Karunya Health Scheme

The eligibility criteria listed out by the government of Kerala for enrolling in this scheme can be listed as follows: 

1. The beneficiary must be a resident of Kerala. 
2. People belonging to below poverty line and above poverty line sections of the society can apply for this coverage. 
3. Beneficiaries must provide their Aadhaar card and income certificate while enrolling in this coverage. 
4. The annual income must be below Rs.3 lakh for every household under Below Poverty line (BPL) and Above Poverty line (APL) categories 

Benefits of Karunya Health Scheme

The Karunya Health Scheme by the Government of Kerala functions similar to that of a critical illness cover. People suffering from major chronic illnesses can avail treatment benefits under this cover. Some of the acute ailments covered under this policy include the following: 

1. Cancer 
2. Hemophilia 
3. Kidney diseases 
4. Heart diseases 
5. Palliative Care 

Note: 

1. For the above mentioned health ailments, the government offers treatment benefits up to Rs.2 lakh.  
2. For certain cases of extreme illnesses, the treatment benefits can be increased to Rs.3 lakh. 
3. Reimbursement will be provided if the treatment cost exceeds the estimated treatment cost. 

Required Documents for Karunya Health Scheme

The following is the list of required documents for availing Karunya Health Scheme by Kerala Government: 

1. Aadhar card or Voter ID card 
2. Ration card 
3. Original copy of address proof 
4. Documents related to your income information based on which Kerala Government determines eligibility 
5. Candidates Below Poverty Line (BPL) must provide evidence to support their claim when signing up for the Karunya Health Insurance Scheme's benefits online 

1. Passport-sized photograph 

Key Features of Karunya Health Scheme

Some of the key features of Karunya Health Scheme can be listed as follows: 

1. The health insurance scheme is government funded 
2. The government has allocated about Rs.250 crore for this scheme in the recent financial year. 
3. For secondary and tertiary hospitalisation in both public and private empanelled hospitals, the scheme offers Rs.5 lakh annual coverage per family. 
4. Cashless access to medical services in empanelled hospitals can be availed by the beneficiaries 
5. The scheme targets to cut down the high medical cost and make it affordable for all 
6. The scheme does not limit the beneficiaries on the basis of the number of children in the house, age or gender of the insured members. 
7. Claim for pre-existing diseases can be availed by the insured members from the first day of the commencement of the policy. 
8. The scheme is valid across the country 
9. The scheme covers approximately 1,573 medical procedures and includes treatment-related expenses, such as medications, physician fees, surgical fees, OT, equipment, diagnostic services, accommodation and board, and ICU fees, etc. 
10. Treatments benefits under scheme can be availed through both government healthcare facilities or hospitals and different empaneled private hospitals. 

1. Any information regarding this policy can be found in its official website: http://www.karunya.kerala.gov.in/ 
2. The website provides extensive details about application forms, declaration, claim process, network hospitals, etc. 
3. The list of network hospitals in a particular district can be easily accessed by visiting the site. Just click on ‘list of hospitals’ in the menu and choose your district and region in the respective tabs. The list of hospitals will be displayed thereafter. 
4. The website also provides details regarding the list of beneficiaries in a particular location. Just click on ‘list of beneficiaries’ in the menu and choose your district, hospital, and applicable dates. 
5. For application tracking, click on ‘application tracking’ and provide the file number in the respective tab. The status of the application will be displayed following that. 

Coverage of Karunya Health Insurance

The following are the coverages under the Karunya Health Insurance scheme by the Kerala Government: 

1. The cost of implants 
2. Non-intensive and intensive care services 
3. Laboratory and diagnostics charges 
4. Complication during hospitalisation 
5. Medical consultation, examination, and treatment 
6. Cost of pre-hospitalisation for three days before the first day of admission 
7. Cost of post-hospitalisation for up to 15 days after the discharge date 

How Does Karunya Health Insurance Work? 

The following are the steps as to how Karunya Health Insurance work: 

1. In the beginning, medical treatment could only be availed from government institutions. 
2. A number of private hospitals were later able to provide medical care to the insured after receiving accreditation. 
3. The Kerala Government funds Rs.250 crore for Karunya Health Insurance Scheme due to which beneficiaries can claim for all the treatment related expenses without spending a penny. 
4. Beneficiaries can visit the official website to register for the scheme and access all the updated information related to the scheme. 
5. The beneficiaries can also access the details of network hospital and claiming process through the website. 

How to Apply for Karunya Health Insurance Scheme Online?

The following are the steps to apply for Karunya Health Insurance Scheme online:

1. Visit the Kerala Government's official website at http://karunya.kerala.gov.in
2. Download the application by clicking on ‘How to Apply’
3. Provide all the required information

1. Submit the application
2. To track your application status, click on ‘Application Tracking’ option
3. You can also find you name on the home page, under the ‘List of Beneficiaries’ option

How to Find Empanelled Hospitals under Karunya Health Scheme

To locate empanelled hospitals:

1. Official SHA Kerala Website: Visit the State Health Agency Kerala website.  

2. District-wise Listings: The site provides lists of empanelled public and private hospitals categorized by district.

3. Hospital Finder Tool: Use the "Find Hospital" feature to search for empanelled hospitals in your area.

Contact Address

You can reach out for any insurance related queries through the following address of the Karunya Health Insurance Scheme:

State Health Agency Kerala (SHA), 5th and 8th Floor,

Artech Meenakshi Plaza,  Opposite Government Women and Children's Hospital,

Thycaud, Thiruvananthapuram - 695 014

The contact number for Karunya Health Insurance Scheme is 0471 4063121.

Conclusion

The Karunya Health Scheme aims to provide coverage for the underprivileged section of the society against various chronic diseases. The government is utilizing its lottery money to good use by helping poor people access quality healthcare. Though there were rumours regarding the discontinuation of this scheme, the government responded saying that it has no plans to abandon Karunya Health Scheme in the near future.