What is the Jyothi Sanjeevini Scheme?

Jyothi Sanjeevini Scheme Details

State Government employees living in any part of Karnataka can get registered under Jyothi Sanjeevini, the State Government’s health insurance scheme formed under the aegis of the Arogya Suraksha Trust. It is a comprehensive health policy formulated for government employees and those dependent on them. This scheme allows them to get cashless treatment across an extensive network of hospitals in Karnataka, associated with the Jyothi Sanjeevini Scheme (JSS).

Beneficiaries can avail tertiary medical care and emergency services related to chronic illnesses that may involve hospital admission, surgery, and other advanced therapies upon enrollment in JSS.

Scheme Design

The Jyothi Sanjeevini Scheme is an assurance plan implemented by Suvarna Arogya Suraksha Trust for State Government employees and their dependents. It has a network of empanelled hospitals, where beneficiaries can avail the benefits of the scheme. The scheme offers the cashless facility to the beneficiaries except under the following instances:

(i) where the beneficiary opts for implants, prostheses, stents, etc., that are more expensive than the ones included in the scheme and

(ii) where the beneficiary chooses to stay in superior wards and not in the one to which they are entitled. During such a case, the beneficiary will bear the additional cost.

Features and Benefits of the Jyothi Sanjeevini Scheme

• JSS covers a total of 449 procedures under 7 medical specialties such as neurology, oncology, cardiology, burns, cases of poly-trauma (not including medico-legal ones) as well as genitourinary, neonatal, and paediatric surgical procedures.

• Healthcare services amounting to ₹1.5 Lakh per annum can be availed by the Jyothi Sanjeevini subscribers, including charges towards hospitalisation, doctor consultation, food, transport, complication management, medicines, and pre and post-operative medical care.

• A government employee has to manage 30% of the charges if treatment is carried out in the general ward of any of the facilities mentioned in the Jyothi Sanjeevini Scheme hospital list network. The government takes care of the remaining 70%.

• The government bears 50% of the charges in case of admission to super-specialty wards of the Jyothi Sanjeevini Scheme hospital list.

 Benefit Packages

The Jyothi Sanjeevini Scheme covers tertiary treatment and 7 broad specialties–cardio-vascular diseases, cancer, renal diseases, neurological diseases, burns, poly-trauma cases (excluding medico-legal cases), and neonatal cases. The plan also includes 1068 procedures pertaining to 7 specialties mentioned above. It includes consultation fees, procedure costs, diagnostics, food, medication, hospital charges, as well as post-hospitalisation services for up to 10. For procedures that require implants, stents, etc., the scheme has set an upper limit. If the beneficiary exceeds the limit, they will have to cover the excess amount.

Karnataka Jyothi Sanjeevini Yojana Objectives

The objective behind launching the Karnataka Jyoti Sanjeevini Yojana is to provide better medical facilities to the State Government employees and their families. Every beneficiary is given a JSS card which enables them to seek healthcare services from the nearest empanelled hospital. With the cashless system, the government ensures that no one misuses the benefits of the Jyothi Sanjeevini Yojana. The scheme covers all major diseases and illnesses to ascertain that beneficiaries can undergo treatment for every type of health condition.

Who is Eligible for the Jyothi Sanjeevini Scheme?

Any government employee and their family members qualify for registration in Jyothi Sanjeevini. However, they should not be enrolled in any other government health insurance scheme in India to be eligible for JSS benefits.

A declaration with details of the family members as well as valid certification is to be furnished at the time of enrolling in the scheme. As per the clauses mentioned under Rule 2(1) of the Government Servants (Medical Attendant) Rules, 1963 in Karnataka, the following dependants are eligible for enrollment:

• Wife or husband of the government employee

• Children, including step-children, if any, are dependent on the government servant

• Parents living with a government servant with a monthly income less than ₹6,000

How to Apply for Jyothi Sanjeevini

JSS beneficiaries are identified from the Karnataka Government Insurance Department (KGID) policy number that they hold. This is verified along with the HRMS database recorded at the Karnataka Government's Department of Personnel and Administrative Reforms. All you need to do is carry the KGID number and Aadhaar card at the hospital visit and get it verified by Arogyamitra. No registration is required as well as no cards are issued by the Suvarna Arogya Suraksha Trust.

How Does the Jyothi Sanjeevini Scheme Function?

The Jyothi Sanjeevini Scheme works as an assurance plan. It offers a fixed percentage to the employee for themselves and their families. Moreover, there is no limit on the cost covered under the scheme. The terms provided in this scheme are implemented by the Suvarna Arogya Suraksha Trust. The Jyothi Sanjeevini Scheme applies to all employees. However, you shall not be covered if you opt for services or treatments that are expensive/advanced and thus, beyond the scheme. If you go for a more expensive ward than the ones prescribed in the scheme, you won’t be covered.

The below table illustrates the ward entitlement for employees covered under the Jyothi Sanjeevini Scheme:

How to View Jyothi Sanjeevini Yojana Karnataka Hospital List

Here’s how you can view the Jyothi Sanjeevini Scheme hospital list:

Step 1: Visit the official website of Suvarna Arogya Suraksha Trust.

Step 2: Click on the ‘Network Hospital' option available on the home page.

Step 3: Select the district and the type of hospital you need.

Step 4: You will now see the related information on your mobile/computer screen.

List of Hospitals Empanelled Under the Jyothi Sanjeevini Scheme

Let us explore the list of hospitals tied to the Jyothi Sanjeevini Scheme where the beneficiaries can avail healthcare services:

Conclusion

The increasing incidence of chronic illnesses and the spiralling medical cost have encouraged State as well as Central Governments to introduce healthcare plans like the Jyothi Sanjeevini Scheme. The goal behind such a scheme is to make medical services accessible to all. However, this scheme is valid for government employees only, whereas each one of us needs medical insurance.

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