Karnataka Sandhya Kiran Scheme: Pensioners To Get Cashless Healthcare Up To Rs 5 Lakh

The Karnataka Cabinet has approved the Sandhya Kiran cashless healthcare scheme for state government pensioners below 70 years, family pensioners and their eligible dependents. The scheme will initially cover around 4.93 lakh beneficiaries, including about 3.11 lakh state government pensioners below 70 years and their eligible dependents.

Cashless Treatment Benefit

Under the scheme, eligible families will get cashless treatment of up to Rs 5 lakh a year on a floater basis. The coverage will include secondary, tertiary and emergency healthcare at hospitals empanelled under the scheme. According to a PTI report, the scheme has been framed under the Ayushman Bharat-Arogya Karnataka (AB-ArK) regulations, with the benefit packages and revised package rates under AB-ArK applicable to Sandhya Kiran.

The scheme is contributory, meaning beneficiaries will have to pay a portion of their pension towards the healthcare cover. Service pensioners will contribute 1.25 per cent of their basic pension, while family pensioners will contribute 0.75 per cent of their basic family pension.

Sandhya Kiran Scheme Funding Details

The Karnataka government expects the scheme to generate around Rs 117 crore annually through beneficiary contributions, stated the PTIreport. The estimated annual treatment cost under the scheme is around Rs 81.75 crore.

Of the treatment cost, 70 per cent will be met through the beneficiary contribution, and the remaining 30 per cent will be funded by the state government. This translates into about Rs 57.22 crore from beneficiaries and Rs 24.53 crore from the state each year.

The government has also proposed an automatic revision mechanism for the contribution rate to maintain the scheme's financial balance. If corpus utilisation crosses 85 per cent, the contribution rate will increase by 0.05 percentage points, equivalent to five basis points.

Karnataka Sandhya Kiran Scheme: How It Will Work

The Suvarna Arogya Suraksha Trust will implement the scheme through the existing AB-ArK system. The implementation framework will cover beneficiary registration, contribution collection, hospital empanelment, cashless treatment and claims management.

The Rs 5 lakh annual cover will operate on a family floater basis, allowing eligible members of a beneficiary family to use the available coverage. Treatment will be provided at empanelled hospitals and will follow the applicable AB-ArK packages and rates.

The Cabinet approval sets the framework for the new healthcare scheme; registration and other operational tasks will be carried out via the AB-ArK system. The scheme is targeted at state government pensioners under 70 years of age, family pensioners and eligible dependents, as per the eligibility criteria.

FAQs

1. What is the Sandhya Kiran scheme in Karnataka?
   It is a cashless healthcare scheme offering eligible beneficiaries up to Rs 5 lakh a year for secondary, tertiary and emergency care.

2. Who is eligible for the Sandhya Kiran health scheme?
   State government pensioners below 70 years, family pensioners and their eligible dependents are covered.

3. How much does Sandhya Kiran health insurance cost?
   Service pensioners contribute 1.25 per cent of their basic pension, while family pensioners contribute 0.75 per cent of their basic family pension.

4. How much will Karnataka pensioners pay for Rs 5 lakh health cover?
   The amount depends on the basic pension. A service pensioner with a Rs 30,000 basic pension would pay Rs 375 a month, while a family pensioner with a Rs 30,000 basic family pension would pay Rs 225 a month.