Yeshasvini Health Insurance Scheme

The Yeshasvini Health Insurance Scheme offers affordable and comprehensive healthcare coverage to millions in rural Karnataka. Discover the scheme’s benefits, eligibility criteria, and application process to secure your health and well-being.
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3 min
24-08-2024
The Yeshasvini Health Insurance Scheme is a pioneering initiative by the Karnataka Government aimed at providing affordable healthcare services to rural and semi-urban cooperative society members. Launched in 2003, this scheme has significantly impacted the lives of millions by offering extensive healthcare coverage at a minimal cost.

Overview of the Yeshasvini Health Insurance Scheme

The Yeshasvini Health Insurance Scheme was introduced with the primary objective of providing access to quality healthcare for individuals associated with cooperative societies in rural Karnataka. The scheme focuses on covering medical procedures and surgeries that are often unaffordable for low-income families. Over the years, it has evolved into a comprehensive healthcare program, encompassing a wide range of medical services and procedures.

Explore: List of government health insurance schemes in India

Benefits of the Yeshasvini Health Insurance Scheme

Given below are the benefits of Yeshasvini Health Insurance Scheme:

  • Comprehensive coverage: The Yeshasvini Health Insurance Scheme covers over 1,650 medical procedures, including around 823 surgical interventions, ensuring a broad spectrum of healthcare services for beneficiaries.
  • Cashless treatment: Patients can benefit from cashless treatment for pre-approved surgeries, with the insurance provider directly settling the bills with empaneled hospitals.
  • Substantial sum insured: Families below the poverty line are eligible for up to Rs. 5 lakh in annual coverage, ensuring financial protection during medical emergencies.
  • Extensive treatment costs covered: The scheme covers various expenses, including medication, hospital charges, surgery costs, and professional fees, among others.
  • Discounted rates: Beneficiaries receive discounted rates for treatments and diagnostic tests compared to standard hospital charges, making healthcare more affordable.

What is covered under the Yeshasvini Health Insurance Scheme?

Below is the list of things covered under the scheme:

  • General surgery
  • Neurosurgery
  • Polytrauma
  • Cardiology
  • Cardiovascular surgery
  • Cardiothoracic surgery
  • Obstetrics
  • Gynaecology
  • ENT (Ear, Nose, Throat) Infections/Diseases
  • General Medicine
  • Mental Disorder Packages
  • Neonatal
  • Paediatrics
  • Ophthalmology, Urology and
  • Medical, Surgical and Radiation Oncology
  • Orthopaedics

What is not covered under the Yeshasvini Health Insurance Scheme?

There are certain exclusions under the scheme. Beneficiaries must refer to the list of what’s not covered given below:

  • Burns
  • Transplants
  • Vaccination
  • Follow-up treatment
  • Dental surgery
  • Dialysis
  • Spectacles, hearing aids
  • Skin grafting for wounds
  • Biopsies
  • Road traffic accidents
  • Angioplasty
  • Implants including valves, grafts, mesh, nails, screws
  • Joint replacement surgeries
  • Any other expenditure not related to hospitalisation with surgery.
Also, read: Exclusions under health insurance

Eligibility criteria for Yeshasvini Health Insurance Scheme

Given below is the eligibility criteria for the Yeshasvini Health Insurance Scheme:

  • Age: Individuals under 75 years can enroll in the Yeshasvini Health Care Scheme.
  • Membership requirement: To be eligible for the Yeshasvini Scheme, an individual must be a member of a cooperative society in Karnataka for at least 90 days. Family members of the enrolled individual can also benefit from the scheme, even if they are not part of a cooperative society.
  • Coverage: The scheme covers the enrolled person, their spouse, dependent children, and parents.
  • Scheme duration: The annual tenure of the scheme runs from August 1st of the current year to July 31st of the following year.
Also, check: Vajpayee Arogyashree Yojana

Features of Yeshasvini Scheme

Discussed below are the key features of the scheme:

Fee contribution:

  • Rural Cooperative Members: An annual contribution of Rs. 500 is required per family of four members. For families exceeding four members, an additional 20% fee (Rs. 100) is charged per additional member.
  • Urban Cooperative Members: The annual contribution is Rs. 1,000 per family of four, with an additional 20% fee (Rs. 200) for each extra member.
  • SC/ST Families: The government covers the premium cost, exempting these families from payment.

