Arogya Raksha Policy

The Arogya Raksha policy, introduced in 2017 by the Chief Minister of Hyderabad, stands as a beacon of affordable healthcare for the residents of Andhra Pradesh. This health insurance scheme is designed to provide cashless facilities, ensuring that beneficiaries receive premium-quality healthcare without bearing the financial burden. The scheme boasts a vast network of hospitals, encompassing both government and private institutions, fostering accessibility during medical emergencies.

• Cashless Facilities: Enjoy the convenience of cashless health insurance, where hospital bills are directly settled by network hospitals with insurers. This eliminates the need for beneficiaries to pay for medical expenses out of their own pockets.

• Huge Network of Hospitals: Arogya Raksha has established affiliations with numerous government and private hospitals. This extensive network ensures that enrolled individuals have seamless access to healthcare services when faced with medical emergencies.

The Arogya Raksha scheme offers a plethora of benefits, ensuring extensive coverage and financial relief for policyholders. Here's a breakdown of the notable benefits:

• Large Scope of Coverage: The Arogya Raksha policy encompasses a diverse range of diseases, providing coverage for over 1,000 different types of treatments. This expansive coverage minimises the likelihood of patients being denied treatment for specific ailments, ensuring comprehensive healthcare support.

• Coverage for Follow-up Treatments: A unique feature of the Arogya Raksha scheme is its provision for follow-up treatments. Recognising the financial burden associated with post-treatment care, this benefit offers coverage for follow-up treatments, alleviating the financial strain on patients and their families.

• Ayurvedic Treatment Coverage: Emphasising holistic healthcare, the Arogya Raksha scheme extends coverage to Ayurvedic treatments. Beneficiaries opting for Ayurvedic treatment at government hospitals will find it covered under the policy. Additionally, treatments received at the Quality Council of India/National Accreditation Board on Health-accredited hospitals are included, promoting alternative healthcare options for policyholders.

The Arogya Raksha Scheme offers flexibility with three distinct plans catering to varying coverage needs and beneficiaries. Each plan comes with a total sum insured ranging from ₹1 lakh to ₹10 lakh. Here's a detailed breakdown of the plans and their respective premiums:

• Plan A: Geared towards individuals with an exit age of 35 years, this plan covers the account holder, along with two dependent children and a spouse. The annual premium for Plan A falls within the ₹2,000 to ₹14,500 range, providing comprehensive coverage.

• Plan B: With an exit age of 70 years, this plan extends coverage to the account holder, two dependent children, and a spouse. Plan B offers flexibility and security, with an annual premium ranging from ₹3,000 to ₹25,500.

• Plan C: Also featuring an exit age of 70 years, Plan C is designed for those seeking broader coverage. It includes the account holder, two dependent children, dependent parents, and a spouse. Plan C's premium varies from ₹5,000 to ₹62,500 per year, accommodating diverse healthcare needs.

   

It's essential to note that the premium amount is influenced by the chosen coverage amount.

The Arogya Raksha policy provides extensive coverage to its beneficiaries, ensuring comprehensive healthcare support. The coverage inclusions encompass various medical expenses and treatments:

• Hospitalization Expenses: Covering room rent, boarding, nursing expenses, ICU charges, surgeon and specialist fees, blood, oxygen, operation theatre charges, and more

• Daycare Treatment: Inclusive of pre and post-hospitalization ayurvedic treatment, and medical or surgical treatments falling under daycare treatment

• Advanced Medical Procedures: Including modern treatments like Uterine Artery Embolisation, HIFU, oral chemotherapy, and robotic surgeries

• Maternity Expenses: Covering expenses for the first two childbirths

• Personal Accident Death Cover: Providing 100% coverage for the account holder, 50% for spouses, and 25% for children

• Co-payment: A 10% co-payment is applicable on claims for insured individuals above 65 years

• In-Patient Hospitalization Expenses: Covered up to 25% of the sum insured, with a maximum limit of ₹3,00,000 per year. Mental illnesses such as Depression, Obsessive Compulsive Disorders, Psychosis, Schizophrenia, and Bipolar Affective Disorders are also covered

Certain situations are excluded from the Arogya Raksha health insurance scheme, and insurance companies are not liable to pay for these exclusions. The coverage exclusions include:

• Cosmetic or Plastic Surgery: Unless required as a part of the treatment for injuries due to an accident

• Change of Gender Surgeries

• Eyesight Correction, expenses for spectacles, contact lenses, or hearing aids

• Dental Treatment for aesthetic purposes without accidental injury

• Obesity Treatment

• Psychiatric and Psychosomatic Disorders

• Attempted Suicide or Suicide

• Infertility or Sterility

• Venereal Diseases

• Congenital Anomalies

• Treatment arising from excessive use of intoxicating substances

• AIDS Treatment

• Cost of vitamins and tonics, unless prescribed by a certified medical professional

