The Karnataka Arogya Sanjeevini Scheme (KASS) is a comprehensive healthcare scheme launched by the Karnataka government to provide cashless medical treatment to state government employees and their families.
Introduction
The Karnataka government, committed to the well-being of its employees, introduced the Karnataka Arogya Sanjeevini Scheme (KASS). Announced in the 2021-22 budget, KASS aims to provide financial security and ease medical burden for government employees and their families residing in Karnataka. This article explores the scheme’s purpose, benefits, eligibility criteria, and application process.
Understanding KASS
KASS is a cashless medical treatment scheme for Karnataka state government employees and their dependents. The scheme facilitates treatment at impaneled hospitals across the state, eliminating upfront medical expenses for beneficiaries. This initiative promotes timely access to quality healthcare, improving the overall health and well-being of government employees and their families.
Key Highlights of the Karnataka Arogya Sanjeevini Scheme (KASS)
- The scheme covers both allopathic and AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homoeopathy) systems of medicine.
- It aims to maintain a balance between the life and health of government employees and help them cope with medical situations.
- The state government has set aside ₹250 crore for the implementation of this scheme
Benefits of KASS
- Cashless Medical Treatment: A significant advantage of KASS is the elimination of upfront medical costs. Beneficiaries can avail of treatment at impanelled hospitals without worrying about immediate payment.
- Improved Access to Healthcare: KASS encourages employees to seek timely medical intervention without financial constraints. This early diagnosis and treatment can lead to better health outcomes.
- Wider Coverage: The scheme covers a broad spectrum of medical procedures, including hospitalization, surgeries, and daycare procedures.
- Reduced Financial Burden: KASS significantly reduces the financial burden on government employees facing medical emergencies.
- Peace of Mind: Knowing that medical expenses are covered provides peace of mind to employees and their families during challenging times.
Eligibility for KASS
KASS applies to all Karnataka state government employees and their eligible dependents, which may include:
- A permanent resident of Karnataka
- A government employee
Scope of Coverage
The KASS covers the following beneficiaries:
- Spouse
- Dependent children (age restrictions may apply)
- Parents (dependent on the employee)
- Unmarried siblings (dependent on the employee)
Important Note: The exact definition of eligible dependents and any age limitations may vary. It’s recommended to consult the official KASS guidelines for the latest information.
How to Apply for KASS
the key steps to enroll in the Karnataka Arogya Sanjeevini Scheme (KASS) are:
- Obtain the Application Form: The KASS application form has been released by the Karnataka government. Eligible government employees need to obtain this form.
- Employee Registration: Government employees will likely need to register themselves and their dependents on a designated KASS portal.
- E-Card Issuance: Upon successful registration, an e-card containing beneficiary details might be issued. This e-card would serve as identification for availing of cashless treatment.
- Hospital Selection: Beneficiaries can choose from a network of impanelled hospitals for their treatment.
- Submit the Application: The completed application form needs to be submitted through the Head of Office/Reporting Officer to the Drawing and Disbursing Officer (DDO).
- The DDOs are required to enter the employee details in the Human Resource Management System (HRMS) portal.
- Provide Required Documents: Along with the application form, the following documents need to be submitted:
- Aadhaar card copy
- Date of birth certificates for the employee and dependents
- Latest pay slip
- Passport-size photographs of the employee and dependents
- Self-declaration form
- Aadhaar Authentication: The employee has to approach the DDO for Aadhaar authentication of all their dependents. This needs to be completed before the dependent details are approved in the HRMS.
- Declaration Document Upload: After the Aadhaar authentication, the employee has to upload the declaration document in the KASS mobile application.
- Approval of Dependents: Once the dependent details are digitally approved by the DDO, the employee cannot modify the existing records. Any new dependents will require submission of the declaration document.
So in summary, the enrollment process involves obtaining the application form, submitting it with the required documents, getting the data entered in HRMS, completing Aadhaar authentication, and uploading the declaration – all of which need to be done through the designated office channels.
