Yashasvini Health Insurance Scheme:-Yashasvini Health Insurance Scheme Online Registration, Eligibility, and Benefits | Yashaswini Card Online Application, Renewal, and Download, Hospital List | State governments all over the country have made consistent efforts to provide the general public, particularly the economically disadvantaged segment of the population, with high-quality healthcare.
Workers and farmers in the countryside do not have access to healthcare services because of the cost. As a result, a slew of government programs have been devised with the goal of lowering medical costs and enhancing citizens’ health.
Yashasvini Health Insurance Scheme
One such program is the Yeshasvini Health Insurance Scheme run by the Karnataka government. The Karnataka government uses it as one of the most common forms of health insurance for Indian farmers. The Yeshasvini Health Insurance Scheme’s features and benefits, eligibility requirements, coverage, registration, list of medical services covered, included network hospitals, and other details can all be found in the post below.
Yashasvini Health Insurance Scheme Details
|Launched By||Government of Karnataka|
|Name of Scheme||Yeshasvini Health Insurance Scheme 2023|
|Objective||To provide medical facilities|
|Benefits||Get many diagnostic tests at affordable prices|
|Eligibility Criteria||Residents of Karnataka|
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About Yashasvini Health Insurance Scheme
The Yashasvini Health Insurance Scheme is a community-based medical insurance program for middle- and lower-middle-income workers in Karnataka’s informal economy. In 2003, former Karnataka chief minister S.M. Krishna introduced the Yeshasvini Health Insurance Scheme to provide farmers who are members of state cooperative organizations with full coverage. The Department of Cooperatives collaborates with the Karnataka Government on this program. It provides rural unorganized workers with affordable access to necessary healthcare facilities by utilizing the funds earned by cooperative societies through the Yeshasvini trust.
The program that covers people in more than 30 Karnataka districts is managed by the Yeshasvini Cooperative Health Care Trust, which is registered under the Indian Trust Act of 1882.
Yeshasvini Health Insurance Scheme Administration
The table below provides a comprehensive description of this program’s administration:
|Department of Cooperation||It reviews the total amount of publicity required for the program and monitors the beneficiaries’ entrance.|
|Cooperative societies||to add beneficiaries to the program|
|Network hospitals||to provide program beneficiaries with all medical resources subject to restrictions|
|Management Support Service Provider (IRDA licensed)||supervises claims resolution and other administrative matters|
|Yeshasvini Cooperative Farmers Health Care Trust Board||Meets once every three months to discuss important policy issues and the scheme’s funding distribution.|
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The Yashasvini Health Insurance Plan’s Pros and Cons
The Yashasvini Health Insurance Plan has the following main features and benefits:
- This program, which is exclusive to Karnataka, covers the entire state.
- Beneficiaries of this insurance plan may also qualify for discounted rates on a number of diagnostic tests.
- To be eligible for this insurance plan’s benefits, you must have been a member of the Karnataka Rural Co-operative Society for at least three months. The main player will then be you.
- From July to October of each year, this program allows for enrollment.
- You can also take advantage of discounted hospital stays at several hospitals in the program’s network.
- The maximum age at which a person can purchase a policy for a newborn child is 75.
- The benefits can be used at any time between the first of June and the last day of May in the following year by those who enlist during the specified period.
Financing for the Yeshasvini Health Insurance Scheme
The Yeshasvini Co-operative Farmers Health Care Scheme is one of India’s largest self-funded healthcare programs. Beneficiaries of the Yeshasvini Co-operative Farmers Health Care Scheme are required to make small annual contributions in order to receive the benefits it provides, making it a contributory plan. For 2013–14, the fixed contribution was Rs. 210 annually.
