What is the Yeshasvini Scheme?

Yeshasvini Health Insurance Scheme: Benefits and Eligibility Guide

Yeshasvini Health Insurance Scheme, one of India's first community-based health programs, was designed to empower rural farmers and cooperative members in Karnataka. It is not merely a health card—it's a passport to dignity, care, and security for thousands of poor families.

Introduced in 2003, the scheme covers costs for various procedures at several medical facilities, such as treatment for animal bites and farm accidents. It is intended to provide healthcare support to weavers, farmers, fishermen, self-help groups, and Stree Shakti groups of the state.  

Read ahead to learn more about this scheme's operation, features, eligibility criteria, and other details.

How the Yeshasvini Scheme Works?

The Yeshasvini scheme works on the principle of collecting contributions from members of cooperative societies, which are pooled together into a fund that is managed by the Yeshasvini Cooperative Members Health Care Trust.

The trust provides low-cost treatment for more than 1,650 medical procedures at its partner hospitals. Members do not have to pay anything at the time of accessing care at these hospitals; they simply have to produce their card, and the hospital will directly pay the fund. The scheme also covers around 30 districts in Karnataka.

Features of the Yeshasvini Scheme

The Yeshasvini Health Insurance Scheme offers various salient features for its members, including:

● Ample Coverage: Members of the Yeshasvini Health Insurance Scheme are covered under an annual amount of ₹5 lakhs. They may also avail of cashless benefits at any of the network hospitals.

● Wide Range of Disease Coverage: This health insurance scheme pays cashless claims for 1,650 unique medical ailments in earmarked network hospitals.

● Lower Diagnostic Test Charges: Although diagnostic test charges are not included in health insurance claims, the beneficiaries of the Yeshasvini Health Insurance Scheme can undergo these tests at lower costs.

● Lower Treatment Charges: One major advantage of this scheme is the pre-fixed rates for certain medical procedures, which are much lower than usual market prices.

● Cashless Claim Option: This scheme offers an option for cashless claims at network hospitals. This feature greatly reduces the economic burden on beneficiaries during medical emergencies because they are not required to pay any initial amounts for treatment.

● Family Member Coverage: The program also provides advantages to family members, allowing them to get coverage even if they are not members of a rural cooperative society. This way, the whole family gets medical coverage when needed.

Eligibility Criteria of the Yeshasvini Scheme

To be eligible for the Yeshasvini Health Insurance Scheme, individuals need to fulfil the following criteria:

● Age Requirement: Applicants should be between 18 and 60 years of age to apply for this scheme.

● Membership: Prospective applicants must be members of a rural cooperative society for at least six months before being accepted into the scheme.

● Residency: Applicants should be living away from the rural areas of Karnataka cities and corporations.

● Target Groups: Cooperative societies of self-help groups (SHGs), beedi workers, weavers, and fishermen are eligible for registration.

● Income Limitations: Those employed in the government or private sectors who earn more than ₹30,000 monthly are not eligible.

List of Treatments Covered Under Yeshasvini Health Insurance Scheme

The following surgery and treatment expenditures have been covered under the Yeshasvini health scheme:

● Cardiac Arrest

● General Surgery

● Pediatric Surgery

● Orthopaedic Surgery

● Neonatal Intensive Care Unit

● Surgical Oncology

● Cardiothoracic Surgery

● Obstetrics

● Gynecological Surgery

● Ophthalmic Surgery

● Drowning Incidents

● Vascular Surgery

● Genitourinary Surgery

● Snake Bites

● Normal Delivery

● Dog Bites

● Neurosurgery

● Accidents involving Agricultural Equipment

Exclusions Under the Yeshasvini Scheme

Some medical procedures excluded under the Yeshasvini Health Insurance Scheme are as follows:

● Heart Transplant

● Diagnostic investigations

● Burns

● Cosmetic surgery

● Regular follow-up treatment and medico-legal Cases

● Nasal Septum

● Dental Surgery

● Skin treatment or grafting

● Kidney Transplant

● Autoimmune diseases

● Inpatient medical treatment

● Chemotherapy

● Joint replacement surgery

● Implants, prosthesis

● Dialysis

Documents Required to Register for the Yeshasvini Scheme

Mentioned below are the documents required to register under the Yeshasvini Health Insurance Scheme:

● Age Proof: You must produce a document of age, like an Aadhaar card or a birth certificate, to confirm that you are between 18 and 60 years old.

● Proof of Address: You must provide an official identification document proving your address to help them accurately assign your coverage.

● Certificate of Rural or Urban Cooperative Societies: A certificate from the cooperative society where you reside and work in Karnataka is required to become eligible.

● Caste Certificate: By providing a caste certificate, you let them know about any special discounts or benefits you might be entitled to due to your community status.

The Yeshasvini scheme facilitates beneficiaries' receiving cashless surgical care at negotiated prices across a chain of hospitals, extending the reach of quality healthcare to all. With its robust cooperative base and rural focus, it is an important step towards inclusive and equitable health coverage in India.