Dr YSR Aarogyasri Health Plan - Benefits, Enrollment & Coverage

About Dr YSR Aarogyasri

Benefits of Dr YSR Aarogyasri Health Scheme

The Dr. YSR Aarogyasri scheme is targeted at those desiring excellent health care in Andhra Pradesh and Telangana at discounted costs. Some of the scheme’s features include:

• Hospital care: In-patient care for all the listed diseases are covered by the scheme when hospitalization is required.

• Out-Patient Care: Health camps and network hospitals provide these treatments as part of their cashless services under the scheme.

• Cashless Services: An annual coverage of Rs. 5 Lakhs per family is available to registered family members and beneficiaries when they require it.

• Pre-Existing Disease Coverage: An uncommon feature of this plan is that it covers diseases that the beneficiary is already suffering from prior to registering for the scheme.

• Follow-Up: The Dr. YSR Aarogyasri scheme also covers procedures post hospitalization which can cost a fair amount on their own.

• Family-Floater Health Insurance: The sum insured can be made use of by the entire family with no need for separate plans to be taken out for individual family members.

Dr YSR Aarogyasri Scheme - Inclusions

A number of treatments ranging from fairly straightforward procedures to critical treatments are covered by the scheme. Many of them are listed below. 

• General Surgery

• ENT Surgery

• Ophthalmology

• Gynaecology & Obstetrics

• Orthopedic Surgery And Procedures

• Surgical Gastroenterology

• Cardiothoracic Surgery

• Paediatric Surgeries

• Genitourinary Surgeries

• Neuro Surgery

• Surgical Oncology

• Medical Oncology

• Radiation Oncology

• Plastic Surgery

• Polytrauma

• Prostheses

• Critical Care

• General Medicine

• Infectious Diseases

• Paediatrics

• Cardiology

• Nephrology

• Neurology

• Pulmonology

• Dermatology

• Rheumatology

• Endocrinology

• GastroEnterology

• Psychiatry

Dr YSR Aarogyasri Scheme - Exclusions

However, there are some treatments that aren’t covered, including the following:

• Knee replacement surgeries

• Gamma-knife procedures in neurosurgery

• Medical treatment related to bone marrow

• Leprosy

• Filaria

• Assisted devices for cardiac failures

• Cardiac and liver transplantations

• Malaria

• HIV/AIDS

• Tuberculosis

• Infectious diseases

• Gastroenteritis

• Jaundice

Eligibility Criteria for YSR Aarogyasri Scheme

The benefits of the scheme are available to all native families of Andhra Pradesh or Telangana, that have an annual household income below Rs. 5 Lakhs and are white ration card holders. Families that are enrolled in the Antodaya Anna Yojana may also avail the benefits of this scheme.

Enrollment process for YSR Aarogyasri Scheme 

Those eligible for enrollment may register at the enrollment centre with appropriate documentation. Once these documents are verified, the beneficiaries shall be provided with a YSR Health Card. They may also log on to the Aarogyasri portal online by obtaining their login details from the nearest MeeSeva centre. Beneficiaries may directly register through contact any of these locations: 

• Vaidya Mitra counters at Primary Health Care (PHC)

• Health Camp organized by the PHCs or Network Hospital (NWH)

• Direct registration at an NWH via referrals

• Referral from Certified Medical Compliance Officer (CMCO) 

Documents Required for Application 

• Aadhaar card

• Address proof

• Income certificate or income tax returns

YSR Health Card 

Once enrollment is complete, families will receive a YSR Health Card that contains a unique card number, the holder’s photograph, and other details. The YSR Health Card proves the beneficiaries enrolment under the scheme and provides them with cashless facilities at the network hospitals. 

YSR Health Card Status Checking Process 

The YSR Health Card’s status can be looked at by means of the YSRAHCT which is the YSR Health Care Trust’s mobile application. Customer care can be contacted through helpline numbers if there is no information on the portal. Pensioners and Employees can check their info by clicking the following link:

http://www.ehs.ap.gov.in/EHSAP/hcStatusAction.do?actionFlag=onload&theme=darkgreen

Downloading Aarogyasri App: 

Details regarding the Dr. YSR Aarogyasri scheme can be found on the Aarogyasri App available on Google Play Store. To download, simply:

• Open the “Google Play Store” on your Android operated phone

• Search the store for “Aarogyasri Trust”

• Press “Install”

YSR Aarogyasri Scheme Vs. Ayushman Bharat Scheme 

As per Telangana Today, the Dr. YSR Aarogyasri scheme has been shown to be more impactful in comparison to the Ayushman Bharat Yojana introduced all over the country, when weighed against each other based on the following points:

1. Sum Insured: The Aayushman Bharat Yojana offers a sum insured of Rs. 5 Lakhs which falls short of the Rs. 2 to Rs. 13 Lakhs offered by the YSR Aarogyasri scheme.

