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AP EHS - Employee Health Scheme by Government of Andhra Pradesh

The Employee Health Scheme (EHS) was enacted under the patronage of the Dr. YSR Aarogyasri Healthcare Trust and is managed by the government of Andhra Pradesh. By availing of this scheme, government employees, pensioners, and their families can benefit from cashless treatment at a range of empanelled network hospitals.

 

The Employee Health Scheme covers various treatments, including in-patient treatment, out-patient treatment (in the case of long-term illnesses), hospitalisation, and follow-ups.

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Features and Benefits of Employee Health Scheme

The primary objective of EHS Andhra Pradesh is to provide a cashless hospitalisation facility to employees, pensioners, and their family members. Here are some salient features and benefits offered by the policy:

Coverage of EHS

FFeatures and Benefits

Inpatient treatment

Treatment and free of-cost outpatient evaluation of specific therapies for diseases identified under EHS

Cashless treatment up to 10 days after discharge

Medicines with cover for complications up to 30 days after being discharged

Follow-ups

Can be availed up to 1 year for different packages including doctor consultation, routine investigations, drugs or others in specific treatment areas

Outpatient treatment for long term illnesses

Pre-defined conditions are treated by specialists at specific hospitals

Hospitalisation

Semi-private ward for Slab A (Pay grade 1 to 4)

Semi-private ward for Slab B (Pay grade 5 to 17)

Private ward for Slab C (Pay grade 18 to 32)

Financial cover

A maximum of ₹2 Lakh for every illness episode.

If packages exceed the ₹2 Lakhs limit, the above sum does not apply;

Claims above ₹2 Lakhs are directed for settlement to the CEO of the Aarogyasri Trust

 

Who is Not Covered Under the Employee Health Scheme?

Not all individuals are offered health cover under the scheme. Here is a list of those not covered: 

  • Legal officers including state counsels, prosecutors, advocate generals, public prosecutors, etc.

  • Central Government Health Scheme (CGHS) beneficiaries

  • Employees of Road Transport Corporation, ESIS, Aarogya Sahayata of Prohibition, Aarogya Bhadratha of Police Department, Excise Department and Railways

  • Daily wage workers, AIS officers and pensioners

  • Any independent children, biological parents in case there are adopted parents as well

How to Enrol as an Employee Under EHS?

For employees who are currently working with the Andhra Pradesh State Government are required to register by following these steps: 

  1. Go to the official EHS website

  2. Enter the employee ID as the username and a password to log in as an employee

  3. Fill in all the necessary details and save

  4. Now, select the ‘Print Application’ option and take a printout for reference

  5. Click on ‘Submit Application’ online

All applications reach the Drawing and Disbursing Officer (DDO) of an area who is responsible for verification, after which your EHS health card is generated.

Eligibility Criteria of EHS (YSRAHCT)

Unlike health insurance available on Bajaj Markets, which can be purchased by anyone irrespective of the place of residence in India, this State Government scheme can only be availed by certain beneficiaries as explained below:

Beneficiary

Details

Currently employed State Government employees

This includes regular government employees as well as those on provisional duties of local bodies in Andhra Pradesh

State Government employees who are no longer working

Service pensioners of Andhra Pradesh state, including those who have been re-employed, family pensioners with no dependents

Dependents

Parents, either biological or adopted

Legally wedded husband or wife of currently employed or retired employees of Andhra Pradesh state 

Legal dependent children biological or adopted

Besides, EHS classifies the dependents further as follows –

  • Parents: Financially dependent on the employee

  • Children: Daughters who are unemployed/unmarried/widowed/divorced/deserted and sons who are 25 years of age or below

  • Disabled Children: Children and young adults who are unable to find employment because of their disablement

Documents Required for EHS Pensioners Registration Process

You require scanned copies of the below-mentioned documents to register as a pensioner with the EHS or Employee Health scheme:

  • Aadhaar card with photo and number

  • 45mm x 35mm passport size photograph (size: 200 kb)

  • Disability certificate, if any

  • Pension or employee ID of spouse if working with the state government

  • Birth certificate of dependent family members below the age of 5 years

How to Update Details for the Employee Health Scheme?

