When Was the Yeshasvini Scheme Established?

Everything About Yeshasvini Scheme Establishment

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.

When Was the Yeshasvini Scheme Established?

Although it was initiated in 2002, the Yeshasvini scheme officially began in 2003. It focused on enhancing the availability of healthcare services for poor people and improving the economic situation across the state. It soon developed a wide network and became India's largest health micro-insurance program.

Since its launch, the scheme has enrolled around 2 million people, providing more surgical procedures, outpatient department (OPD) services, a help desk for policyholders, and a number of other benefits.

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. 

How Does the Yeshasvini Scheme Work?

The Yeshasvini Scheme is a medical insurance program founded for members of cooperative societies across Karnataka, wherein financial assistance towards healthcare expenditure is offered.

On a community basis, members of the cooperative society contribute to the common fund and are governed by the Yeshasvini Cooperative Members Health Care Trust. The trust promotes cashless services for over 1,600 procedures at constituent hospitals.

Benefits of the Yeshasvini Scheme

The Yeshasvini Health Insurance scheme is a carefully drafted healthcare scheme that attempts to cater to the medical requirements of Karnataka's rural and cooperative sector population. It provides financial cover, quality medical care, and peace of mind for thousands of families. Listed below are the benefits of this scheme:

₹5 Lakh Annual Sum Insured

The scheme provides a maximum annual health coverage of ₹5 lakhs to a family. This large amount covers the expenses of surgeries, treatments, and hospitalizations for families, particularly those living below the poverty line.

Covers Medical and Surgical Procedures

Beneficiaries are eligible for treatment of over 1,650 medical conditions, including 823 vital surgical procedures. With such expansive coverage, the most prevalent and serious health conditions are taken care of smoothly.

Cashless Hospitalization at Network Hospitals

The scheme offers cashless, hassle-free treatment at empanelled hospitals. The patient only needs to submit their Yeshasvini membership card, and billing is directly settled between the insurer and the hospital.

Pre-Fixed, Discounted Charges for Treatment

The scheme offers treatments at fixed and discounted prices, making them much cheaper than normal hospital rates, particularly for high-cost surgeries.

Discounts for Diagnostic Tests and Lab Services

Along with treatments, beneficiaries also get discounts on diagnostic tests, which are otherwise excluded from general insurance schemes. This also cuts down on total medical costs.

Overall Hospital Charge Coverage

The scheme covers various medical costs such as surgery charges, cost of medicines, operation theatre charges, consultation charges, anaesthesia, nursing, and bed charges—providing almost complete financial coverage while being hospitalized.

Eligibility of Different Group Members

Any individual who has been a member of a Karnataka rural cooperative society for a minimum of three months is entitled to the same. Once a member, the benefits automatically cover all family members, even if they are not direct members of the society.

Affordable Premiums with Government Support

The premium amount is low, so it is affordable. Rural society members pay ₹500 for four family members, with ₹100 per additional member. Urban cooperative members pay ₹1,000 for four, with ₹200 for extra members. The government pays the premium completely for SC/ST families.

Support for SHGs and Other Groups

The scheme also encompasses members of Self-Help Groups (SHGs), Stree Shakti Groups, and cooperative societies of fishermen, weavers, and Beedi workers—provided they are connected to a cooperative society or bank. 

Who is Eligible for the Yeshasvini Scheme?

Mentioned below are the eligibility criteria for the Yeshasvini Scheme: 

• There is no age limit to enrol.
• Members enrolled in self-help groups organized by District Central Cooperative Banks or Primary Agricultural Cooperative Societies are also eligible to apply.
• Members of Cooperative Societies registered under the Karnataka Cooperative Societies Act, 1957, the Karnataka Souharda Sahakari Act, 1997, or the Multi-State Cooperative Societies Act, 2002, are eligible.
• Members of Rural Cooperative Societies who are beedi workers, weavers, or fishermen by occupation are also eligible.
• Applicants should be residents of rural Karnataka and not city corporations.
• Three months minimum membership of a Cooperative Society as approved is the prerequisite for eligibility.

Who are Not Eligible for a Yeshasvini Card in Karnataka?

The Yeshaswini Health Insurance Scheme is meant for the support of certain groups of people, and some are disqualified on the basis of employment, income, and age, among others. Listed below are the types of people not covered:

• Married daughters residing outside the coverage area of the scheme.
• Members of employees' cooperative societies, as the scheme aims at other groups of cooperative members.
• Employees of the government or private sectors who are receiving a regular salary.
• People who are earning more than ₹30,000 per month.
• Individuals above 75 years, since there is an age limit for registration under the scheme.

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.

How to Claim a Yeshasvini Card?

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.

The Yeshasvini Scheme is not only an insurance scheme—it's a ray of hope for rural households. Merging affordability with accessibility has saved lives and protected livelihoods in Karnataka. Yeshasvini highlights how an effective insurance policy and a people-centred approach can make a real difference in people's lives.

Also Read:

→ How to Apply for a Yeshasvini Card

→ Who Are Not Eligible for a Yeshasvini Card in Karnataka

→ How to Claim a Yeshasvini Card

→ What is the Yeshasvini Scheme