Karnataka Yeshasvini Scheme

Scheme Introduction: A Brief Overview

Medical emergencies and major surgeries can create a significant financial burden for families, especially for those living in rural areas or working in the cooperative sector. Recognizing the need for affordable healthcare, the Government of Karnataka revived the Yeshasvini Cooperative Members Health Care Scheme to provide quality medical treatment to cooperative members and their families at a minimal annual contribution.

Administered by the Yeshasvini Co-operative Members Health Care Trust, the scheme offers cashless healthcare coverage of up to ₹5 lakh per family per year through a wide network of empaneled hospitals across Karnataka. The scheme is open to members of rural and urban cooperative societies, self-help groups (SHGs), fishermen, weavers, beedi workers, and other eligible cooperative members who have completed the prescribed membership period.

One of the key highlights of the scheme is its extensive medical coverage. Beneficiaries can avail cashless treatment for 2,128 medical procedures, including 1,650 treatment procedures and 478 ancillary procedures covering ICU, ICU with ventilator support, and HDU services. Treatment is available across multiple specialties such as general surgery, cardiology, orthopaedics, neurosurgery, urology, oncology, ENT, ophthalmology, obstetrics and gynaecology, and many others.

To make healthcare accessible and affordable, the annual contribution has been kept at just ₹500 for rural cooperative members and ₹1,000 for urban cooperative members. After enrollment, beneficiaries receive a Plastic Membership Card with Unique Identification Number and QR Code which enables them to access cashless treatment at network hospitals across the state.

The Yeshasvini Scheme is one of several initiatives aimed at improving healthcare access in Karnataka. Beneficiaries may also find useful information about the Karnataka Dr Puneeth Rajkumar Hrudaya Jyothi Scheme, which provides emergency cardiac care, the Arogya Sanjeevini Scheme for health insurance coverage, the KSRTC Arogya Scheme for eligible transport employees, and the Ambedkar Karmika Sahaya Hastha Scheme for worker assistance and financial support.

Scheme Benefits

• Cashless hospitalization at empaneled network hospitals.
• Access to specialist and super-specialist medical care.
• Coverage for more than 2,128 medical and surgical procedures.
• No age restriction for beneficiaries.
• Treatment available throughout Karnataka through network hospitals.
• Discounted diagnostic services.
• Affordable outpatient consultation services.
• Coverage for surgeries, hospitalization, investigations, medicines, and related treatment expenses.
• OPD Consultation Benefits

Coverage Under the Scheme

The scheme provides health coverage of up to ₹5 lakh per family per year for eligible treatments.

Beneficiaries can receive cashless treatment for:

• Major surgeries
• Specialized medical procedures
• Hospitalization expenses
• Intensive care services
• Diagnostic investigations included in package rates
• Surgical implants and consumables as per approved package conditions

Eligibility Requirements

• He or she is a member of a registered cooperative society in Karnataka.
• He or she is a member of a cooperative self-help group.
• The member has completed the prescribed membership period.
• Eligible family members and dependents are covered under the scheme.
• There is no minimum or maximum age limit.
• Benefits are available from birth throughout the beneficiary's lifetime.

Definition of Family

For the purpose of the scheme, a family may include:

• Principal Applicant
• Father
• Mother
• Husband or Wife
• Sons
• Unmarried Daughters
• Daughters-in-law
• Grandchildren

Eligible family members can avail benefits under the same membership subject to scheme guidelines.

Membership Contribution

The annual membership contribution under the scheme is:

• Rural Cooperative Members
• ₹500 per year.
• Coverage for the primary member and eligible family members (up to four members per family).
• Urban Cooperative Members
• ₹1,000 per year.

The contribution amount is collected through the concerned cooperative society during the enrollment period.

Membership Card

Every enrolled beneficiary family receives a plastic Yeshasvini membership card.

Features of the Card

• Unique Identification Number
• Beneficiary Details
• Family Information
• Used for Hospital Verification
• Required for Cashless Treatment
• Accepted Across Empaneled Network Hospitals

The card serves as proof of enrollment and must be produced while seeking treatment.