• Stem Cell Implantation/Surgery

• Injuries due to War

Upon successful enrollment in the Arogya Raksha Scheme, beneficiaries are issued a valuable health card. This Arogya Raksha health card serves as the key to unlocking the scheme's coverage, offering a range of health benefits. The card can be obtained either directly from the kiosk operator or through a simple downloading procedure. Below are the steps to download your Arogya Raksha health card:

The following is the procedure to apply for an Arogya Raksha Health Card:

• Navigate to the official website of Dr YSR Arogyasri Healthcare Trust.

• Click on the 'Arogya Raksha' button prominently displayed on the website.

• Locate and click on 'Click here to enrol' to initiate the enrollment process.

• Enter your Aadhaar number in the designated box and click 'Go' to proceed.

• Provide your mobile number and click on 'Send OTP' to receive a One-Time Password.

• Enter the OTP received and click 'Verify' to authenticate your details.

• Choose a family member from the list and click on 'Download Health Card.'

Beneficiaries can conveniently check their Arogya Raksha claim status by contacting the customer care number or reaching out directly to the health insurance TPA/insurance company. This streamlined approach ensures that individuals can stay informed about the status of their claims promptly.

Ensuring continuous health coverage is a breeze with the straightforward Arogya Raksha policy renewal process. Follow the steps below for a hassle-free renewal via Indian Bank:

1. Renewal Timing

• Initiate the Arogya Raksha renewal process during the last 30 days of the policy period. Please note that renewal cannot be processed before this period

• The renewal window is available between 6 AM and 9 PM

   

2. Account with Indian Bank

• Ensure you have an active account with Indian Bank. An account number with Indian Bank is essential for viewing or renewing the existing Arogya Raksha policy

3. Payment Options

• To facilitate the renewal, an account holder can use the net banking facility provided by Indian Bank

• The payment process is streamlined, making it convenient for beneficiaries to renew their Arogya Raksha Policy seamlessly

For detailed information and to proceed with the renewal, visit the Arogya Raksha Renewal Portal.

The Arogya Raksha scheme prioritises holistic healthcare by extending its coverage to include post-hospitalization or follow-up treatments. Understanding the significance of ongoing medical care, the scheme offers cashless benefits for follow-up treatments, ensuring continued recovery and well-being. Here are the key features of Arogya Raksha Follow-Up Packages:

1. Commencement of Cashless Follow-Up: Cashless follow-up treatment kicks in from the 11th day post-discharge from the hospital.

2. Covered Expenses: The scheme encompasses various expenses related to follow-up, including diagnostic tests, consultations, and medicines.

3. Simplified Claim Process: Beneficiaries are relieved from the hassle of filing separate claims for follow-up treatments, streamlining the process for enhanced convenience.

4. Quarterly Division of Follow-Up Packages: Follow-up packages are structured across four quarters in a year, with the highest compensation available in the initial quarter following hospitalization.

For detailed information on the cost associated with each follow-up package, beneficiaries can refer to the official Arogya Raksha website: Arogya Raksha Follow-Up Packages

For prompt assistance, the Dr YSR Arogyasri Health Care Trust is readily available to address queries and grievances. You can find the contact details below

Arogya Raksha Toll-Free Number:

• 1800 599 1111

Contact Numbers for General Inquiries:

• 0863 222 2802

• 0863 225 9861

Address:

D.No. 25-16-116/B, Chuttugunta, 

Behind Gautam’s Hero Showroom,

Guntur, Andhra Pradesh 522004

India

Grievance Contact Details:

• Contact Number: 83338 17424/23/20/07 (during office hours)

• Extension: 0863 225 9861 (Ext: 326)

• Email Address: ap_grievance@ysrArogyasri.ap.gov.in

Medical Reimbursement Inquiries:

• Contact Number: 83338 17363

• Extension: 0863 225 9861 (Ext: 329)

• Email Address: ap_mr@ysrArogyasri.ap.gov.in

While the Arogya Raksha policy stands as a commendable initiative offering health coverage to Andhra Pradesh residents, it's essential to note that individuals residing outside the state cannot avail themselves of this government health insurance initiative.

For those ineligible for government health schemes or seeking to bolster their coverage, Bajaj Markets offers a range of outstanding private health insurance plans. The company’s insurance policies provide additional benefits such as cashless claims across an extensive network of hospitals and seamless Health Insurance Renewals Online. Elevate your health coverage today by purchasing a health insurance plan from Bajaj Markets!