programme accepts enrollment from July through October each year.
- You may also benefit from discounted hospital stays at several network hospitals as part of this programme.
- The oldest person who can obtain a newborn child’s insurance is 75 years old.
- Enlistees who sign up during the designated period may take use of the perks at any time between 1 June and 31 May of the following year.
Finance for the Yeshasvini Health Insurance Scheme
The Yeshasvini Co-operative Farmers Health Care Scheme is one of India’s biggest independently funded healthcare initiatives. Beneficiaries of the Yeshasvini Co-operative Farmers Health Care Scheme are required to make small annual contributions, making the programme a contributing one. For 2013–14, the fixed contribution was Rs. 210 annually.
Administration of the Yeshasvini Health Insurance Scheme
The following table provides a detailed description of how this programme is administered:
|Department Of Cooperation||In addition to monitoring the entry of beneficiaries, it assesses the program’s overall publicity requirements.|
|Cooperative societies||To sign up participants in the programme|
|Network hospitals||To offer programme participants all available medical resources, with limitations|
|Management Support Service Provider (IRDA licensed)||controls how claims and other administrative concerns are resolved|
|Yeshasvini Cooperative Farmers Health Care Trust Board||meets once every three months to go through important policy matters and to look at how the scheme’s funds are distributed.|
Coverage Offered by the Scheme
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.
The Yeshasvini Health Insurance Program’s list of medical services covered
For the members of Urban & Rural Co-operative Societies, the Yeshasvini health programme was implemented, and it covers the following costs for surgery and treatment:
- cardiothoracic Surgery
- Cardiac Arrest
- Vascular Surgery
- Neurological Surgery
- Neonatal Intensive Care
- Normal Delivery
- Dog bite
- Ophthalmology Surgery
- Genito-urinary Surgery
- Surgical Oncology
- Accidents during operation of agricultural implements
Exclusions of the Yeshasvini Health Insurance Scheme
The Yeshasvini Health Insurance Scheme does not provide coverage for any of the aforementioned medical treatments.
- Kidney transplant
- Heart transplant
- Diagnostic investigations
- Road accidents
- Vaccination or inoculation
- Skin treatment or grafting
- Cosmetic surgery
- Cost of vitamins, or sanitary items
- Dental surgery
- Joint replacement surgery
- Post-surgery follow-up treatment
- Inpatient medical treatment
The table below lists the requirements for the Yashasvini Health Insurance Scheme:
- Anyone under the age of 75 can apply for the programme.
- beginning August 1 and finishing July 31
- A person may join a cooperative society prior to the start of the first six months of the plan. Rural cooperative society members members of weaving cooperative societies Self-help groups tackling a cooperative society Members of Beedi Workers Cooperative Societies Members of the Fishermen’s Cooperative Society
- The primary recipient’s family is still eligible to receive benefits under this programme even if they are not members of the rural cooperative society.
- Rural places in Karnataka Cities and Corporations are not covered.
- Regarding enrolment in this programme, the following details are provided: The Department of Cooperation of the Government of Karnataka publishes enrollment and renewal regulations each year. The Deputy Registrar of Cooperative Societies and Cooperative Development Officers, among others, help with beneficiary enrollment 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. The second year saw the distribution of photo ID cards. Main members have been receiving enrollment documents for Unique Health Identification since 2008. The registration form contains information about the principal beneficiary, his or her family, relationships, and other facts.
The following documents are necessary for the Yashasvini Health Insurance Scheme:
- Address Proof
- Age Proof
- A statement verifying one’s participation in rural or urban cooperative societies
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How do I enrol in the Yeshasvini Health Insurance Scheme
- To sign up for this programme, the applicant must have been a member of the cooperative societies for at least three months.
- The Karnataka Yeshasvini plan’s annual new enrolment period runs from May to June at all pertinent corporative entities.
How Can I Obtain a Yeshasvini Health Card
The processes to obtain a Yeshasvini Health Card list below:
- Applicants first need to visit the official website of Yeshasvini Health Insurance Scheme.
- The homepage will appear on your screen.
- Then select “Register for the Cooperative Society.”
- Next, select the link that says “Apply Online for Yeshasvini Health Card.”
- On the online registration form, complete all the fields and press “Submit.”
- Once the submission is complete, your User ID and Password will send to you.
- Visit the “Home Page.”
- Utilize your credentials to log into the gateway.
- You’ll take the form for the Yeshasvini Health Card.
- Complete the form, then press the “Submit” button.
How to File a Claim for the Yeshasvini Health Insurance Scheme
One should go to a hospital in the network of the Yeshasvini Health Insurance Scheme and follow the instructions to receive the program’s benefits:
- Applicants first visit a hospital in this program’s network.
- Contact a medical coordinating officer and deliver all necessary paperwork.
- You must pay the enrollment cost for the medical testing after the documents are validated.
- If medical surgery is required based on the diagnosis, a pre-authorization request will be issued to the Management Service Provider (MSP).
- The request will be verified by the MSP, who will then give the go-ahead for cashless treatment.
- The hospital will give MSP the discharge report and costs for claim payment following discharge.
The Yeshasvini Health Insurance Scheme’s implementation plan
A coordinator looks through the UHID card of the beneficiary when they go to one of the Network Hospitals, pays the enrollment cost, and accepts the preliminary diagnosis. If surgery is require, a pre-authorization request is sent to MSP. Experts evaluate the request. The beneficiary may receive cashless care for any surgery, within the stated limits. The patient’s signed bill summary and other pertinent documents are sent by the network hospitals to MSP for claims processing. The Yeshasvini Health Insurance Scheme Trust pays the network hospitals via MSP after 45 days of receiving the invoices.
Steps for Yashasvini Health Insurance Scheme Implementation
Affiliated There are both public and private hospitals. In accordance with the empowerment 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 implement in the manner describe below:
- The Yeshasvini beneficiary is seen at a network hospital that the trust approves of and acknowledges.
- An officer in charge of network hospitals will examine the beneficiary’s UHID card.
- The enrolling party must make a payment.
- The patient must next undergo a preliminary diagnostic and a few standard medical examinations.
- Based on the initial diagnosis, the network hospital will send an online pre-authorization request to the MSP with accompanying evidence.
- The request will review by doctors the MSP has selected, and a decision will be made the following day.
- The network hospital will adhere to the guidelines of the programme while providing the recipient with cashless care.
- After the patient is discharge, the network hospital will submit the MSP the original bills, discharge summary, and other medical data to settle the claim.
- The trust will settle the claim with the network hospital through the MSP within 45 days of obtaining the supporting documents.