Yeshasvini Health Insurance Scheme

‘Health is wealth’ is a common saying that we hear around us. Considering the current times, taking care of our health should be our first duty. A health insurance policy takes care of our health in times of medical emergency, but unfortunately, many rural people are not aware of it. Yeshasvini Health Insurance Scheme is one of the biggest cooperative health care schemes launched by the Government of Karnataka to ensure the farmer cooperators of the state remain in good health. This insurance scheme is specially designed for the farmers who are members of the cooperative societies in Karnataka.

Launched by the former Chief Minister of Karnataka S. M. Krishna on June 1, 2003, the Yeshasvini Health Insurance Scheme became in its full effect from 2013 with revolutionizing the rural health care system. In 2014, it was extended to urban cooperative also. The main principle behind the launch of this scheme is “One for all and all for one.”

Here, we will talk about the features, reimbursement amount, contribution amount, etc. for the Yeshasvini Health Insurance Scheme. Keep reading to know more!

Yeshasvini Health Insurance Scheme & Its Striking Features

What are those special features of the Yeshasvini Health Insurance Scheme that have made it so popular among the rural farmers who are members of the cooperatives across Karnataka? Well, you can check them below.

1. The best part about Yeshasvini Health Insurance Scheme is its self-funded nature where both beneficiary and government contribute a specified amount every year.
2. As we said earlier, the members of cooperative societies can enjoy healthcare benefits under this scheme. However, all the members of a family don’t need to become members of a particular cooperative society. Any family member can become the society’s member and other members can enjoy the benefits of this scheme by making the contribution payment separately.
3. Talking about membership of the cooperative society, any individual can become a member from a newborn baby to a person in his or her lifetime. There is no age limit when it comes to attaining membership. However, he or she will need to fulfill the eligibility criteria of this scheme.
4. There is a definite enrollment window within which an individual can become a member. This window starts from January/ February and closes by August every year.
5. Any member can enjoy quality healthcare without any limitation on the kind of disease he or she has been suffering from.
6. Under the Yeshasvini Health Insurance Scheme, there are 823 types of surgeries for which members can get the cover.
7. An individual needs to be a member of a cooperative society for at least 3 months if he or she wants to benefit from this Karnataka Government’s scheme.
8. Under this scheme, the Department of Cooperation is the supporting department, while the implementing agency at present is MDIndia Healthcare Networx Pvt. Ltd. This agency coordinates between the network hospitals under the scheme, beneficiaries and trust.

Who Can be a Member of this Scheme?

Other than the members of Rural Cooperative Societies, the following people are also eligible to become members under the Yeshasvini Health Insurance Scheme. Take a look!

1. Members of Self-help group/Sthree Shakthi Groups who have a financial relationship with cooperative societies/co-operative bank
2. Members of the fisherman co-operatives
3. Beedi workers co-operatives
4. Weavers co-operatives

What is the Maximum Reimbursement Amount an Individual Can Get?

Under the Yeshasvini Health Insurance Scheme, rural members can get cover for surgeries up to INR 1.25 lakh. This limit can be as high as INR 2 lakh if a member is undergoing multiple medical surgeries. On the other hand, urban members can enjoy coverage of up to INR 1.75 lakh for single admission, while it can be up to INR 2.50 lakh for multiple admission in the same year.

What Amount do Members Need to Contribute?

Now that you have information about the maximum converge amount under this scheme, you should also know the annual amount that a member needs to pay. We are showing them in the below table. Have a look!

What is Covered under Yeshasvini Health Insurance Scheme?

It is important to know the facilities that members can enjoy with this scheme. We are showing all of them below. Do check!

1. Cost of medicines during surgeries
2. Consumables during a hospital stay
3. Operation Theatre expenses
4. Anesthesia, Surgeon Fee, Professional charges
5. Consultation Fee
6. Nursing Charges
7. General Ward Charges
8. Free Outpatient consultation
9. Discount on Lab Investigation and Diagnostic Tests

Other than these, this scheme also provides several special benefits to the members. To know more about them, you can check below.

1. Angioplasty Procedure
2. Normal Delivery coverage
3. Neo-Natal Care procedure
4. Medical emergencies such as Dog bite, Snakebite, drowning, and accidents happened during agricultural activities

What’s not Covered under Yeshasvini Health Insurance Scheme?

Yeshasvini Health Insurance Scheme does not reimburse members for a few specified medical procedures that are shown below.

1. Prosthesis
2. Burnt Cases
3. Dental Surgeries
4. Road traffic accidents
5. Medico-legal cases
6. Kidney and Heart Transplants
7. Chemotherapy
8. Diagnostic investigations
9. Skin grafting
10. Dialysis
11. Expenses on screws and stents for orthopedic and urological surgeries
12. Medical and follow-up treatment
13. Implants
14. Joint Replacement Surgeries

How Can a Member Avail of the Treatment under this Scheme?

To enjoy the healthcare benefits under the Yeshasvini Health Insurance Scheme, a member (who holds the unique health identification number) only needs to go to any of the 550 network hospitals. The hospital would then check your beneficiary details and see whether the surgery is covered under the scheme or not. After this, the hospital will seek authorization from the Management Services Provider (MSP) online. After getting the approval, the hospital will conduct surgery.