In case, employees want to correct, edit or update any information on the EHS AP employee health card for themself or a family member, they can:

  1. Visit the EHS website

  2. Enter the EHS AP login ID, which is the employee ID, and the first-time password

  3. You should now be able to make changes, upload photographs or update any details under the Employee Health Scheme

How to Search for Employee Enrolment Status?

To know your EHS enrolment status, follow the procedure below: 

  1. On the EHS website, go to ‘Search Employee Enrolment Status’ under the employee category.

  2. Enter your name, date of birth, department and DDO details to initiate a search by clicking on it.

  3. If you are enrolled for an EHS card, a message with ‘application approved’ is displayed. Otherwise, the status is shown as ‘Not Enrolled’.

  4. In the latter case, click on ‘Enrol’ and enter your email ID and contact details to receive the username and password for login. Click on ‘Save Details’.

How to Check Employee Medical Reimbursement Status?

You can find out the medical reimbursement status of your EHS card using the instructions below: 

  1. Go to the EHS - YSRAHCT service link 

  2. Click on the ‘Employee Medical Reimbursement Status’ option

  3. On the new page, select if the process was initiated online or offline

  4. Enter the DME number, and Trust number, and click on ‘Search’

  5. Details such as the employee name, DME number, patient name and other information will be revealed along with the EHS reimbursement status

How to Enrol as a Pensioner Under EHS?

Past employees of the Andhra Pradesh government who have retired from service or draw pension can also register for the EHS health card. You can either go to the STO/APPO or association representatives or submit the application online in the following way:

  1. Go to the official EHS - YSRAHCT website 

  2. Input the EHS AP login and password. In case the user ID is not known, contact the STO/APPO or dial the EHS Toll-Free Number 104.

  3. Once logged in, go through the instructions on the page and fill out the enrolment form with the necessary details.

  4. Upload the supporting documents and verify the information before submitting the application.

  5. Proceed to take a printout of the application form.

  6. Sign the application form and upload the signed document form online.

  7. Take a printout of the form with the signature and submit it with your respective STO/APPO.

  8. An acknowledgement will be shared either on the given phone number or by mail.

Sample Application Form for EHS Pensioners

Details

What to fill

PPO number

Enter the Pension Payment Order (PPO) number

Name

As stated in PPO

Aadhaar card number

As stated in Aadhaar card

Aadhaar enrolment Id

As written in the acknowledgement slip

Date of birth

As per PPO

Gender

Male or Female

Married or single

Current status

Retirement date

Day on which retired

Community

SC or ST, Minorities, others

Disability

Details about type and percentage of disability

Nationality

Whether a resident of India

Contact details

Address

Current residential address. Also update your mobile number and email id

Identification details

Ration card number

As in the ration card allotted to you

Marks of identification

Any two visible marks on your body with their exact location

Posting details

HOD

Name of your head of Department

District

District where you were posted

Pay grade

Pay details of your last post

STO or APPO

Code and Name of the office from where your pension is coming to

Attachments

Photo

ICAO compliant passport size photographs 35X45mm in size of the employee or pensioner along with the dependent family members

Aadhaar card

Scanned copy with Aadhaar number and photo visible clearly

Date of birth

When one of the dependent family members is a child below 5 years of age

Disability certificate

For any disabled family members

Family member details

Name, relationship, Aadhaar number

 

Employee id/pensioner ID of spouse

 

 

How to Check Pensioners Medical Reimbursement Status?

To know whether medical expenses have been reimbursed, follow the steps below: 

  1. Visit the EHS section on the Aarogyasri Health Scheme portal

  2. Scroll down to the ‘Pensioner’s’ section and click on ‘Pensioners Medical Reimbursement Status’

  3. On the new page, confirm the online or offline reimbursement initiation

  4. Enter the Trust Number and DME number to know the EHS reimbursement status

Enrolment Process for EHS Health Card

Once you register for the scheme, your application is processed and scrutinised, following which temporary EHS - YSRAHCT health cards are generated for you and other family members. You can take the printout of these cards by logging onto the EHS portal for Andhra Pradesh with your username and password. You can get your EHS health card laminated by paying a nominal fee at the Mee Seva Centre.

