Health insurance plans provide protection against high medical costs. They typically cover hospitalization expenses before and after hospitalization. The Government of Karnataka launched the Jyothi Sanjeevini Scheme to provide health insurance to state government employees. Under this, beneficiaries can get cashless treatment at empaneled hospitals.
Details of Jyothi Sanjeevini Scheme
The Jyothi Sanjeevini Scheme was introduced by the Karnataka government to provide health insurance to state employees and dependents. It is a comprehensive healthcare scheme where beneficiaries can avail cashless treatment at networked hospitals. It covers tertiary and emergency care for catastrophic illnesses needing hospitalization, surgery, etc. Treatment can be availed from empaneled super specialty hospitals.
The scheme includes tertiary and emergency treatment for 7 specialties - cardiology, oncology, genitourinary surgery, neurology, burns, polytrauma cases, neonatal and pediatric surgery. Beneficiaries don't need to register separately. They must update their details and dependents in the HRMS database under DPAR.
| Specialties Covered | Procedures Covered |
|---|---|
| Cardiology and CTVS | 10684 |
| Oncology | Radiation Oncology Procedures |
| Neurology | Neurology Procedures |
Beneficiary Identification
Beneficiaries are identified via the government insurance policy number matched with the HRMS database under DPAR. Suvarna Arogya Suraksha Trust can access the database of all government employees and dependents - spouse, parents (if income under Rs.6000), and dependent children.
Those already under another government scheme can't avail this.
Implementation Details
Jyothi Sanjeevini is implemented in assurance mode via Suvarna Arogya Suraksha Trust. All state employees and dependents benefit. Empaneled hospitals across Karnataka provide cashless treatment. Vajpayee Arogyashree empaneled hospitals are also covered here. Treatment exclusions are:
- Treatment outside Karnataka
- Treatment in non-empaneled hospitals
- Excluded procedures
Objective
The scheme aims to provide health insurance to Karnataka state employees. Cashless hospitalization is enabled through empaneled hospitals. This protects against financial burden of treatment. All tertiary and emergency treatments across 7 specialties are covered. The government ensures cashless facility to beneficiaries.
Benefits
Key benefits of the Jyothi Sanjeevini Scheme include:
- Cashless IPD treatment at empaneled hospitals
- Coverage of tertiary and emergency care
- Treatment for 7 specialties
- 10684 procedures covered
- No separate registration needed
- Financial protection for government employees
Eligibility Criteria
The eligibility criteria to avail Jyothi Sanjeevini Scheme is as follows:
- Permanent Karnataka state government employees
- Employee's spouse
- Dependent children
- Dependent parents with income under Rs.6000
Conclusion:
The Jyothi Sanjeevini Scheme launched by the Karnataka government aims to provide health insurance coverage to state employees and their dependents. It enables cashless treatment at empaneled hospitals for tertiary and emergency care. Key benefits include financial protection, cashless hospitalization, coverage of 10684 procedures under 7 specialties. Eligible beneficiaries include government employees, spouse, dependent children and parents.
FAQ:
Q1: What is Jyothi Sanjeevini Scheme?
A1: Jyothi Sanjeevini Scheme is a health insurance scheme launched by the Government of Karnataka to provide coverage to state government employees and their dependents.
Q2: Who are the eligible beneficiaries?
A2: Eligible beneficiaries include permanent Karnataka state government employees, their spouse, dependent children and parents with income under Rs.6000.
Q3: What treatments are covered?
A3: The scheme covers tertiary and emergency care for 7 specialties - cardiology, oncology, neurology, genitourinary surgery, burns, polytrauma and neonatal/pediatric surgery.
Q4: How can one avail benefits?
A4: Beneficiaries can avail cashless treatment at empaneled hospitals across Karnataka. No separate registration is needed.
Q5: What is the claim process?
A5: It is a cashless scheme so the claim is directly settled between the hospital and insurance provider. No reimbursement process for beneficiaries.
Q6: Are there any exclusions?
A6: Treatment outside Karnataka, non-empaneled hospitals and excluded procedures are not covered.
