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Overview of the Yeshasvini Health Insurance Scheme by the Karnataka Government

Team AckoNov 18, 2022

According to the Institute for Social and Economic Change report, there are 13.74 million farmers in Karnataka. Most of them cannot access quality healthcare, as they do not have a fixed income and depend on variable factors like weather, the quantity of produce, sales, etc., for income. The Karnataka government introduced the Yeshasvini Health Insurance Scheme to enable such farmers to access healthcare services. This article discusses the benefits and features of this health insurance scheme.

Yeshasvini Health Insurance Scheme (YCFHS)

Contents

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What is the Yeshasvini Health Insurance Scheme (YCFHS)?

The Yeshasvini Health Insurance Scheme is a community-based medical insurance program that seeks to assist workers in Karnataka's unorganised sector who fall into the middle and lower-middle income brackets. The Department of Co-operatives runs this programme in collaboration with the Government of Karnataka. In order to provide the necessary healthcare facilities for the rural informal workers at a lower cost, it leverages the cash raised by Co-operative Societies through the Yeshasvini trust. The objective of the Yeshasvini Health Insurance Scheme is to offer cost-effective, high-quality healthcare throughout the state of Karnataka.

Benefits of the Yeshasvini Health Insurance Scheme

Here are the benefits offered by the Yeshasvini Health Insurance Scheme.

  • Rs. 5 lakh sum insured: The Yeshasvini Health Insurance Scheme offers an annual sum insured of Rs. 5 lakh. Insured members can also avail cashless facilities in any of the network hospitals.

  • Wide number of diseases covered: The health insurance scheme provides cashless claim benefits for 1,650 diseases at select network hospitals.

  • Discounts on treatment costs: One of the major advantages of this scheme is the fixed cost for certain medical treatments that are significantly lower than the standard costs.

  • Discounts on diagnostic tests: The costs of diagnostic tests are usually excluded from health insurance claims. However, the beneficiaries of the Yeshasvini Health Insurance Scheme can undergo these tests at a discounted rate.

Important features of Yeshasvini Health Insurance Scheme

Following are the benefits of the Yeshasvini Health Insurance Scheme.

  • Benefits for members of other groups: You need to be a Karnataka Rural Co-operative Society member for at least three months to benefit from this insurance plan. You'll become the primary participant as a result of this. After that, regardless of whether they are society members, every member of your family will be able to use the scheme's benefits. Additionally, participants in this programme may be Stree Shakti Group members, members of self-help organisations, Co-operative Societies for fishermen, weavers, or Beedi employees that transact with Co-operative Societies or banks.

  • Contribution fee: For SC/ST families, the government will pay the premium amount. Members of Rural Co-operative Societies or SHGs must pay a premium of Rs. 500 for a family of four members and Rs. 100 each for the fifth member onwards. Members of Co-operative Societies in urban areas must pay a premium of Rs. 1,000 for a family of four members and Rs. 200 each for the fifth member onwards.

  • Period of enrollment: Enrollment in this scheme is open from 01, November 2022. Members can apply for the scheme benefits from this date.

  • Period of operation: Individuals who enlist during the specified period can take advantage of its benefits starting from 01, January 2023.

Coverages offered by Yeshasvini Health Insurance Scheme (YCFHS)

As mentioned earlier, the Yeshasvini Health Insurance Scheme offers coverage for more than 1,600 medical procedures. Following are the types of medical treatment that the insured members can avail of.

  • Cardiac, orthopaedic, general, and paediatric surgery

  • Ear, nose, throat diseases

  • Surgical oncology, vascular surgery, and gastroenterology

  • Ophthalmology, neurosurgery, and genito-urinary medicine

  • Drowning, dog bites, snake bites, and so on

  • Treatment for electrical shocks suffered when operating agricultural implements

  • Obstetrics, gynaecology, and newborn intensive care

The Yeshasvini Health Insurance Scheme includes the cost of medicines, in-patient hospitalisation, surgery cost, operation theatre rent, anaesthetist fees, surgeon fees, consultant fees, bed charges, nurse fees, etc. Members are eligible for treatment in the General Ward of a hospital. For out-patient treatment (OPD), a limit of Rs. 200 (for a period of three months) can be claimed under the scheme. OPD treatment can be availed at any of the network hospitals. 

Exclusions of the Yeshasvini Health Insurance Scheme 

Yeshasvini Health Insurance Scheme does not cover you for the expenses incurred on the following.

  • The cost of follow-up treatments

  • Dental surgery

  • Medico-legal cases

  • Implants

  • Deviated nasal septum surgery

  • Skin grafting

  • Burns

  • Cosmetic surgery

  • The cost of prosthesis

  • Dialysis

  • Road accidents

  • Joint replacement surgery

  • The expenses related to kidney and heart transplant surgeries

List of Treatments Covered Under Yeshasvini Health Insurance Scheme

Eligibility for Yeshasvini Health Insurance Scheme

Here is a list of prerequisites you must meet in order to sign up for this health insurance scheme.

  1. Co-operative Society members enrolled under the Karnataka Co-operative Societies Act, 1957, Karnataka Souhardha Sahakari Act, 1997, or Multi-State Co-operative Societies Act, 2002, can take advantage of the Yeshasvini Health Insurance Scheme.