1. Eligibility: The main point of difference between the two, lies in the eligibility criteria involved. While the Ayushman Bharat Scheme utilises Socio-Economic Caste Census Data(SECC), the YSR Aarogyasri scheme does not and would in fact, exclude some families if it followed the same criteria.

1. Implementation: The YSR Aarogyasri scheme has been implemented for over a decade now and hence, state governments are far more experienced in its inner workings. Conversely, the Ayushman Bharat Scheme is relatively young and many families are still yet to enroll and avail its benefits.

Dr YSR Aarogyasri Health Scheme COVID-19 Coverage

New procedures have been included in the scheme to account for the COVID-19 outbreak. 

• Intensive care management of Septic Shock

• Medical Management of Acute Bronchitis with Pneumonia and Respiratory Failure

• Medical Management of Acute Respiratory Failure (With Ventilator)

• Medical Management of Acute Respiratory Failure (Without Ventilator)

• Medical Management of Acute Severe Asthma With Acute Respiratory Failure

• Medical Management of ARDS

• Medical Management of ARDS with DIC (Blood & Blood Products) (D65)

• Medical Management of ARDS with DIC (Blood & Blood Products) (D65) in Paediatrics

• Medical Management of ARDS with Multi-Organ failure (R65.1)

• Medical Management Of ARDS with multi-organ Failure in Paediatrics

• Medical Management of Confirmed COVID – 19 (Stable)

• Medical Management of Confirmed of COVID – 19 with Comorbidities – HTN, DM, COPD, HIV, Chr. Liver Disease, Chr. Renal Disease

• Medical Management of COPD with Respiratory Failure (Infective Exacerbation)

• Medical Management of Pneumonias

• Medical Management of suspected COVID – 19 (Stable)

Steps to Claim for YSR Aarogyasri Scheme

Claim Process For Beneficiaries: 

Beneficiaries simply have to present their YSR Health Cards to a Vaidya Mitra for verification. In case they do not possess a physical card, the beneficiary may provide the YSR Health Card number to the same. In case, there is no physical proof of enrollment, the details are obtainable through the Aarogyasri Trust.

Claim Process for Hospitals: 

The hospital must obtain authorization for any surgical treatments. The trust can only fulfill claims if hospital authorities meet the following: 

• The hospitals are pre-authorized to perform a treatment that has been approved under the scheme.

• The claim is filed at the earliest.

• The claim amount is less than the pre-authorized limit.

• There exists photographic evidence of the treatment for claim settlement. 

The Dr.YSR Aarogyasri portal can also be used to collect claim documents,intimate claims, scrutinize claim documents, etc. The following information is verified once the claim is filed and received: 

• The patient’s identity

• Treatment evidence

• Claim amount in relation to the authorized amount

• Case management with respect to prior authorization

Dr. YSR Aarogyasri Health Care Trust Hospital List

A wide array of hospitals now operate under the Aarogyasri Health Care Trust and offer cashless treatments to patients seeking care under the Dr. YSR Aarogyasri Health Scheme in medical emergencies. Some of these hospitals are: 

Incorporation of New Procedures at Government General Hospitals

An advantage of the programme is its inclusion of newer procedures as part of its coverage that allow beneficiaries to avail treatments in a wide array of situations and illnesses. Some of them include: 

Dr. YSR Aarogyasri Health Care Trust Toll-Free/Helpline Number and Address

The Dr. YSR Aarogyasri Health Care Trust can be contacted through the following contact details: 

Aarogyasri Helpline Number: 

• 1800-599-1111 

• The PAN India helpline number 104 can also be used to resolve your queries. 

Contact Number: 

• 0863 – 2222802 / 2259861

Dr.YSR Aarogyasri Address: 

• D.No. 25-16-116/B, Chuttugunta, Behind Gautam’s Hero Showroom, Guntur – 522004, Andhra Pradesh, India

Conclusion

Weighing a variety of policies and their benefits against each other is a crucial first step towards determining the ideal plan for your requirements. Health insurance policies available on the Finserv MARKETS come with a high claim settlement ratio, key benefits and an easy online application process that provide you and your family with the coverage to face any situation.