Arogya Karnataka Scheme - Benefits, Eligibility Criteria, Documents Needed and Enrollment Process

The main motive behind starting the Arogya Karnataka scheme (ಸಮಗ್ರ ಆರೋಗ್ಯ ಕರ್ನಾಟಕ ಜಾರಿ) is to expand Universal Health Coverage to the people of Karnataka State. This scheme will provide primary health care specific secondary as well as tertiary health care benefits. The scheme is similar to the Ayushman Bharat scheme, which also offers financial protection to poor as well as vulnerable families. This scheme will help to provide financial support to those people who are not able to get treatment for their severe diseases due to the high cost of health infrastructure. This scheme is started to attain operational efficiency. This scheme is also known as the Ayushman Bharat- Arogya Karnataka scheme.

Benefits

  • The eligible patients can get financial support up to INR 5 lakh per annum for the simple health care services, secondary healthcare treatment as well as tertiary healthcare facilities.
  • This depends upon the family members like one or more persons of the family who can use the full cover of INR 5 lakh.
  • General Patient shall be able to get the benefit of 30% of Government package rates, with an overall annual limit of INR 1.50 lakh for one family per year on a co-payment basis.

Eligibility Criteria

The eligibility criterion for Eligible Patient Ayushman Bharat- Arogya Karnataka Scheme is explained below:

Eligible patient 

A patient who has residence proof of Karnataka State as well as belongs to an Eligible Household that was defined under the National Food Security Act, 2013 is eligible for Ayushman Bharat- Arogya Karnataka Scheme.

General Patient

This condition applies when a patient is a resident of Karnataka State but does not come under the definition of Eligible Household as defined under the National Food Security Act, 2013, for this treatment cost will be on a co-payment basis.

Exclusions

The categories that are not included in this scheme but they can get healthcare through other schemes that are mentioned below:

  • Residents who are covered under the Employees' State Insurance Scheme
  • Residents who are covered under health assurance or health insurance schemes 
  • Residents who have taken any private health insurance policies on their own
  • Residents who are covered under the Health Scheme of the Government of India by Central Government 
  • Employees of Government of Karnataka till the amendment in the Karnataka Government Servants' Rules

Documents Needed

There are some required documents that patients have to submit to enrol in Ayushman Bharat - Arogya Karnataka Scheme. All the documents are mentioned below:

  • The beneficiary must carry Aadhaar card and ration card if in case the beneficiary does not have Aadhaar Card ration card is mandatory to get the benefits of this scheme.
  • In case if you do not have a Ration Card but have Aadhaar card then also you can easily enrol under this scheme. But in this condition, you will be treated as a general patient.
  • If you have a Ration card but do not have an Aadhaar card, then for once you will get enrolled under this scheme for the benefit. Still, when you visit the empanelled private hospital after being referred from a Public Health Institute, then you have to show an Aadhaar card. You can also show an acknowledgement that shows you have applied for an Aadhaar card.
  • If you do not have both the Aadhaar or Ration cards, then you are not eligible to get enrolled under this scheme and to get benefits of this scheme.
  • Children whose age is below three years can get registered under the scheme with their parent's or guardian's Aadhaar card or any other identity proof.

Enrollment Process

  • To enroll under Ayushman Bharat - Arogya Karnataka scheme the beneficiary has to follow a one-time enrollment process. The beneficiary can complete this process at the Public Health Institute, Private Empanelled Hospital as well as Enrollment Centers.
  • When the patient will visit a Public Health Institute for the treatment then the staff of the public health institute enrolls the patient on the official portal created for the Arogya Karnataka scheme.
  • If a beneficiary wants to enroll under this scheme and wants to get benefits from this scheme he must have an Aadhaar card and a PDS card. An Aadhaar card is mandatory for the beneficiary to get enrolled. And a PDS card is also necessary for the beneficiary if he wants to get registered as an "Eligible Patient". 
  • If the patient does not have a PDS card then he will be treated as a general patient regardless of financial status.
  • In the first step, the beneficiary has to provide his or her Aadhaar card number as well as his biometric impression on a biometric machine. 
  • The biometric data of the candidate will be used for the verification process. If this option is not working then the candidate is able to enroll by OTP.
  • At the time of enrollment, the beneficiary must have to provide his Ration card to the enrollment staff.
  • The ration card details of the beneficiary will be verified with the help of web service and the data that is stored in the Food and Civil Service Database to check that the candidate belongs to "Eligible Category" or not.
  • If the beneficiary does not have a ration card or does not belong to the eligible patient category, he will be enrolled as a general patient.

Ayushman Bharat - Arogya Karnataka Scheme ID Card

  • The cards that are provided under the Ayushman Bharat - Arogya Karnataka scheme is known as AB-Ark Card as well as the unique ID generated when the candidate is enrolling is known as AB-ArK ID.
  • When the candidate successfully gets registered under Ayushman Bharat - Arogya Karnataka Scheme then he will be provided with a unique identity number, AB-ArK ID will be generated, and this health care is known as "Ayushman Bharat - Arogya Karnataka Card".
  • The unique AB-ArK ID is the same as the PDS card Number with a separator (-) as well as a sequential number for every member of the family that reaches a PHI for service and asks to get enrolled.
  • The UHC card will contain various details of the beneficiary like Photo, Name, Unique Scheme ID, and many other Basic Details.
  • After enrollment, a message will be sent to the registered mobile number of the candidate.
  • Once the candidate gets the health card of this scheme, then the patient is ready to access the treatment under the "Ayushman Bharat - Arogya Karnataka" scheme.
  • After the verification process completion, the patient doesn't need to take his Aadhaar card or ration card with him when he visits the hospital for treatment.
  • At the time when the patient will visit the hospital and need to urge any therapy, he has got to show only Ayushman Bharat - Arogya Karnataka card.
  • The patient has to pay a one time fee that is Rs. 10 for the Ayushman Bharat - Arogya Karnataka Card.
  • In case if the beneficiary lost his health card, then he can get a duplicate card from any public health institute or at the enrollment centre only with the payment Rs. 20.

Official Website

You can learn more about this scheme on arogya.karnataka.gov.in