SAHAKARA SINDHU
Department Of Cooperation, Government of Karnataka

 

YESHASVINI

1. What is Yeshasvini Scheme?

    Yeshasvini Scheme is a prestigious scheme implemented by Department of Co-operation which aims at providing medical facility to rural cooperators.

2. Who can become the beneficiary under Yeshasvini Scheme?

    To avail the benefit of Yeshasvini Scheme, a person should be a member of rural cooperative society of the state for a minimum period of 6 months before commencement of treatment under Yeshasvini i.e., at least 6 months before 1st of June every year.

3. What is the amount to be paid by the beneficiary?

    The beneficiary has to pay Rs 210.00 p.a. to become member. This amount may be revised from time to time.

4. Whether it is necessary for all the members of the family to become members of cooperative society?

    No, only the member has to be the member of cooperative society. Other members can avail the benefit under the scheme by making payment of the contribution separately.

5. When does the enrollment commence every year?

    The enrollment commences from January/February and closes by August.

6. Who can become the member under Yeshasvini scheme?

    Apart from the members of the rural cooperative societies, members of self help group/Sthree Shakthi Groups who have financial transactions with cooperative societies/co-operative bank, members of the fisherman co-operatives, Beedi workers co-operatives and weavers co-operatives are also eligible to become the members.

7. What is the age limit fixed?

    The higher age limit fixed is 75 years. i.e., from new born to 75 years.

8. What is the identification for members?

    Upto 2007-08 photo identity cards were issued and those without ID cards accessed services based on letter from District Registrar of Co-operatives. From 2008-09 onwards unique health identification enrollment form is given. It is pre defined number using bar code reader.

9. How many type of surgeries are covered under this scheme?

    805 types of surgical procedures identified by the Yeshasvini Trust are covered.

10. What facilities are given to beneficiaries under the scheme?

    (a) During surgeries, the beneficiaries are given cost of medicines, consumables during hospital stay, cost of Operation Theater, Anesthesia, surgeons          fee, professional charge, consultation fee, nursing fee, general ward bed charges etc. The surgery package rates for each of the surgery is fixed under          the scheme.
    (b) Free out patient consultation.
    (c) Discounted tariffs for lab investigations and tests.

11. What is not covered under Yeshasvini Scheme?

    Yeshasvini scheme does not cover medical and follow up treatment, implants, prosthesis, joint replacement surgeries, kidney and heart transplants, chemo-therapy, cosmetic surgery, burnt cases, dental surgeries, road traffic accidents, medico legal cases, diagnostic investigations, auto immune diseases, skin grafting, dialysis, artificial limb, deviated nasal septum, screws and stunt etc for orthopedic and urological surgeries.

12. What are the special benefits included under Yeshasvini Scheme?

    Medical emergencies such as dog bite, snake bite, drowning and accidents occurred while operating agricultural implements, bull gore injuries, electric shocks, normal delivery, neo natal care and angioplasty procedure.

13. What is the maximum amount reimbursed?

    It is Rs 1.00 lakh in case of single surgery and Rs 2.00 lakhs in case of multiple surgery.

14. Is it an insurance scheme?

    No, it is a self fund scheme where the beneficiary contributes a specified amount every year. The government also contributes to the scheme every year.

15. Who is the supporting department in government?

    The Department of Co-operation is the supporting department.

16. Which hospital can give the treatment?

    Only Network hospitals recognized by the Yeshasvini trust can impart treatment to the beneficiaries.

17. How many hospitals are recognized in Karnataka?

     Nearly 492 hospitals are recognized as of now.

18. Who is third party agency?

    The third party agency assists in effective implementation of the scheme. At present the TPA is Medi assist India Pvt. Ltd.

19. What is the procedure for getting the treatment?

    The beneficiaries holding unique identification number should approach the Yeshasvini network hospital. The hospital checks whether the applicant is Yeshasvini beneficiary and whether the surgery is covered under Yeshasvini scheme. Later, preauthorization is sought from TPA through internet. The TPA gives pre authorization and then the hospital conducts surgery.

20. How the bills of the hospital settled?

    The hospital forwards bills to the TPA (Third Party Agency). The bills are scrutinised and sent to Yeshasvini Trust. Yeshasvini trust passes the bills and after approval in specified sub committee meetings, the payment is made to TPA. TPA inturn makes payment to the hospital.

21. What is the official website of yeshasvini scheme?

     www.yeshasvini.org

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