How to get an OTP for the KASS application
To get an OTP (One Time Password) for the Karnataka Arogya Sanjeevini Scheme (KASS) mobile application, follow these steps:
- Open the KASS mobile application on your Android or iOS device.
- If you are a first-time user, click on “New User” to register. Enter your KGID (Karnataka Government Identity) number and click on “Verify”.
- Click on “Get OTP”. An OTP will be sent to your registered mobile number.
- Enter the received OTP and click on “Verify”.
- Set a desired password as per the password policy and confirm it. Click on “Save” to complete the registration process.
- For subsequent logins, enter your KGID number, password, and captcha. Click on “Verify”.
- Click on “Get OTP” again. Enter the OTP sent to your mobile number and click on “Login” to access the application.
If you forget your password, click on “Forgot Password” on the login screen. Enter your KGID number, click on “Get OTP”, enter the received OTP, and click on “Submit” to reset your password.
The OTP is an essential security feature that ensures only authorized users can access the KASS mobile application and manage their family-dependent details.
Required Documents:
the key documents required to enroll in the Karnataka Arogya Sanjeevini Scheme (KASS) are:
- Application Form: Eligible government employees need to submit the KASS application form, which has been released by the government. The form needs to be submitted through the Head of Office/Reporting Officer to the Drawing and Disbursing Officer (DDO).
- Aadhaar Card: A copy of the Aadhaar card is required to be submitted along with the application form.
- Date of Birth Certificate: Proof of the employee’s and their dependents’ date of birth, such as a birth certificate, needs to be provided.
- Pay Slip: The latest pay slip of the government employee must be submitted.
- Photographs: Passport-size photographs of the employee and all their dependents (spouse, parents, and children) need to be provided.
- Self-Declaration: The employee must submit a self-declaration form along with the application.
The DDOs are also required to enter the details of the employees in the Human Resource Management System (HRMS) portal. The KASS mobile application has also been launched to enable employees to enter their family-dependent details.
In summary, the key documents needed are the application form, Aadhaar card, date of birth proof, pay slip, photographs, and a self-declaration form. The complete process involves submission of the application through the office as well as data entry in the HRMS portal.
Recent Developments and Future of KASS
The Karnataka government is working on finalizing the KASS implementation details. This may include finalizing the list of impanelled hospitals, outlining the coverage amount, and establishing the grievance redressal mechanism.
Here are some resources to stay updated on KASS developments:
- Karnataka Department of Health and Family Welfare (https://hfwcom.karnataka.gov.in/english)
- Suvarna Arogya Suraksha Trust (SAST) (http://arogya.karnataka.gov.in/sast/english/)
Implementation and Launch of the Scheme
The Karnataka government has collaborated with the Suvarna Arogya Sanjeevini Scheme to implement the KASS.
The state government employees’ association is expecting the Chief Minister to officially announce the launch of the KASS during their convention on February 27, 2024
How does the KASS scheme compare to other health insurance schemes in India
The Karnataka Arogya Sanjeevini Scheme (KASS) is a comprehensive health insurance scheme launched by the Karnataka government to provide cashless medical treatment to state government employees and their families. While it shares some similarities with other government health insurance schemes in India, there are a few key differences:
Scope of Coverage
KASS covers both allopathic and AYUSH systems of medicine, providing a broader range of treatment options compared to some other schemes that focus solely on allopathic medicine.
Beneficiaries
KASS is specifically designed for Karnataka state government employees and their families, including the employee’s spouse, parents, and children. Other schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) target a wider population, such as unorganized sector workers, poor families, and below-poverty-line households.
Sum Insured
The sum insured under KASS is not specified in the available information. In comparison, AB-PMJAY provides an annual coverage of up to ₹5 lakhs per family for secondary and tertiary care hospital treatment.
