Karnataka Launches Sandhya Kiran Cashless Healthcare Cover

Karnataka has approved the Sandhya Kiran contributory cashless healthcare scheme for retired Karnataka State Government employees below 70 years of age, family pensioners, and their eligible dependents. The scheme provides annual cashless medical cover of up to ₹5 lakh per family on a floater basis for secondary, tertiary, and emergency treatment at designated hospitals.

Scheme Framework

Sandhya Kiran operates under the Ayushman Bharat-Arogya Karnataka (AB-ArK) framework. The Suvarna Arogya Suraksha Trust is the implementing body for the scheme in Karnataka.

Eligibility and Coverage

The scheme covers service pensioners, family pensioners, and eligible dependents within the notified age and category limits. The benefit ceiling is ₹5 lakh per family per year, and the cover applies on a floater basis, which means the total amount can be used by any eligible member of the family.

Contribution Structure and Funding

Service pensioners are required to contribute 1.25% of their basic pension, while family pensioners are required to contribute 0.75% of their basic family pension. The projected annual premium collection is ₹117 crore, and the estimated treatment cost is ₹81.75 crore.

The cost-sharing pattern places about 70% of the burden on beneficiaries, estimated at ₹57.22 crore, and about 30% on the State Government, estimated at ₹24.53 crore. A fiscal safeguard has been built into the scheme, and contribution rates will rise by five basis points if corpus utilisation crosses 85%.

Important Facts for Exams

• Ayushman Bharat-Arogya Karnataka is a state health protection framework used in Karnataka for cashless medical care.
• A floater health cover allows the insured amount to be shared among eligible family members within one policy year.
• Secondary care and tertiary care are standard classifications used in public health systems for hospital-based treatment.
• Cashless treatment schemes usually require empanelled or designated hospitals for direct settlement of medical bills.

Administrative and Fiscal Features

The scheme is designed as a contributory model rather than a fully subsidised welfare benefit. The automatic revision clause linked to corpus utilisation is a financial control mechanism for long-term scheme stability.