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  • Yeshasvini Health Insurance Scheme by Govt. of Karnataka

    What is Yeshasvini Health Insurance Scheme?

    The Yeshasvini Co-operative Farmers Health Care Scheme provides cost-effective medical facilities to farmers across the state courtesy cooperative societies registered with the Department of Cooperatives. This scheme targets informal workers in the lower-middle income and middle-income groups. In other words, any peasant in Karnataka can have access to medical facilities, provided he or she is a member of any cooperative society.

    Genesis of Yeshasvini Health Insurance Scheme:

    The former chief minister of Karnataka S.M.Krishna formally launched the Yeshasvini Co-operative Farmers Health Care Scheme on November 14th, 2002. The Yeshasvini Health Care Scheme became operational in 2013 and available to co-operative farmers via network hospitals spread across the state of Karnataka.

    What is Yeshasvini Cooperative Farmers Health Care Trust?

    Registered under the Indian Trust Act 1882, the Yeshasvini Cooperative Farmers Health Care Trust was established to ensure efficient implementation of the Yeshasvini Health Insurance Scheme. The chief patron of the Trust is the chief minister of Karnataka while the patron is the minister for cooperation. It is important to note that the state government makes contributions to the Trust. The governing body of the Trust comprises five senior officers, who in turn, report to the principal secretary, cooperation department. The governing body also consists of five renowned doctors across the state as listed in the table below:

    Designation Member
    Chairman of Yeshasvini Cooperative Farmers Health Care Trust Principal Secretary, Cooperation Department, Government of Karnataka
    Senior Officers of Government of Karnataka

    Managing Director, Karnataka State Cooperative Apex Bank Ltd, Bangalore

    Registrar of Cooperative Societies, Bangalore

    Commissioner for Cane Development and Director of Sugar, Bangalore

    Managing Director Karnataka State Cooperative Milk Producers Federation Ltd. Bangalore

    Additional. Registrar of Co-operative Societies, Bangalore

    List of Doctors

    Dr.L.H.Bidri, Bidri's Ashwini Hospital, Bijapur & Trustee

    Dr. Manjunath Shetty, Head of Nephrology Department, J.S.S College, Mysore

    Dr. Chandra Mouli, MBBS, M.S, Consultant Surgeon, Fortis Hospital,Bangalore

    Dr. Deviprasad Shetty, Narayana Hrudayalaya, Bangalore

    Dr. C.N. Manjunath Director, Jayadeva Institute of Cardiology, Bangalore

    How is the Yeshasvini Health Insurance Scheme administered?

    The following table shows details of the administration of this scheme:

    Feature Particulars
    Department of Cooperation Reviews the overall publicity required for the scheme besides monitoring the entry of beneficiaries
    Cooperative societies Enroll beneficiaries into the scheme
    Network hospitals Provide all medical facilities to the beneficiaries under the scheme, subject to conditions
    Management Support Service Provider

    (IRDA licensed)

    Manages claims settlement and other administrative matters
    Yeshasvini Cooperative Farmers Health Care Trust Board Meets once in three months to take important policy decisions, review funds availability and disbursement under the scheme

    Funding of Yeshasvini Health Insurance Scheme:

    The Yeshasvini Co-operative Farmers Health Care Scheme is one of the biggest self-funded health care schemes in India. The Yeshasvini Co-operative Farmers Health Care Scheme is, therefore, a contributory scheme in that beneficiaries make small contributions (rate of annual contributions) annually to avail of the benefits under this scheme. In 2013-14, the contribution fixed amounted to Rs.210 p.a.