Yeshasvini Health Insurance Scheme Eligibility Criteria
The following table outlines the Yashasvini Health Insurance Scheme’s eligibility requirements:
|Age Limit||The program is open to applicants under the age of 75.|
|Period||Beginning August 1 and concluding July 31|
|Eligible members||A person can join a cooperative society prior to the first six months of the scheme. Beedi Workers Cooperative Societies members Fisherman Cooperative Societies members Members of rural cooperative societies Members of cooperative societies for weavers Self-help organizations addressing cooperative societies|
|Availability||The primary recipient’s family members are eligible for benefits under this program even if they are not members of the rural cooperative society.|
|Coverage||The rural areas of Karnataka’s cities and corporations are not covered.|
|Enrolment||In order to enroll in this program, the following information is provided: Rules for enrolling and renewing students are published annually by the Department of Cooperation of the Government of Karnataka. The Deputy Registrar of Cooperative Societies and Cooperative Development Officers, among others, help with beneficiary enrollment and premium collection. After being collected, the funds are transferred from District Central Cooperative Banks to Apex Bank in Bangalore. The district registrar of cooperatives sent a letter the first year. The second year saw the distribution of photo ID cards. Main members have been receiving enrollment forms for Unique Health Identification since 2008. The enrollment form contains information about the primary beneficiary’s family, relationships, and other details.|
Documents Needed for the Yashasvini Health Insurance Scheme
The Yashasvini Health Insurance Scheme requires the following documents:
- Age proof
- Address Proof
- a document proving a person’s membership in cooperative societies, whether in urban or rural areas
Coverage Provided by the Scheme
Up to Rs. 1,000 can be covered for farmers. 2.5 lakh through the Yeshasvini Health Insurance Scheme, with a minimum annual premium of Rs. 250. Farmers who sign up for this program get paid in case a family member gets sick.
The Yeshasvini Health Insurance Program’s List of Medical Services
The members of Urban & Rural Co-operative Societies are eligible for the Yeshasvini health program, which covers the following costs associated with treatment and surgery:
|General Surgery||Gynecology Surgery|
|Orthopedic, Pediatric, cardiothoracic Surgery||Cardiac Arrest|
|Neurological Surgery||Neonatal Intensive Care|
|Normal Delivery||Dog bite|
|Surgical Oncology||Accidents during operation of agricultural implements|
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Exclusions from the Yeshasvini Health Insurance Plan
The Yeshasvini Health Insurance Scheme does not cover any of the following medical procedures.
|Kidney transplant||Heart transplant|
|Diagnostic investigations||Road accidents|
|Burns||Vaccination or inoculation|
|Dialysis||Skin treatment or grafting|
|Cosmetic surgery||Cost of vitamins, or sanitary items|
|Dental surgery||Joint replacement surgery|
|Post-surgery follow-up treatment||Inpatient medical treatment|
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Hospitals in the Yeshasvini Health Insurance Program’s Network
There are approximately 572 hospitals in the Yeshasvini Co-operative Farmers Health Care Scheme’s network. The table below shows the number of network hospitals in Karnataka.
|District Name||Number of network hospitals|
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How do I sign up for the Yeshasvini Health Insurance Program?
- To be eligible for this program, the applicant must have been a member of the cooperative societies for at least three months.
- At all relevant corporate organizations, new enrollment for the Karnataka Yeshasvini plan is completed annually from May to June.
Methodology for Putting the Yeshasvini Health Insurance Program into Action:
A coordinator examines a beneficiary’s UHID card, pays the enrollment fee, and approves the preliminary diagnosis when the beneficiary visits one of the Network Hospitals. If surgery is required, an application for pre-authorization is sent to MSP. Experts look into the request. The beneficiary may receive non-cash treatment for any surgery within the established limits. For the purpose of processing claims, the network hospitals send MSP the patient’s signed bill summary and other necessary documents. Within 45 days of receiving the invoices, the Yeshasvini Health Insurance Scheme Trust pays the network hospitals via MSP.
Steps for Putting the Yashasvini Health Insurance Plan into Action
730 network hospitals with ties to the trust are implementing the Yeshasvini Health Insurance Scheme. Included are both public and private hospitals. Under the empanelment standards, the trust grants authorization to the network hospitals to provide medical services. The Management Support Service Provider (MSP) arranges for cashless hospitalization through these 730 network hospitals. The Yeshasvini Health Insurance Scheme is implemented through the following steps:
- The Yeshasvini beneficiary visits a network hospital that the trust recognizes and authorizes.
- The beneficiary’s UHID card will be checked by a network hospital coordinating officer.
- There is a fee that must be paid by the enrolling party.
- The patient must then undergo a few fundamental medical tests and a preliminary diagnosis.
- Based on the initial diagnosis, the network hospital will submit an online pre-authorization request to the MSP with supporting documentation.
- The MSP-chosen physicians will examine the request, and the following day, approval will be granted.
- In accordance with the program’s restrictions, the network hospital will provide the beneficiary with cashless treatment.
- In order to settle the claim, the network hospital will send the MSP the patient’s original invoices, summary of discharge, and other medical records.
- The MSP will be used by the trust to resolve the claim with the network hospital within 45 days of receiving the documentation.
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