How to Claim a Yeshasvini Card?

Get the Most from Your Yeshasvini Card – Apply and Claim Easily

Introduced by the Government of Karnataka in 2003, the Yeshasvini Health Insurance scheme aims to make healthcare affordable for farmers and cooperative society members. It provides financial support for surgeries, hospitalizations, and other treatment procedures in empanelled hospitals.

The Yeshasvini card offers medical insurance coverage and various surgical procedures coverage at reasonable premiums and good-quality healthcare. If you are not sure how to obtain one or how to claim its advantages, don't worry. We have explained each step in detail so you can concentrate on your health.

Steps to Enroll in the Yeshasvini Scheme to Obtain the Health Card

Getting a Yeshasvini health card is a simple process that allows you to enjoy the benefits of the Yeshasvini Health Insurance scheme. This card gives you access to quality and affordable healthcare services at reputed network hospitals. Here's how to get it:

● Step 1: Membership Requirement: You must be a member of a cooperative society recognized under the Souharda Sahakari Act, Karnataka Cooperative Societies Act, or Multi-State Cooperative Societies Act. You should have been a member for at least three months prior to applying for the card.

● Step 2: Enrollment Through Cooperative Societies: Visit your local cooperative society or self-help group (SHG) branch where you are registered. Get the Unique Health Identification (UHID) enrollment form, which has spaces for the primary applicant and family members.

● Step 3: Submit Required Documents: Make sure you submit these documents: an aadhaar card, proof of the cooperative society, a ration card to confirm family information and two passport photographs of every member to be enrolled. Provide a caste certificate if applicable.

● Step 4: Premium Payment Yearly: Rural cooperative members must pay ₹500 for a family size of up to four and ₹100 for every additional member. Urban cooperative members must pay ₹1,000 for a family of four and an additional ₹200 per additional member.

● Step 5: Issuance of Cards: Once you pay the premium and submit the documents, the cooperative society will start the enrollment process. When verified, you will be provided with your Yeshasvini health card, which will include your UHID, name, and the details of your family members.

Do not forget to renew your card annually by paying the premium in order to continue enjoying the scheme's benefits.

Steps to Claim the Benefits Under the Yeshasvini Health Insurance Scheme

Here's a step-by-step guide on how to avail benefits under the Yeshasvini Health Insurance Scheme:

● Step 1: Go to a Network Hospital: Start by visiting a hospital included in the Yeshasvini network.

● Step 2: TPA Verification: At the hospital, the Third-Party Administrator (TPA) will verify your beneficiary status under Yeshasvini and verify if your needed treatment or operation is covered by the scheme. On verification, you may proceed with the required medical tests.

● Step 3: Request for Pre-Authorization: After the initial check-up, the network hospital will initiate a request for pre-authorization along with the documents in e-format to the Management Services Provider (MSP) online.

● Step 4: Approval Process: The MSP will review and authorize the hospital's request, usually within a day.

● Step 5: Treatment and Payment: Once approved, the medical staff can proceed with your treatment at the network hospital. After the treatment is finished, the MSP will verify and pay the hospital.

What Coverage Can You Claim Under the Yeshasvini Scheme?

The Yeshasvini Scheme provides comprehensive coverage, which the enrolled beneficiaries can use to avail themselves of all types of medical treatments, acting as a supporting pillar for rural families. Here's what they can look forward to:

● In-patient Hospitalization: This involves coverage of surgeries, fees for ICU, and costs incurred prior to and subsequent to hospitalization.

● Emergency Care: The plan offers instant care for emergency cases such as snake bites, dog bites, and drowning.

● Specialized Surgeries: Members can avail themselves of procedures in fields like cardiology, vascular health, orthopaedics, oncology, and paediatrics in the network hospitals.

● General Ward Access: Members are hospitalized in general wards and have the choice of shifting to private rooms at an extra cost.

● Obstetrics and Gynecology: Maternity services and newborn critical care are included in the coverage.

What are the Exclusions Under Yeshasvini Scheme Claims?

The claims under the Yeshasvini Health Insurance Scheme will not be entertained for cosmetic or dental surgeries (except injury-related), dialysis, organ transplants, accident-related treatments, or any pre-existing conditions diagnosed prior to joining the scheme. These exclusions should be indicated prior to taking claim benefits under the scheme.

The Yeshasvini card is not only a card but also acts as a lifesaver for many rural families in Karnataka. By knowing how to redeem it and utilize it prudently, you can get adequate financial support and peace of mind in the event of a medical emergency.