Additional benefits:

Members can avail up to Rs. 200 for OPD services at network hospitals, which cannot charge beyond this limit.

Documents required for the Yeshasvini Scheme in Karnataka

To access the benefits of the Yeshasvini Insurance Scheme, an enrolled individual must obtain a Yeshasvini Health Card. It is recommended to have both the original and photocopies of the following documents ready to avoid any delays during the application process:

  • Proof of age
  • Proof of address
  • An official document verifying membership in a rural or urban cooperative society for the required minimum period.

How to register for the Yeshasvini Health Insurance online?

Registration for the Yeshasvini Health Insurance Scheme is available annually from July to October through eligible cooperative organisations. To qualify, applicants must be members of a cooperative society for at least three months. Once this requirement is met, you can visit the official website of the Yeshasvini Health Insurance Scheme to complete the online registration process.

Also, read: Health insurance in Bangalore

How to get a Yeshasvini Insurance Scheme Health Card?

The Yeshasvini Health Card is crucial for availing benefits under the scheme. Once acquired, the insured individual or their family members can use it to receive cashless treatment at network hospitals.

The card is issued upon enrollment and can be easily renewed at cooperative societies. Registration and renewal occur annually between May and June.

Steps to apply for a Yeshasvini Health Card online:

Step 1: Register with a cooperative society in Karnataka via the government website.

Step 2: Select ‘Register for the Cooperative Society.’

Step 3: Click on ‘Apply Online for Yeshasvini Health Card.’

Step 4: Complete and submit the registration form.

Step 5: Log in to the website and access the Yeshasvini Health Card form.

Step 6: Fill out the form, review details, and submit it to finalise the application.

How to claim the Yeshasvini Health Scheme in Karnataka?

To claim benefits under the Yeshasvini Health Scheme, the insured individual or their family members can visit a network hospital. The process involves:

  • Locate a network hospital: Find the nearest hospital in the scheme's network.
  • Document verification: A medical coordinating officer will verify your documents and health card.
  • Pre-diagnosis: Pay the enrollment fee for any required pre-diagnosis tests.
  • Approval for surgery: If surgery is necessary, the request is sent to the Management Support Service Provider for approval.
  • Cashless treatment: Upon approval, the patient receives cashless treatment up to the coverage limit.
  • Claim settlement: After discharge, the hospital sends medical bills and documents for claim settlement, which is processed by the Yeshasvini Health Insurance Scheme trust.
The Karnataka Government's Yeshasvini Health Care Scheme offers coverage for various surgeries and treatments at network hospitals throughout the state. Eligible individuals can obtain a Yeshasvini Health Card for cashless treatment of covered procedures up to the insured limit. This coverage also extends to the family members of the insured, providing comprehensive health insurance benefits.

Frequently asked questions

What documents are required to apply for the Yeshasvini Health Insurance Scheme?
To apply for the Yeshasvini Health Insurance Scheme, you will need to provide proof of identity (such as an Aadhar card), proof of residence, and income details. Additionally, a recent photograph and a completed application form are required.

What medical treatments are covered under the Yeshasvini Health Insurance Scheme?
The Yeshasvini Health Insurance Scheme covers a range of medical treatments, including major surgeries, hospitalisation costs, and various health procedures. The specific treatments covered may vary based on the network hospitals and the scheme's terms.

How much premium do I need to pay for the Yeshasvini Health Insurance Scheme?
The premium for the Yeshasvini Health Insurance Scheme is nominal and varies based on the individual's age and coverage requirements. Generally, the scheme aims to keep premiums affordable to ensure broader accessibility.

How do I check my eligibility for the Yeshasvini Health Insurance Scheme?
To check your eligibility for the Yeshasvini Health Insurance Scheme, visit the official scheme website or contact local health care centers. Eligibility is typically based on factors such as income level and residency in Karnataka.

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