Implementation
KASS is being implemented in collaboration with the Suvarna Arogya Sanjeevini Scheme. Some other schemes like Rashtriya Swasthya Bima Yojana (RSBY) are implemented at the national level.
Funding
The Karnataka government has allocated ₹250 crore for the implementation of KASS. The funding mechanism for other schemes may vary, with some like RSBY having subsidized premiums by the government.
In summary, while KASS shares the goal of providing affordable healthcare coverage with other government schemes, its specific focus on Karnataka state government employees, inclusion of AYUSH treatments, and implementation in partnership with the Suvarna Arogya Sanjeevini Scheme sets it apart from some of the other major health insurance schemes in India
The most common diseases covered under the KASS scheme
The Karnataka Arogya Sanjeevini Scheme (KASS) covers a wide range of diseases, both severe and minor, under its comprehensive healthcare coverage for state government employees and their families. While the specific list of covered diseases is not mentioned in the available information, some key points can be inferred:
- KASS covers diseases eligible under the Vajpayee Arogyashree Yojana, which is another healthcare scheme implemented in Karnataka.
- The scheme aims to provide cashless treatment for all diseases, unlike the previous Jyothi Sanjeevini scheme that only included tertiary treatment and emergency care for broad specialities such as cardiovascular diseases, cancer, renal diseases, neurological conditions, burns, polytrauma cases and neonatal cases.
- By offering broader coverage compared to the Jyothi Sanjeevini scheme, KASS is expected to eliminate the need for employees and their families to pay out-of-pocket expenses for treatment and later claim reimbursement.
- The scheme allows beneficiaries to seek treatment at any empanelled hospital, be it government or private, further expanding their options for healthcare.
In summary, while the exact list of covered diseases is not specified, KASS aims to provide comprehensive healthcare coverage for a wide range of severe and minor ailments, ensuring that state government employees and their families can access cashless treatment without any financial burden.
Process for claiming benefits under the KASS scheme
The process for claiming benefits under the Karnataka Arogya Sanjeevini Scheme (KASS) involves the following steps:
- The patient must go to one of the network hospitals impanelled under the scheme.
- If the patient is a KASS beneficiary, the Third Party Administrator (TPA) of the hospital will confirm that the necessary treatment/surgery is covered by the scheme.
- Once confirmed, the patient must go through the required medical tests.
- The network hospital will share a pre-authorization request with supporting documents to the Management Services Provider (MSP) online based on the initial diagnosis.
- The MSP will then confirm the request shared by the hospital. The request should get approved within a day.
- After the request is approved, the doctors at the network hospital can start the treatment.
- The MSP will then pay the hospital after verification of the claim.
KASS beneficiaries can avail of cashless treatment at empanelled hospitals, where the hospital obtains pre-authorization from the scheme administrators, provides treatment, and gets reimbursed, without the patient having to make any out-of-pocket payments. The exact documentation required may vary, but the overall process is designed to be convenient for the beneficiaries.
FAQs on Karnataka Arogya Sanjeevini Scheme
- What are the eligibility criteria for KASS?
The scheme is likely to cover all Karnataka government employees and their eligible dependents. Refer to the official guidelines for the latest information on dependent eligibility.
- What kind of medical expenses are covered under KASS?
The exact coverage details haven’t been finalized yet. However, KASS is expected to cover hospitalization charges, surgeries, and daycare procedures.
- How can I apply for KASS?
An official application process is yet to be announced. It’s likely to involve employee registration on a designated portal and issuance of an e-card.
- Where can I find a list of impanelled hospitals under KASS?
The list of impanelled hospitals is still under development. Keep an eye on the Department of Health and Family Welfare or SAST websites for updates.
Conclusion
The Karnataka Arogya Sanjeevini Scheme is a welcome initiative by the state government. It empowers employees to focus on their health and well-being without financial anxieties. KASS holds the potential to significantly improve the healthcare access and financial security of government employees and their families in Karnataka.
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