Karnataka pensioners get new health cover: Contribution rates, benefits explained

Karnataka pensioners get new health cover: Contribution rates, benefits explained


Karnataka has approved a cashless healthcare scheme for state government pensioners, family pensioners and eligible dependents, offering health cover of up to ₹5 lakh a year.

The ‘Sandhya Kiran’ scheme will initially cover around 4.93 lakh beneficiaries, including 3.11 lakh state government pensioners below 70 years and their eligible dependents.

Under the scheme, eligible families can avail themselves of cashless treatment for secondary, tertiary and emergency care at empanelled hospitals. The annual cover of up to ₹5 lakh will be available on a family-floater basis.

The scheme has been formulated under the Ayushman Bharat-Arogya Karnataka (AB-ArK) framework, with its benefit packages and revised treatment rates applicable to Sandhya Kiran as well.

How much will pensioners contribute?

Service pensioners will contribute 1.25% of their basic pension, while family pensioners will pay 0.75% of their basic family pension towards the scheme.

For example, a service pensioner receiving a basic pension of ₹40,000 a month would contribute about ₹500 a month under the proposed rate. A family pensioner with a basic family pension of ₹30,000 would contribute about ₹225 a month.

The government expects the scheme to generate around ₹117 crore annually through beneficiary contributions, against an estimated annual treatment cost of ₹81.75 crore.

Of the estimated treatment cost, 70% will be funded through beneficiary contributions and the remaining 30% by the state government.Contribution rate could rise if utilisation is high

The scheme also has a provision to protect its financial sustainability. If utilisation of the scheme’s corpus exceeds 85%, the contribution rate will automatically increase by 0.05 percentage point, or five basis points.

The Suvarna Arogya Suraksha Trust will implement the scheme. Registration, contribution collection, hospital-network management, cashless treatment and claims administration will be handled through the AB-ArK system.

For pensioners, the scheme could reduce the need to meet large medical bills from retirement savings, particularly for hospitalisation and emergency treatment covered under the scheme.

-With PTI inputs



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