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:
|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:
|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
|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:
|Upper Age Limit||75 years|
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
- Surgical Oncology
- Vascular Surgery
- Surgical Gastroenterology
- Dog bite
- Snake bite
- Neo natal care
- Accidents during operation of agricultural implements
- Electrics shocks
- Normal Delivery
Exclusions under Yeshasvini Health Insurance Scheme:
The list of exclusions under this scheme are as follows:
- Diagnostic Investigations
- Burns Cases
- Autoimmune diseases
- Follow-up Treatment
- Medico Legal Cases
- Cosmetic surgery
- Deviated Nasal Septum
- Joint replacement surgeries
- Kidney and Heart Transplants
- 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|
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.
Yeshasvini Card Apply Online
Members of Cooperative Societies who have been members for minimum 3 months can register for the scheme. New members registration and old members renewal for the scheme can be done at all Cooperative Societies from May to June. The scheme will be be valid from 1 June 2017 to 31 May 2018. Visit http://yeshasvini.kar.nic.in to apply for the Yeshasvini card online.
About the Yeshasvini Health Insurance Scheme Evolution
Yeshasvini Cooperative Farmers Health Care Scheme was launched on 14 November 2002 by the former Chief Minister, Sri S M Krishna. The scheme was launched by the Karnataka government along with the cooperative farmers of the state. The scheme became operational from 1 June 2003. This is a self-funded health care scheme. Cooperative farmers of Karnataka are given quality and cost-effective healthcare facilities through the Yeshasvini Health Care Scheme in network hospitals.
Though the scheme was implemented with some modifications made to the concept of rural healthcare scheme by Sri A Ramaswamy, a former Principal Secretary to the Karnataka government and the Cooperation Department, the concept of 'Rural healthcare scheme' was actually initiated by Narayana Hrudayalaya’s Dr. Devi Prasad Shetty in Bangalore. The Karnataka government offers contribution to the Yeshasvini Cooperative Farmers Health Care Trust for implementing the scheme.
Salient Features of Yeshasvini Health Insurance Scheme
Members of Karnataka Rural Co-operative Society are eligible for the Yeshasvini Health Insurance Scheme.
- The family of the main member of Rural Co-operative Society can avail the benefits offered under the scheme.
- Every year, the beneficiaries of this scheme must pay a fixed amount of annual contribution. For FY2017-18, Rs.300 is the member contribution for Rural Yeshasvini, and for Urban Yeshasvini, it is Rs.710.
- Each enrollment period for the scheme starts from July to October every year.
- The scheme begins from 1st June and ends on 31st May of the next year.
- Members of self-help groups, weavers, fisherman cooperative societies, Beedi workers, and Stree Shakti Group carrying out financial transactions with cooperative society or banks are eligible for the scheme.
Yeshasvini Health Insurance Scheme Implementation Procedure
730 network hospitals having a tie-up with the trust are involved in the implementation of Yeshasvini Health Insurance Scheme. It includes private as well as government hospitals. According to the empanelment criteria, the network hospitals are given approval by the trust to offer medical facilities. The Management Support Service Provider (MSP) arranges for cashless hospitalisation through these 730 network hospitals. The Yeshasvini Health Insurance Scheme implementation process is as follows:
- The Yeshasvini beneficiary visits a network hospital that the trust recognises and approves of.
- A coordinating officer of the network hospital will examine the beneficiary’ UHID card.
- Beneficiary must pay an enrollment fee.
- Then the patient has to undergo initial diagnosis and few basic medical tests.
- Depending on the initial diagnosis, the network hospital will send a pre-authorisation request online with supporting documents to the MSP.
- Doctors appointed by the MSP will examine the request and approval will be given within a day.
- Making note of the limits specified under the scheme, cashless treatment will be provided to the beneficiary by the network hospital.
- After discharge, the network hospital will submit the original bills, discharge summary, and other medical documents to the MSP for settling the claim.
- The trust will settle the claim to the network hospital through the MSP within 45 days of receipt of the documents.
Yeshasvini Health Insurance Scheme Medical Benefits
- Surgical procedures of 823 types specified by the Yeshasvini Trust is covered under the scheme at rates pre-negotiated with the partner hospitals.
- Medical emergencies like snake bite, dog bite, bull gore injuries, electric shocks, accidents, and drowning occurring when using agricultural implements are covered under the scheme.
- Normal delivery, angioplasty procedures, and neonatal care are covered under the scheme.
Administration of the Yeshasvini Health Insurance Scheme
Karnataka CM is the chief patron of the Yeshasvini Cooperative Farmers Health Care Trust, registered under the Indian Trust Act 1882. Minister for Health and Family Welfare and Cooperation are the other patrons. The governing body of the trust includes 9 senior officers of the state government and 5 doctors from different areas of state. Chairman of the Trust is the Principal Secretary to the Karnataka government, Health and Family Welfare Department. Co-Chairman of the Trust is the Principal Secretary to Government of Karnataka, Cooperation Department.
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.