What is the Yeshasvini Health Scheme?

Access to affordable healthcare remains a significant challenge for many rural and semi-urban residents in Karnataka, particularly for farmers, artisans, and members of self-help groups. The Yeshasvini Health Scheme, 2025, bridges this gap by offering low-cost, cashless medical care. 

Reintroduced by the Government of Karnataka’s Department of Co-operation, the scheme ensures cooperative members can receive essential surgeries and treatments at subsidized rates across a wide network of empaneled hospitals.

This guide will take you through everything you need to know, the scheme's features, eligibility, inclusions, exclusions, enrollment steps, and claim process. Let's dive in.

Quick Overview

Administered by the Yeshasvini Cooperative Members Health Care Trust, the scheme’s goal is simple: to reduce medical expenses for Karnataka’s cooperative community without compromising on quality care.

Take a quick look at the key highlights of the scheme:

• Operated by: Department of Co-operation, Govt. of Karnataka
• Managed by: Yeshasvini Cooperative Members Health Care Trust, Bengaluru
• Scheme Period: April 1 – March 31 every year
• Third-Party Administrator (TPA): FHPL — Family Health Plan Insurance TPA Ltd.

What are the key features of Yeshasvini Health Insurance Scheme ?

The Yeshasvini Cooperative Members Health Care Trust, which manages the Yeshasvini Health plan, aims to make healthcare affordable for members of its cooperative societies and their families across Karnataka. It offers comprehensive medical protection at minimal cost. Here are the key features of the scheme:

1) Wide Coverage: Over 2,191 procedures including over 1,650 medical and surgical procedures across specialties like cardiology, neurology, orthopedics, ENT, gynecology, and oncology.

2) Cashless Facility: Members can access treatment without upfront payment at empaneled hospitals using a unique health card.

3) Sum Insured: There is no sum insured; each treatment is reimbursed strictly as per approved package rates with Rs. 5 lakhs maximum limit/year/family.

4) Extensive Family Coverage: Protects the principal member, spouse, dependent children, parents, unmarried daughters, daughters-in-law, and grandchildren.

5) No Age Bar: Open to individuals of all ages.

6) Affordable Premium: The scheme requires a minimal annual contribution from its beneficiaries. Here is an overview of the subscription amounts:

7) Additional Benefits:  25% discount on diagnostics and OPD Benefits Consultation ₹200 (₹100 by beneficiary, ₹100 reimbursed)

8) Scheme Duration: Runs annually from August 1 to July 31.

9) Expanded Coverage:The Scheme now covers 2,191 medical procedures, up from around 1,650 earlier, with upgraded treatment rates. In a recent year, it supported over 68,000 beneficiaries, funding treatments worth ₹117.79 crore at an average cost of just ₹17,000 per case.

10) Revised Rates for Advanced Treatments: An expert committee has proposed increasing rates by up to 50% for complex medical procedures under the scheme, ensuring fairer compensation for hospitals and better access to advanced care for beneficiaries.

What is the Eligibility Criteria for the Yeshasvini Health Scheme?

The Yeshasvini Health Scheme offers coverage to its members with simple eligibility conditions:

1. Membership: Must be part of a rural/urban cooperative society or a self-help group linked to a cooperative (with an account) for at least 3 months.
2. Family Coverage: Includes spouse, parents, sons, unmarried daughters, daughters-in-law, and grandchildren.
3. Special Groups: Cooperative fishermen, beedi workers, and weavers are also eligible for this program.
4. Married Daughters: Covered only if they live with parents or brothers due to widowhood, divorce, or separation, and pay the subscription. Those living separately are not eligible.
5. Newborn child: Is eligible for the scheme's benefits using the mother's card for a period of 30 days from the date of their birth.

What are the Inclusions and Exclusions of the Yeshasvini Health Scheme? 

Let’s take a quick look at what is included and what is not under this scheme:

Click here to view the guidelines for Network Hospitals recognized under the Yeshasvini Scheme.

How to Register for the Yeshasvini Health Insurance Online?

Joining the Yeshasvini Health Scheme is straightforward and occurs through cooperative societies. Here’s how you can enroll:

1. Check Enrollment Window: Registration usually opens once a year ( Usually open November to March every year). Please confirm the dates with your cooperative society.
2. Visit Your Cooperative Society or Bank: Go to your local cooperative society or affiliated cooperative bank where you are a member. Please collect and complete the enrollment form.
3. Submit Documents: Provide proof of identity , proof of address, cooperative membership certificate, family details, photographs, and caste certificate( for subsidy) .
4. Pay the Premium: Pay the required annual subscription as per rural or urban member rates.
5. Get Your Health Card: The society submits your details to the central system. A Yeshasvini Health Card or Unique Health ID (UHID) will be issued for you and your family.

Activation Period: In most cases, the card becomes active after a short waiting period (around 15 days) before you can start using it for hospital treatment.

What is the Claim Process of the Yeshasvini Health Scheme?

The Yeshasvini scheme allows cashless and straightforward claims if you follow the proper steps. Here’s what to do:

1. Choose a Network Hospital: Visit a hospital that is listed under Yeshasvini (check the official website or ask your cooperative society).
2. Show Your Card: Present your Yeshasvini Health Card or UHID at the hospital for verification. The coordinator will verify your membership, coverage, and validity.
3. Get Pre-Authorization via FHPL: For surgeries or major procedures, the hospital sends reports and doctor recommendations to the scheme’s approval unit.
4. Cashless Treatment: Once approved, you get treatment without paying upfront (except for excluded or extra costs).
5. Post-Discharge Process: After discharge, the hospital submits bills, reports, and summaries to the Yeshasvini Trust for settlement.
6. Claim Settlement: The scheme directly settles the approved amount with the hospital, without any  reimbursement paperwork for the patient.

Note: All claims must be submitted within 10 days of the patient's discharge. Any expenses beyond the package or excluded under the policy must be paid by the patient. The Trust settles the approved claim amount directly with the hospital within 45 days of receiving the claim.

Here’s a snippet of the check list of documents required to file a claim:

Ditto’s Take on the Yeshasvini Health scheme

The Yeshasvini Health Scheme is a great initiative by the Karnataka Government for those who may not be able to afford comprehensive health insurance. It provides a basic safety net, ensuring access to essential healthcare at a minimal cost.

However, if you prefer flexibility in choosing network hospitals, doctors, and treatment options, or want faster, priority-based care, relying solely on government schemes may not serve the purpose. Such programs are often subject to policy changes and revisions. 

If your budget allows, having a comprehensive personal health insurance plan alongside such schemes ensures more freedom, better coverage, and long-term financial security for your healthcare needs.

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Final Thoughts

Here’s what you should remember about the Yeshasvini Health Scheme:

1. The scheme is a self-funded health plan, not an insurance plan for farmers, informal workers, and cooperative members.
   Click here to check the package based details offered by the scheme.
2. Covers 1,650+ surgeries and procedures in network hospitals with cashless treatment.
3. Low annual premium, made affordable through subsidies and cooperative support.
4. Enrollment is open annually and requires a minimum of three months of cooperative membership.
5. While it offers wide access and affordability, it also has exclusions and package limits.
6. Always check the latest official list of procedures and rules before enrolling.

Still unsure how to go about purchasing a personal health plan? Book a call with us, and let our experts guide you through the process.

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