The Karnataka government has approved the 'Sandhya Kiran' scheme, offering up to ₹5 lakh in annual cashless healthcare for state pensioners and their dependents. The contributory program aims to support over 4.93 lakh beneficiaries, with specific premium rates set for service and family pensioners to ensure fiscal sustainability.
The Karnataka state cabinet has officially approved the 'Sandhya Kiran' healthcare scheme, a new welfare initiative designed to provide financial and medical security to the state's retired workforce. The program offers cashless treatment coverage of up to ₹5 lakh annually for pensioners under the age of 70, family pensioners, and their eligible dependents.
Financial Structure and Contributory Model
Unlike fully state-funded welfare programs, 'Sandhya Kiran' operates on a contributory model designed to balance individual beneficiary participation with state fiscal support. To access these benefits, service pensioners are required to contribute 1.25% of their basic pension, while family pensioners contribute 0.75% of their basic family pension.
The state government expects total annual contributions to reach approximately ₹117 crore, intended to cover the estimated treatment cost of ₹81.75 crore. Current projections suggest that beneficiary contributions will fund 70% of total expenses, with the state government covering the remaining 30%. This structure is aimed at reducing the long-term fiscal burden on the state treasury while ensuring essential healthcare access for the retired population.
Sustainability Safeguards
To address the risk of rising medical inflation and potential fund shortages, the government has included a specific financial safeguard. If the scheme's utilization of the allocated corpus exceeds 85%, the contribution rates will automatically increase by five basis points. This mechanism is intended to prevent the program from becoming a permanent strain on the state’s fiscal resources, ensuring that the healthcare network—managed by the Suvarna Arogya Suraksha Trust—remains operationally viable.
Implementation and Coverage
The scheme will be implemented under the existing framework of the Ayushman Bharat-Arogya Karnataka (AB-ArK) regulations. This utilizes an established network of empanelled hospitals for secondary, tertiary, and emergency medical services. By leveraging the existing AB-ArK infrastructure for registration and claims processing, the government aims to minimize operational overheads and administrative delays for the approximately 4.93 lakh expected beneficiaries.
The key monitorable for the state government will be the scheme's participation rate and the actual utilization of medical services versus projected costs. If claims processing exceeds initial estimates, the automatic adjustment mechanism will be the primary lever for maintaining the scheme’s financial health.