Cabinet Approves “Sandhya Kiran” Contributory Cashless Healthcare Scheme for State Government Pensioners
Bengaluru: The State Cabinet has approved the launch of “Sandhya Kiran” contributory cashless healthcare scheme. This scheme aims to provide health and financial security to State Government pensioners under 70 years of age, family pensioners, and their eligible dependent family members.
To ensure comprehensive healthcare coverage for retired State Government employees and their eligible dependents, this new scheme has been formulated under the regulations of the Ayushman Bharat-Arogya Karnataka (AB-ArK) scheme.
Key Features of the Scheme:
Coverage & Beneficiaries: In the initial phase, approximately 3.11 lakh State Government pensioners under 70 years of age and their eligible dependents, bringing a total of about 4.93 lakh beneficiaries, will come under the scope of this scheme.
Healthcare Benefits: As a contributory cashless health scheme, it provides cashless access to secondary, tertiary, and emergency medical treatments up to ₹5.00 Lakh per eligible family per year on a floater basis.
Hospital Network: Benefit packages and revised package rates applicable under AB-ArK will extend to this scheme as well. Beneficiaries can avail of cashless treatment facilities at enrolled/approved hospitals under the scheme.
Premium Contributions:
Service pensioners must contribute 1.25% of their basic pension.
Family pensioners must contribute 0.75% of their basic family pension.
Financial Impact (Treatment Costs):
The scheme is expected to collect an estimated ₹117 Crore annually in premiums, with the annual treatment cost estimated at approximately ₹81.75 Crore.
As per AB-ArK policy, 70% of the treatment cost will be borne by the beneficiaries’ share and 30% by the State Government’s share.
Accordingly, the annual share will be approximately ₹57.22 Crore from beneficiaries and ₹24.53 Crore from the State Government.
To ensure long-term financial stability and effective corpus management, a mechanism is proposed to automatically increase the current premium rate by 0.05% (5 basis points) whenever corpus utilization exceeds 85%.
Implementation & Management: The “Sandhya Kiran” scheme will be implemented through the Suvarna Arogya Suraksha Trust (SAST) as the implementing agency.
Beneficiary registration, premium collection, hospital network administration, cashless treatment provision, claim management, and overall scheme oversight will be seamlessly coordinated with the AB-ArK system.
Social Security Significance: This scheme is a vital social security measure ensuring quality, affordable, and cashless healthcare services for State Government pensioners and their families, helping significantly reduce the financial burden of unexpected medical expenses.