Arogya Karnataka: Features, Eligibility & Coverage

Quick Overview

Ayushman Bharat Arogya Karnataka (AB-ArK) is Karnataka's government-backed health insurance scheme that offers eligible families cashless hospitalization coverage. For below-poverty-line (BPL) households, the coverage goes up to ₹5 lakh per family per year at empaneled hospitals. Families above the poverty line (APL) can also enroll on a copayment basis. The scheme is managed by the Suvarna Arogya Suraksha Trust (SAST).

The Arogya Karnataka scheme was launched by the Government of Karnataka on March 2, 2018, to provide universal health coverage to every resident of the state. When Ayushman Bharat (PM-JAY) was launched nationally later that year, both schemes were merged into a single integrated program. It's been running as Ayushman Bharat Arogya Karnataka (AB-ArK) since October 30, 2018.

Before AB-ArK, Karnataka residents had to navigate multiple schemes, such as Vajpayee Arogyashree, Yeshaswini, Rashtriya Swasthya Bima Yojana (RSBY), Rajiv Arogya Bhagya, and others. Arogya Karnataka combined all of them into a single scheme.

In this guide, we break down everything about Arogya Karnataka: coverage, eligibility, how to apply, and whether it can replace personal health insurance.

Key Features of Arogya Karnataka

Coverage

BPL families (eligible households under the National Food Security Act (NFSA), 2013) get a cashless cover of ₹5 lakh per family per year at no cost. APL or general patients are eligible for coverage up to 30% of the government package, capped at ₹1.5 lakhs per family per year.

Treatment Scope

AB-ArK covers simple and complex secondary, tertiary, and emergency procedures. The scheme supports over 1,650 medical procedures across specialties like cardiology, oncology, neurosurgery, orthopedics, pediatrics, and general surgery.

Cashless Treatment

Treatment is completely cashless at empaneled hospitals. The AB-ArK card (issued for ₹10 in A4 format or ₹35 as a plastic card) is your access pass.

No Waiting Period

The scheme does not impose a standard waiting period for pre-existing conditions. Coverage starts from day one of enrollment.

Inclusions and Exclusions of Arogya Karnataka

Inclusions	Exclusions
Inpatient hospitalization, including emergency procedures	Outpatient Department (OPD) consultations
Pre-hospitalization costs (up to 3 days before admission)	Cosmetic procedures not related to a medical condition
Post-hospitalization costs (up to 15 days after discharge)	Dental treatments (except oral surgery, included in packages)
Surgeries across 25+ specialties and ambulance coverage	Maternity expenses and fertility treatments like In Vitro Fertilization (IVF)
Diagnostics, medicines, and doctor fees during admission	Non-medical expenses like gloves, masks, syringes, and PPE kits

CTA

Eligibility and Application Process for Arogya Karnataka

Eligibility Criteria

There are two categories of beneficiaries for this scheme:

Eligible Patients (Free Coverage): Applicant must be a Karnataka resident and belong to an eligible household as defined under NFSA, 2013. This broadly covers BPL families and RSBY-enrolled households.
General Patients (APL): The beneficiaries must be Karnataka residents who do not fall under the NFSA eligible household definition.

Did You Know?

Residents who already have healthcare coverage through another source cannot enroll in AB-ArK. This includes those covered under Employees' State Insurance (ESI), Central Government Health Scheme (CGHS), an employer health scheme, or a private health insurance policy. Karnataka government employees and members of the Karnataka Legislature are also excluded until the relevant service rules are amended.

How to Apply

Step 1: Visit the nearest Primary Health Institute (PHI), Bangalore One (B1) or Karnataka One (K1) center, or a citizen service center.

Step 2: Provide your Aadhaar card, and a biometric verification is done on-site. If biometrics fail, OTP-based or QR code-based verification is available.

Step 3: E-KYC details are auto-populated from the Aadhaar system.

Step 4: Your AB-ArK card is issued on the spot.

Note: There is no separate online application portal for individual enrollment. It happens at designated centers.

Documents Required

Aadhaar card
Ration card or NFSA document (for BPL/eligible household category)
Proof of Karnataka residence, if not present on Aadhaar
RSBY enrollment details (if applicable)

Contact Directory

Contact Type	Details
Official Website	arogya.karnataka.gov.in
SAST Website	https://sast.karnataka.gov.in/sast/english/
National Helpline	1800 425 8330
Address	Department of Health & Family Welfare Services, Arogya Soudha, Madagi Road,Bengaluru, Karnataka (560023)

How to Find Network Hospitals

You can search for empaneled hospitals on the official SAST portal or directly at hospitals.pmjay.gov.in.

Filter by state (Karnataka), district, hospital type, and specialty to find options near you. Well-known empaneled hospitals in Bengaluru include Victoria Hospital, NIMHANS, Manipal Hospitals, and district-level government hospitals.

Benefits and Limitations of Arogya Karnataka

Benefits

Brings multiple government health benefits under one scheme.
Reduces out-of-pocket hospitalization costs for vulnerable groups.
Improves access to treatment through a large empaneled hospital network.
Makes enrollment and identification easier through Aadhaar-linked verification.

Limitations

You can't choose your hospital freely.
The fixed package rates may not match the actual cost of advanced treatment.
The APL cap of ₹1.5 lakh is low for critical illnesses such as cancer or cardiac surgery.
No coverage outside of Karnataka.

Arogya Karnataka vs Private Insurance: Is It Enough on Its Own?

AB-ArK covers the basic needs. For BPL families, it provides financial protection during emergencies by reducing upfront hospitalization costs. But if you're a working professional, a salaried employee, or someone whose family needs flexibility, the scheme is not sufficient.

A retail health insurance plan offers comprehensive coverage. It lets you choose your hospital and room type, set your own sum insured, add top-ups, and reduce out-of-pocket expenses.

Take a look at the infographic for a clearer understanding of the differences between private insurers and government schemes:

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Ditto’s Take on Arogya Karnataka

The Arogya Karnataka scheme is a safety net for Karnataka residents, especially for BPL families who now have access to cashless hospitalization without any upfront cost.

However, AB-ArK is designed to protect the most vulnerable, not to replace the flexible coverage that a personal health insurance policy offers. A personal health plan builds coverage that isn't tied to state budgets or empanelment decisions.

If you are looking for a health plan from insurers with established track records, we recommend the best health insurance plans.

Frequently Asked Questions

Is there a family size limit for coverage under AB-ArK?

No. The scheme covers the entire family under a single ₹5 lakh annual limit for BPL households, with no cap on the number of family members. However, the ₹5 lakh is shared across all members in a policy year.

Does AB-ArK cover newborns automatically?

Newborns are not automatically enrolled. You need to visit a designated center and complete Aadhaar-based enrollment for the child separately to add them to the family's coverage under the scheme.

Can I use the AB-ArK card outside Karnataka in an emergency?

No. AB-ArK is valid only at empaneled hospitals within Karnataka. If you're hospitalized outside the state, even in an emergency, the scheme does not cover the costs.

Are follow-up consultations after discharge covered?

Post-hospitalization costs are covered for up to 15 days after discharge, but only for expenses directly related to the treated condition. Routine follow-up consultations at OPD beyond this window are not covered.

What is the difference between Ayushman Bharat and Arogya Karnataka?

Ayushman Bharat (PM-JAY) is a central government scheme that covers BPL families across India, providing up to ₹5 lakh per year. Arogya Karnataka is Karnataka's own state scheme, with the same coverage goal but extended to APL families as well.

Last updated on: 11 Apr, 2026