How to Download the EHS Health Card?

After you receive an intimation of your EHS card approval either by SMS or e-mail, you can download it online by logging into the EHS website. Just follow the steps below: 

  1. Visit the EHS portal and click on ‘Download Health Card’

  2. You will be redirected to a new page. Enter your User ID and click on ‘Go’. Your EHS health card is generated.

Claim Process of EHS

The primary aim of EHS is to cover the treatment expenses of the beneficiaries of the scheme. Therefore, there is no claim process as such that the employee/pensioner or their family members need to follow. The claim is raised by the network hospital 10 days after the patient is discharged and settled by the Trust Portal. In other words, retirees, pensioners, or their family members do not need to be involved in the claim process.

Empanelled Hospital List Under the Employee Health Scheme

You can use your AP Employee Health Card at the empanelled hospitals listed under the Employee Health Scheme. Follow the steps below to know the cashless EHS hospital list:

  1. Visit the EHS section on the Aarogyasri Health Scheme portal.

  2. Select the ‘List of Empanelled Hospitals for EHS’ option present at the bottom of the page.

  3. Select your state, district, and speciality from the drop-down menu.

  4. When you click on ‘Search’, the system will display the cashless EHS hospital list as per your preference.

EHS Toll-Free Number and Address

Government employees can dial the EHS Toll-Free Number 104 for any queries about the scheme. If you have any complaints or other issues related to your EHS card, dial 8333817469/14/06 or 0863-2259861 (Ext: 326). Alternatively, you can also send a mail at ap_ehf@ysraarogyasri.ap.gov.in. 

To know the medical reimbursement status and other related information dial 8333817363 or 0863-2259861 (Ext: 329). An e-mail can also be sent to ap_mr@ysraarogyasri.ap.gov.in. The CEO can be reached at 0863-2259861 (Ext: 302).

Address: If you want to send a mail about the Employee Health scheme or visit the Dr YSR Aarogyasri Health Care Trust, here is the address: D.No. 25-16-116/B, Chuttugunta, Behind Gautam’s Hero Showroom, Guntur – 522004, Andhra Pradesh, Phone: 0863-2222802/2259861

Health Insurance Plans Available at Bajaj Markets

FAQs on Employee Health Scheme

✔️How can I find my EHS ID?

 Dial the toll-free helpline number to know your user ID which is required to log into the EHS web portal. You can also contact the Sub Treasury Office (STO)/Assistant Program Officer (APO) in your area.

✔️What is the amount of health cover offered under EHS by the Andhra Pradesh government?

 A maximum of ₹2 Lakh for every episode of illness is offered to government employees, pensioners and their dependent family members. The number of episodes is limited as per APIMA Rules, 1972.

✔️How much do an employee and the state government contribute towards the EHS?

 The contribution of the State Government versus the employee is in the ratio of 60:40. The monthly contribution of employees ranges from ₹90 to ₹120 depending on their slabs and pay grades.

✔️How to check my EHS approval?

 You can check the EHS application status online. Follow the step-by-step guide to check the EHS application status as explained above.

✔️How much do the employees and the State Government contribute towards the EHS?

The employee contributes 40% while the remaining 60% is covered by the State Government. Based on this, the monthly contribution is:

Slab A (Pay Grade I to IV): ₹90

Slab B (Pay Grade V to XVII): ₹90

Slab C (Pay Grade XVIII to XXXII): ₹120

✔️What kind of financial protection does the EHS provide?

The EHS provides a cashless hospitalisation facility to employees, pensioners, and their family members. It provides a cover of maximum of ₹2 Lakh for every illness episode. EHS Health Card limit of ₹2 lakh is applicable only if the package of the eligible employee does not exceed ₹2 lakhs. The claims above ₹2 Lakh are directed for settlement to the CEO of the Aarogyasri Trust.