• Yeshasvini Cooperative Farmers Health Care Scheme

    Health Insurance
    • Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
    • 10,000+ hospitals for cashless treatment
    • Claim up to Rs. 55,000 deduction under section 80D**

    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.

    Eligibility for Yeshasvini Health Care Scheme

    People who wish to avail this cover must meet the following eligibility criteria set forth by the government of Karnataka:

    • The beneficiary must be a member of the Rural Cooperative Society of Karnataka.
    • This coverage is available for anyone from a newborn baby to a senior citizen. There is no age limit for this cover.
    • Family members of the main member can also be enrolled in this cover.
    • Enrolment for this cover is open only between July and October of every year.

    Features of Yeshasvini Health Care Scheme

    Some of the key features of Yeshasvini Health Care Scheme can be listed as follows:

    • Member contribution for rural scheme is Rs.300 per year, and the contribution for urban scheme is Rs.710 per year.
    • For SC/ST members, the government offers subsidy up to Rs.600.
    • Members of all cooperative societies including self-help group members, members having transaction with a cooperative society, members of fishermen cooperative societies, weavers, beedi workers, etc. can also avail this coverage.
    • This is a surgicare cover, and it does not cover inpatient medical expenses unless surgical intervention is required for the treatment.
    • Coverage under this scheme starts from June 1st and ends on May 31st of every year.
    • There are over 730 network hospitals that provide treatment under the Yeshasvini medical insurance scheme.
    • Benefits offered by this cover can be availed only in the network hospitals listed out by the government.
    • Benefits are implemented in the form of cashless treatment under this policy cover.

    Benefits of Yeshasvini Health Care Scheme

    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

    Exclusions of Yeshasvini Health Care Scheme

    Yeshasvini Health Care Scheme will not provide any coverage for the following:

    • Any kinds of follow up medical treatment after surgery
    • Joint replacement surgeries
    • Kidney and heart transplants
    • Cosmetic surgeries of all kinds
    • Road traffic accidents
    • Valves for heart operations
    • Screws and stents
    • Orthopedic and urological surgeries
    • Expenses incurred for diagnostic investigations
    • Expenses related to vaccination or inoculation
    • Expenses related to vitamins, tonics, or sanitary items
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    Claim Procedure

    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.

    FAQs on Yeshasvini Health Care Scheme

    1. When can individuals enroll themselves under the scheme?
    2. 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.

    3. What are the age limits under the scheme?
    4. There are no age restrictions. Individuals of any age can enroll themselves under the scheme.

    5. Are all kinds of surgeries covered under the scheme?
    6. The Yeshasvini trust has listed 823 surgical procedures for which beneficiaries can avail benefits under the scheme.

    7. What kind of treatments are covered under the scheme?
    8. 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.

    9. What is the maximum limit of coverage under the scheme?
    10. 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.

    11. Does the beneficiary have to pay for the coverage?
    12. 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.

    13. Can beneficiaries avail free treatments in any hospital?
    14. No, beneficiaries can enjoy free treatments only in network hospitals recognised by the Yeshasvini trust.

    15. How are the hospital bills settled?
    16. 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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