The Jyothi Sanjeevini Scheme (JSS) was developed by the government of Karnataka as a means of providing a healthcare policy for all government employees. To subscribe to the scheme, employees will have to register with the Arogya Suraksha Trust. The scheme aims to provide its subscribers with quality tertiary healthcare to help treat serious medical illnesses that require hospitalisation and surgical intervention. The JSS functions through a network of super speciality hospitals that provide all government employees with cashless treatment.
Features and Benefits:
- The scheme covers illnesses that fall into 7 broad categories. They are oncology, cardiology, neurological disorders, renal disorders, neonatal and pediatric surgery, genito urinary surgery, polytrauma, and burns.
- JSS covers 449 procedures across the 7 specialities listed in the scheme.
- The scheme is extended to Karnataka government employees and their dependents.
- The scheme is only eligible for those government employees who are not covered under any other government-sponsored healthcare programmes.
- The Karnataka government assigns an insurance policy number to the employee which is linked with the office database.
- The services covered under the policy include post-operative care, preoperative care, hospitalisation charges, doctor consultation, food, transportation, management of complications, and charges for medication.
- Subscribers can avail medical services up to Rs.1.5 lakh per year.
- Employees who are admitted to the general ward of a hospital will have to bear 30% of the hospital charges, while the government bears the remaining 70%.
- For those admitted to super speciality wards, the government bears 50% of the charges incurred.
- The services covered by the scheme can only be availed in hospitals that are listed in the JSS guidelines.
Eligibility to the Scheme:
The scheme is eligible for all government servants in Karnataka and their family members. The eligibility of the employees’ dependents is listed in Rule 2(1) of the Karnataka Government Servants (Medical Attendant) Rules, 1963, under clauses (i), (ii), and (iii). The clause states the eligibility of the dependents as follows:
- Wife or husband of the Government Servant
- The father and mother if they live with the government servant whose monthly income is Rs.6,000 or less.
- Dependent children (adopted as well as stepchildren)
The information about the employee’s dependents will have to be declared and certified by the employee.
How the Scheme Functions:
The scheme works on as an assurance policy. The government has a fixed percentage that is paid to the employee for medical treatment for himself/herself or his/her dependents. The Suvarna Arogya Suraksha Trust implements the terms listed in the scheme. There is no limit on the expenditure that is covered by the scheme.
The scheme is applicable to all employees except in cases where the employee themselves choose services that are more expensive and advanced than those covered by the scheme.
It is also not applicable in cases where the employee chooses a hospital ward that is more superior than the ones listed in the guidelines of the JSS.
The following table depicts the ward entitlement for employees covered by the scheme:
|Pay range||Types of hospital accommodation||Rate|
|Rs.16,000||General ward||Rate list in JSS|
|Rs.16,001 – Rs.43,200||Semi-private ward||10% higher than the general ward|
|Rs.43,201||Private ward||25% higher than the general ward|