  2. People enrolled under self-help groups set up by the District Central Co-operative Banks/Primary Agriculture Co-operative Societies are eligible.

  3. Co-operative Society or rural self-help groups members can register under this health insurance scheme.

  4. Co-operative Society members who are beedi rollers, weavers, and fishermen by profession are eligible.

  5. You must not be a resident of Karnataka Cities and Corporations' rural areas.

  6. There is no upper age limit to being a beneficiary.

  7. Family members of people registered under the above-mentioned Co-operative Societies are eligible.

  8. One member of the family must spend at least 3 months as a member of the mentioned Co-operative Societies so that the family becomes eligible for the Yeshasvini Health Insurance Scheme.

Note that one family can include the primary insured person, spouse, parents, children, and nieces and nephews of the insured member.

Who is not eligible for the Yeshasvini Health Insurance Scheme?

Here is a list of people who are not eligible to register for the Yeshasvini Health Insurance Scheme.

  • Married daughters who are not members of the specified Co-operative Societies and live outside the jurisdiction of this health scheme are not eligible for this benefit.

  • Members of Employees’ Co-operative Society are not eligible.

  • Members of liquidated or defunct Co-operative Society are not eligible.

  • Employees of the government sector or a private company that draws salary cannot apply.

Documents required for registration

The following documents are usually required to register for the Yeshasvini Health Insurance Scheme.

  1. Age proof

  2. Rural or urban co-operative societies ceritifcate

  3. Address Proof

  4. Caste certificate

How to register for Yeshasvini Health Insurance Scheme online

The process of registering for the Yeshasvini Health Insurance Scheme online is fairly simple. The registration process for 2022-23 began from 01 November 2022. You need to be ready with the softcopies of the necessary documents before visiting the portal. Then visit the official website of Yeshasvini Health Insurance Scheme and follow the registration process. 

How to claim Yeshasvini Health Scheme

Here is how to claim Yeshasvini Health Scheme.

  • The patient must go to one of the network hospitals.

  • If the patient is a Yeshasvini beneficiary, the Third Party Administrator (TPA) of this hospital will confirm that the necessary treatment/surgery is covered by the scheme. Once confirmed, the patient must go through medical testing.

  • The network hospital will share a pre-authorisation request with supporting papers to the Management Services Provider (MSP) online based on the initial diagnosis. After that, the MSP will confirm the request that the hospital shared. The request should get approved within a day.

  • The doctors at the network hospital can start the treatment after it has been approved. The MSP will then pay the hospital after verification.

How to get a Yeshasvini Health card

You can get the Yeshasvini Health Insurance Scheme card in the following manner.

  • Any Co-operative Societies can register new members for the scheme and renew existing members. Here they issue a receipt and deposit the premium in a nearby Co-operative bank. The Co-operative Society also provides a UHID (Unique Health Identification) enrollment form.

  • Each enrollment form provides information about the primary member and his or her family members, including the primary member's name, age, relation, society membership number, enrollment date, and photo. 

  • Once all the information is processed, the society will issue the Yeshasvini Health Card.

Contact address

The following are the contact addresses for the Yeshasvini Health Insurance Scheme.

Head office

Office of Registrar Of Co-operative Societies

#1, 

Ali Asker Road, 

Vasant Nagar,

Bangalore-560052

Contact number: 080 22269637/ 22251238

Regional office

Ashwathnarayan

Joint Registrar Of Co-operative Societies, Bengaluru Division

No 146, 8th Cross

3rd Main Road, Margosa Road,

Malleshwaram,

Bengaluru 560003

Contact number: 080-26612911

Email Address: [email protected]

Dr Umesh G

Joint Registrar Of Co-operative Societies, Mysore Division

Public offices building,

Opp Corporation Office, 

New Sayyaji Rao road , 

Mysore 570024.

Contact number: 0821-2520823

Email Address: [email protected]

Patil G M

Joint Registrar Of Co-operative Societies, Belgaum Division

No.5,

Udaya building S.P.M Road

Shahapur

Belgaum -590001

Contact number: 0831-2489760

Email Address: [email protected]

Kantharaju R J

Joint Registrar Of Co-operative Societies, Kalburgi Division Raichur

Venkateshwara Colony, 

House No,1-11-55/56, 

Lingasuguru Road, 

Raichur – 584101.

Contact number: 08532-221753

Email Address: [email protected]

Frequently asked questions

Here are some common questions about the Yeshasvini Health Insurance Scheme.

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Can a beneficiary of the Ayushman Bharat Yojana enrol under the Yeshasvini Health Insurance Scheme?

Yes, the beneficiary of the Ayushman Bharat Yojana can enrol under the Yeshasvini Health Insurance Scheme. However, they will be allowed to claim under any one of these schemes. Multiple claims for one medical event are not permissible. 

What does the word “Yeshaswini/Yashaswini” mean?

The word “Yashaswini” refers to being successful.

When was the Yeshasvini Health Insurance Scheme introduced?

Initially, the Yeshasvini Health Insurance Scheme was launched in 2003 and discontinued in 2018. However, the scheme was relaunched in 2022 to give rural families access to high-quality medical facilities.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet. Please consult a doctor before making any health-related decisions.

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