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Employee Health Scheme (EHS) - Health Card Eligibility & Enrollment

Rising medical costs as well as increasing incidence of diseases in the Indian population has spurred the launch of several state health insurance schemes by the Government of India. Employee Health scheme under the aegis of Dr YSR Aarogyasri Healthcare Trust is one such initiative that is supervised by the Andhra Pradesh government. Government employees and their families as well as pensioners can avail treatment without paying in cash at any empanelled hospital that is part of the network. Earlier they were provided with a medical reimbursement facility which has been replaced by this scheme.

Salient Features of The Scheme

The EHS card helps a beneficiary avail several benefits as described below:

Facilities under the scheme

What is offered

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

Hospital stay

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 Rs. 2 Lakhs for every illness episode.

If packages exceed the Rs. 2 Lakhs limit, the above sum does not apply.

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

Employee Health Scheme – Exclusions

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

Who is Eligible for An EHS Health Card?

Unlike Health insurance available on Finserv 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

State government employees who are no longer working

Service pensioners including those who have been re-employed, family pensioners with no dependants

Dependents

-Parents, either biological or adopted

-Legally wedded husband or wife of currently employed or retired employees

-Legal dependent children biological or adopted

Dependent family members may also include unemployed sons below 25 years of age, unemployed daughters either widowed, unmarried or divorced as well as disabled children.

Enrollment Process for Employee Health Scheme

Depending upon which category you fall into, you need to follow the registration process for the EHS card as under

Employees: Those who are currently working with the Andhra Pradesh state government are required to register as under:

EHS Employee Registration Process

  1. Log on to the EHS website and key in your employee ID as Username with the password to login as an employee.

  2. Click on Login which directs you to a page wherein you need to fill all the necessary information and save it.

  3. Now go to ‘print application’ and take out a print out for reference purpose

  4. End the process by clicking on ‘submit application’.

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.

Chronic Outpatient Treatment

A serving Andhra Pradesh government employee has access to outpatient treatment for chronic diseases under EHS on weekdays between 2 to 4 pm including consultation by the doctor, lab investigations and pharmacy. Those above 40 years of age are also provided with annual health check ups. Operation procedures for conditions such as cardiac failure, Parkinson’s Arrhythmia, Cirrhosis, stroke, kidney diseases and others are covered.

Login Process for Employee

In case, an employee wants to correct, edit or update any information on the EHS health card about him or her or a family member, here is how to login to make the necessary changes:

  • Visit the EHS website and enter your employee id as the user ID as well as your first-time password
  • Once logged in, make the changes that you wish to do online

Search For Employee Enrollment Status

To know the status of your Employee Health scheme enrollment, follow the procedure below:

  • On the EHS website, go to ‘search employee enrollment status’ under the employee category
  • Enter your name, date of birth, department and DDO details to initiate a search by clicking on it
  • If you are enrolled for an EHS card, a message with ‘application approved’ is displayed. Otherwise the status is shown as ‘not enrolled’
  • 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 Know The Status Of Your Medical Reimbursement

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

  • Go to the EHS service link and click on ‘Employee Medical Reimbursement Status’
  • On the new page that opens choose whether you initiated the process online or offline
  • Enter the ‘Trust number’, DME number and click on ‘Search’
  • The employee name, patient name, DME number and other details will be revealed along with the status.

Pensioners

Past employees of the Andhra Pradesh government who have retired from service or draw pension can also register for EHS health card.

EHS Pensioners Registration Process

Following instructions need to be adhered to while trying to register as a pensioner with the Employee Health scheme

A scanned copy of the documents mentioned below is required for the application:

  • Aadhar card with photo and number
  • 45mmX35mm passport size photograph( size:200 kb)
  • Disability certificate if any
  • Pension or employee ID of spouse if working with the state government
  • Date of birth certificate of dependent family members below the age of 5 years

Login Process For Pensioner:

Once you have the documents above, you can either submit the application online or go to the STO/APPO or association representatives. Here is how to login online:

  • Log on to the EHS website with your username and password. Contact STO/APPO or dial EHS Toll-Free Number 104 in case you do not know your User ID.
  • Once logged in, go through the instructions and open the enrolment form. Fill it properly
  • Submit the supporting documents and thoroughly check the information before you submit the application
  • Click on ‘submit’ and then take a print out of the application form
  • Sign the form and upload the signed form online
  • Again take a print out of the form with your signature
  • Deposit this with your respective STO/APPO

You will receive an acknowledgement either on your phone or mail ID.

A Sample EHS Pensioner Application Form

Details

What to fill

PPO number

Enter the Pension payment order number

Name

As stated in PPO

Aadhar card number

As stated in Aadhar card

Aadhar 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

Attachments

Photo

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

Aadhar card

Scanned copy with Aadhar 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, Aadhar number

 

Employee id/pensioner ID of spouse

 

Enrollment Process For EHS Health Card

Once you register for the scheme, your application is processed and scrutinized, following which temporary EHS health cards are generated for you and other family members. You can take the print out of these cards by logging onto the EHS portal with your User ID and password. Get your EHS health card laminated by paying a nominal fee at the Mee Seva centre.

Steps To Check Pensioners Medical Reimbursement Status

To know whether your medical expenses have been reimbursed go to the EHS website and click on ‘Pensioners Medical Reimbursement Status’ under the pensioners category. Confirm the online or offline reimbursement initiation. Key in the trust number and DME number and click on status to know more.

Chronic Outpatient Treatment

Retirees and pensioners of the state government of Andhra Pradesh are entitled to doctor consultation, lab investigations and medicines as a part of the Employee Health scheme.

Claim Process Of EHS

The claim is raised by the network hospital 10 days after the patient is discharged and settled by the Trust portal. Retirees, pensioners or their family members do not need to be involved in the claims process.

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 to the EHS website. Simply click on “download health card’. Enter your user ID and click on go. Your EHS health card is generated.

Employee Health Scheme By AP Government Hospital List

If you want to know about the hospitals empanelled with the Employee Health scheme where you can utilize your EHS health card you can easily do so by visiting the official website of the Aarogyasri Health Scheme.

Go to the EHS section and scroll down to the bottom of the page to click on the list of empanelled hospitals for EHS. Select your state, district and specialty from the drop down menu to display the list of hospitals 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. Alternatively, you can also send a mail at ap_ehf@ysraarogyasri.ap.gov.in.

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

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

Conclusion

For those residing in Andhra Pradesh and working as government employees in the state, registration in the Employee Health scheme can ensure that they get the medical treatment for themselves and their family members. However, if you reside in any other part of India and are on a hunt for a customized health policy, Health Insurance available on Finserv MARKETS is a good choice.

Choose a sum insured starting from Rs. 2 Lakhs to as high as Rs. 50 Lakhs, cover just yourself or your family and put all your worries about hospitalization expenses aside with cashless treatment available at a network of more than 6500 hospitals PAN India. Not only this, claims are settled promptly within an hour of being raised so that you don’t have to go through any inconvenience.

So opt for Health Insurance available on Finserv MARKETS today and protect your loved ones from any health complications in the future to make sure they get the best care possible.

FAQs about Employee Health Scheme (EHS)

  • ✔️How can I find my EHS ID?

    Dial the toll free helpline number to know your user ID which is required to login to 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 Rs. 2 Lakhs for every episode of illness is offered to government employees, pensioners and their dependent family members. The number of episodes are limited as per APIMA Rules, 1972.

  • ✔️How much does 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. Monthly contribution of employees ranges from Rs. 90 to Rs. 120 depending on their slabs and pay grades.

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