Rural health care schemes are currently being promoted by various state governments in the country. Yeshasvini Cooperative Farmers Health Care Scheme was introduced by the state government of Karnataka to provide health insurance coverage for farmers. This is a self-funded scheme that works on the collective ability of the masses enrolled in this plan. This scheme provides coverage for various medical ailments at an affordable price. This scheme is fully managed by the government of Karnataka with the state’s Chief Minister acting as the Chief Patron.
People who wish to avail this cover must meet the following eligibility criteria set forth by the government of Karnataka:
Some of the key features of Yeshasvini Health Care Scheme can be listed as follows:
The medical benefits available under Yeshasvini Health Care Scheme can be listed as follows:
|Benefits||Extent of Cover|
|Surgical procedures||Up to 823 types identified by the Yeshasvini Trust|
|Emergency medical treatment||Covered for emergencies such as dog bite, snake bite, drowning, electric shocks, accidents that occur while handling agricultural equipment, angioplasty, normal delivery, neonatal care, etc.|
|Cost of surgery||Sub-limits as specified in the surgery list|
Yeshasvini Health Care Scheme will not provide any coverage for the following:
Yeshasvini Health Care Scheme is entirely cashless from admission to discharge. This scheme is implemented by Management Support Service Provider (MSP) through various network hospitals. At the time of hospital admission, the enrolled member is required to provide the identity card. Based on the preliminary diagnosis, the requirement for surgical intervention is determined. The network hospital will send the pre-authorisation requirement to the Yeshasvini Trust for approval.
Pre authorisation is typically provided by the Trust within a maximum of 24 hours. After receiving the pre authorisation for medical treatment, doctors and surgeons in the network hospital can proceed with the medical treatment. Following treatment, the network hospital will send all the medical bills and discharge summary of the patient to the MSP. Upon verification of the claim, the Trust will arrange payment to the network hospital.
The enrolment process for the scheme starts from January or February and ends in August. Any eligible individual can enroll himself/herself into the scheme.
There are no age restrictions. Individuals of any age can enroll themselves under the scheme.
The Yeshasvini trust has listed 823 surgical procedures for which beneficiaries can avail benefits under the scheme.
Expenses incurred during the surgery for the cost of anaesthesia, consumables during the hospital stay, medicines, among others are covered. Also, the surgeon’s fee, consultation fee, general ward bed charges, professional charges, nursing fee, operation theatre charges, etc., are also covered. Beneficiaries under the scheme are covered for out-patient consultation and get a discount on the cost of tests and investigations in laboratories.
Under the rural scheme, a beneficiary has the coverage option up to Rs.1.25 lakh for admission once and Rs.2 lakh for more than one surgical procedure. Under the urban scheme, a beneficiary has coverage up to Rs.1.75 lakh for admission once and up to Rs.2.5 lakh for more than one surgical procedure.
Yes, the beneficiary will have to make an annual contribution towards the scheme. The scheme is funded by the beneficiary as well as the government.
No, beneficiaries can enjoy free treatments only in network hospitals recognised by the Yeshasvini trust.
The hospital will first send the details of the expenses incurred to the Management Service Provider (MSP). Once the MSP verifies the details, it is sent to the Yeshasvini trust. After the bill is passed by the Yeshasvini trust and approved at sub-committee meetings, the amount is transferred to the MSP and the MSP transfers it to the concerned hospital.
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