Access to healthcare in India, particularly for economically disadvantaged individuals, remains a challenge. Various state governments, including Kerala, have implemented healthcare initiatives like Karunya Arogya Suraksha Padhathi (KASP) to bridge this gap. KASP is a critical illness plan aiming to provide essential medical aid to the underprivileged. In this article, we will discuss the coverage, benefits, eligibility and more about the Karunya Scheme.
What is the Karunya Health Insurance scheme?
The State of Kerala decided to amalgamate various government-sponsored healthcare schemes, including RSBY (a joint scheme of central and state governments), CHIS (fully funded by Kerala government), SCHIS (providing extra coverage to seniors in RSBY/CHIS families), KBF (a trust model administered by the Lottery department), and Ayushman Bharat – PMJAY, into Karunya Arogya Suraksha Padhathi (KASP). State of Kerala signed an agreement with NHA on 31st October 2018 and constituted State Health Agency (SHA) for implementing the scheme in the State as Karunya Arogya Suraksha Padhathi (KASP).
Karunya Arogya Suraksha Padhathi (KASP): An overview
Scheme name |
Karunya Arogya Suraksha Padhathi (KASP) |
Objective |
Providing health cover of up to Rs. 5 lakh per family for secondary and tertiary care hospitalisation |
Initiated by |
Government of Kerala |
Initiated in |
2012 |
Key features and benefits of the scheme
Given below are the key features and benefits of the Karunya Health Insurance Scheme:
- Fully government-financed healthcare scheme.
- Offers Rs. 5 lakhs annually per family for secondary and tertiary care hospitalisation.
- KASP - PMJAY ensures cashless access to services at hospitals.
- Aims to mitigate catastrophic medical expenses.
- Covers pre-hospitalisation up to 3 days and post-hospitalisation up to 15 days, including diagnostics and medicines.
- No restrictions based on family size, age, or gender.
- Covers all pre-existing conditions from day one.
- Benefits portable nationwide, allowing treatment in any empaneled public or private hospital.
- Includes approximately 1,573 procedures, covering all associated treatment costs like drugs, supplies, and physician fees.
Coverage under Karunya Health Insurance Scheme
Given below are the benefits of the cover:
- The coverage of Rs. 5 lakh is available on family floater basis. This means that all members of the family will be covered within this coverage of Rs. 5 lakh.
- There is no cap on the number of people in each family. As per RSBY, there was a cap of 5 family members, but after the introduction of KASP, this cap was removed.
- Medical examination, treatment, consultation, pre-hospitalisation, medicine and medical consumables, diagnostic and laboratory investigations are al included in this scheme.
- Other coverage includes medical implantation services, accommodation benefits and post-hospitalisation follow-up for up to 15 days.
What is Karunya Benevolent Fund?
The Karunya Benevolent Fund (KBF), administered by the State Lotteries Department, offers financial assistance to economically disadvantaged individuals suffering from severe ailments like cancer, Haemophilia, and heart diseases, funded through Kerala lottery proceeds. It aids those unable to afford treatment costs, especially with an annual family income below Rs. 3 lakh. Beneficiaries can access cashless treatment at KASP empaneled hospitals, with an increasing number of healthcare providers and treatment packages. IT integration improves patient-centric approaches within the KBF scheme.
How is the old KBF different from the KASP KBF?
Given below are the key points of difference between the old KBF and the revised KBF policies after the launch of Karunya health insurance scheme:
Aspect |
Old KBF |
KBF after integration with PMJAY portal |
Beneficiary application process |
Application submitted to District Lottery Officer with photos, ration card, and family photo |
Application directly submitted at KASP hospitals with only ration card and income proof, processed through IT system |
Benefits |
Tertiary care (Rs. 2 lakhs), Kidney ailments (Rs. 3 lakhs), unlimited for Haemophilia |
Secondary and Tertiary care per KASP packages, 1667 procedures across 26 specialties, includes post-discharge medicines for 15 days |
Most utilised package & rate |
Haemodialysis – Rs. 650 per session |
Haemodialysis – Rs. 900 per session |
IT integration |
Manual process with portal data entry, multiple touch points for beneficiaries |
New IT integration with National Health Authority portal, digitalised process, paperless treatment with minimal waiting, hospitals can raise online claims |
Hospitals empaneled |
57 hospitals, 26 dialysis centers |
742 Hospitals – 194 Public, 538 Private |
Eligibility criteria for Karunya Health Insurance Scheme
Eligibility requirements for Karunya Health Insurance are as follows:
- Residency in Kerala is mandatory.
- Applicants must be below the poverty line to qualify.
- Both Below Poverty Line and Above Poverty Line households with an annual income under Rs. 3 lakhs are eligible.
- Documentation including Aadhaar card, income certificate, and other necessary paperwork is required for enrollment.
Application process for KASP
Here's how to apply for the Karunya Health Insurance Scheme online:
Step 1: Visit the official Kerala Government website at http://karunya.kerala.gov.in to initiate the application process.
Step 2: Navigate to the "How to Apply" section and download the application form.
Step 3: Fill in your details accurately on the form and submit it along with the necessary documents.
The Karunya Health Insurance Scheme marks a substantial advancement in Kerala's endeavor to deliver accessible and cost-effective healthcare to its vulnerable demographics. Targeting critical illnesses known for their expensive treatments, the health insurance scheme strives to alleviate financial strains on low and middle-income households, guaranteeing essential healthcare access regardless of financial constraints.