Medical Procedures Covered

The Yeshasvini Scheme covers a total of 2,128 procedures, including:

• Basic Medical and Surgical Procedures
• 1,650 treatment procedures.
• Critical Care Procedure
• 478 ancillary procedures including:
  • ICU Care
  • ICU with Ventilator Support
  • High Dependency Unit (HDU) Services

Major Specialties Covered

Treatment is available under multiple specialties such as:

• General Surgery
• Orthopaedics
• Cardiology
• Cardiothoracic Surgery
• Neurology
• Neurosurgery
• Urology
• Nephrology
• Oncology
• Plastic Surgery
• Obstetrics and Gynaecology
• ENT
• Ophthalmology
• Dental Surgery
• Burns Management
• Gastroenterology
• Pediatric Surgery

What Is Covered in the Package?

The approved package generally includes:

• Registration Charges
• Admission Charges
• Bed Charges
• Nursing Charges
• Operation Theatre Charges
• Procedure Charges
• ICU Charges
• Anaesthesia Charges
• Medicines During Hospitalization
• Surgical Consumables
• Professional Fees of Doctors
• Routine Investigations
• In-patient Consultations

Beneficiaries are not required to pay additional charges for covered treatments included in the approved package.

Required Documents

Applicants may be required to submit the following documents:

• Passport-size photographs of the applicant and family members.
• Identity proof.
• Cooperative society membership details.
• Family member details.
• Membership contribution payment receipt.
• Any other documents required by the concerned cooperative society or enrolling authority.

Note: Enrollment under the Yeshasvini Scheme is generally carried out through eligible cooperative societies and organizations rather than through direct individual registration with the Yeshasvini Trust.

Steps to Apply

• Step 1: Become a member of an eligible Cooperative Society, Self-Help Group (SHG), Fishermen's Cooperative, Weavers' Cooperative, Beedi Workers' Cooperative, or any other eligible organization.
• Step 2: Complete the minimum membership period of three months as required under the scheme.
• Step 3: Obtain the Yeshasvini membership registration form from the concerned cooperative society or organization.
• Step 4: Fill in the application form with details of the applicant and eligible family members.
• Step 5: Attach the required documents and submit the prescribed annual contribution.
• Step 6: The cooperative society verifies the details and forwards the application to the concerned authorities.
• Step 7: After successful registration, a plastic Yeshasvini Membership Card with a unique identification number is issued to the beneficiary family.
• Step 8: Use the membership card to avail cashless treatment at empaneled Yeshasvini Network Hospitals across Karnataka.

Diagnostic Test Benefits

• Hospitals provide diagnostic investigations at discounted rates.
• Beneficiaries are entitled to receive at least a 25% discount on diagnostic tests that are not included in the approved package.

Ward Eligibility

Under the scheme:

• Beneficiaries are entitled to General Ward admission.
• The package covers General Ward expenses.
• If a beneficiary voluntarily chooses a higher-category room, the additional amount must be paid by the beneficiary.
• Hospitals cannot force patients to opt for upgraded rooms.

How to Avail Treatment

• Step 1: Visit an empaneled Yeshasvini Network Hospital.
• Step 2: Present the Yeshasvini Membership Card and identity proof.
• Step 3: The hospital verifies eligibility and obtains electronic pre-authorization.
• Step 4: After approval, treatment is provided on a cashless basis.
• Step 5: The hospital submits the treatment claim to the scheme authorities.

Important Operational Guidelines

• Beneficiaries receive a plastic membership card with a unique ID and QR code.
• Family Health Plan Insurance TPA Ltd. (FHPL) serves as the scheme's Third-Party Administrator.
• Emergency admissions require pre-authorization submission within 48 hours.
• Hospitals should submit claims within 30 days of patient discharge.
• Approved claims are generally settled within 45 days after verification.

Relevant Links

• Official Website of Department of Yeshasvini Co-operation Members Health Care Trust
• Yeshasvini Scheme Details at the Website Page
• Hospital List under Yeshasvini Scheme
• Yeshasvini Scheme Member Registration Guidelines and Enrollment Form (2022–23)
• Network Hospital Agreement under the Yeshasvini Cooperative Members Health Care Scheme
• Yeshasvini Scheme Health Benefit Package and Procedure List (Effective from 25 January 2023)
• Additional Information and Membership Details of the Yeshasvini Scheme
• Protocol Guidelines for Empaneled Network Hospitals under the Yeshasvini Scheme

Contact Information

Yeshasvini Co-operative Members Health Care Trust

• Address: 70, 2nd Floor, K.M.C. Building, Basavanagudi, Bengaluru – 560004
• Helplie Number : 08026671616
• Yeshasvini District Co-ordinators details