    Eligibility criteria for Yeshasvini Health Insurance Scheme:

    The following table shows the various salient features of the scheme:

    Feature Particulars
    Upper Age Limit 75 years
    Eligible members

    An individual can become a member of a cooperative society prior to six months to the commencement of the scheme

    Rural co-operative society members

    Members of Weavers, Cooperative Societies

    Self-help groups dealing with cooperative society

    Members of Beedi Workers Cooperative Societies

    Members of Fisherman Cooperative Societies

    Coverage Rural areas of Karnataka Cities and Corporations are not covered
    Period Starts on August 1st and ends on July 31st
    Availability The family members of the main beneficiary are also eligible to avail of the benefits under this scheme, even if they are not rural co-operative society members
    Enrolment Details regarding enrolment under this scheme are listed below:

    The Department of Cooperation, Government of Karnataka issues enrollment and renewal guidelines every year

    The Deputy Registrar of Cooperative Societies and Cooperative Development Officers among others assist in the enrolment of beneficiaries and premium collection

    The collected amount is remitted to District Central Cooperative Banks which in turn, send it to Apex Bank, Bangalore

    A letter from the District Registrar of Co-operatives was issued in the first year. In the second year, photo ID cards were issued

    Unique Health Identification enrollment forms are being issued to main members since 2008. An enrolment form entails details of main beneficiary, members of his or her family, relationship and so forth

    Coverage of Yeshasvini Health Insurance Scheme:

    The Yeshasvini Co-operative Farmers Health Care Scheme provides health insurance coverage to ryots (Indian peasant or tenant farmer) across 30 districts in the state of Karnataka. The scheme has around 30 lakh beneficiaries. Around 803 surgical procedures are included in the scheme, subject to exclusions. Some of the ailments covered under this scheme are listed below:

    • Neonatal Intensive Care
    • Cardiac and Cardiothoracic Surgery
    • Ophthalmology Surgery
    • General Surgery
    • Pediatric Surgeries
    • Orthopedic Surgeries
    • Gynaecology and Obstetrics
    • Genito Urinary Surgeries
    • Neurosurgery
    • Surgical Oncology
    • Vascular Surgery
    • Surgical Gastroenterology
    • Dog bite
    • Snake bite
    • Neo natal care
    • Drowning
    • Accidents during operation of agricultural implements
    • Electrics shocks
    • Normal Delivery
    • Angioplasty

    Exclusions under Yeshasvini Health Insurance Scheme:

    The list of exclusions under this scheme are as follows:

    • Diagnostic Investigations
    • Burns Cases
    • Chemotherapy
    • Implants
    • Autoimmune diseases
    • Follow-up Treatment
    • Medico Legal Cases
    • Cosmetic surgery
    • Prosthesis
    • Deviated Nasal Septum
    • Joint replacement surgeries
    • Kidney and Heart Transplants
    • Dialysis
    • Dental Surgeries
    • Road Traffic Accidents
    • Artificial Limb
    • Skin Grafting
    • Inpatient medical treatment

    Number of Network Hospitals under the Scheme:

    There are around 572 network hospitals under the Yeshasvini Co-operative Farmers Health Care Scheme. The following table shows the number of network hospitals in Karnataka

    Name of the district Number of network hospitals
    Hassan 20
    Dakshina Kannada 26
    Haveri 16
    Raichur 11
    Bangalore Rural 7
    Davanagere 21
    Belgaum 49
    Ramanagar 11
    Bellary 8
    Chitradurga 12
    Dharwad 19
    Bangalore Urban 61
    Mysore 22
    Gulbarga 16
    Bidar 11
    Chikkaballapura 8
    Bijapur 23
    Mandya 25
    Kolar 11
    Koppal 8
    Gadag 6
    Chamrajnagar 4
    Bagalkote 44
    Chikkamagalur 7
    Kodagu 5
    Udupi 22
    Uttara Kannada 18
    Tumkur 27
    Shimoga 22

    Method of implementation of Yeshasvini Health Insurance Scheme:

    A beneficiary approaches any of the Network Hospitals, following which, a coordinator reviews the former’s UHID card and enrollment fee and approves preliminary diagnosis In case, a surgery is required, a pre-authorization requests are sent to MSP. The request is reviewed by specialists. The beneficiary can avail of cashless treatment for any surgery, subjects to the prescribed limits under this scheme. THe network hospitals forward the bill summary which includes the patient’s signature besides other essential documents to MSP for claims settlement. The Yeshasvini Health Insurance Scheme Trust pays the network hospitals under 45 days of the receipt of the bills via MSP. 

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

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