Rising medical costs and the 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 (EHS), launched under the aegis of Dr YSR Aarogyasri Healthcare Trust, is one such initiative that is supervised by the Andhra Pradesh government. Government employees, their families, as well as pensioners can avail cashless treatment at any empanelled network hospital under the scheme. Earlier, the beneficiaries were provided with a medical reimbursement facility which has been replaced by this scheme.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 |
Features 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 |
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 |
State Government employees who are no longer working |
Service pensioners 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 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
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
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
For employees who are currently working with the Andhra Pradesh State Government are required to register by following these steps:
Go to the official EHS website (https://www.ehs.ap.gov.in/EHSAP/loginAction.do?actionFlag=loginPage&theme=navyblue#)
Enter the employee ID as the username and a password to log in as an employee
Fill in all the necessary details and save
Now, select the ‘Print Application’ option and take a printout for reference
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.
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:
Visit the EHS website (https://www.ehs.ap.gov.in/EHSAP/loginAction.do?actionFlag=loginPage&theme=navyblue#).
Enter the EHS AP login ID, which is the employee ID, and the first-time password
You should now be able to make changes, upload photographs or update any details under the Employee Health Scheme
To know your EHS enrolment status, follow the procedure below:
On the EHS website, go to ‘Search Employee Enrolment 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’.
You can find out the medical reimbursement status of your EHS card using the instructions below:
Go to the EHS - YSRAHCT service link (https://ysraarogyasri.ap.gov.in/web/guest/ehs).
Click on the ‘Employee Medical Reimbursement Status’ option
On the new page, select if the process was initiated online or offline
Enter the DME number, Trust number, and click on ‘Search’
Details such as the employee name, DME number, patient name and other information will be revealed along with the EHS reimbursement status
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:
Go to the official EHS - YSRAHCT website (https://www.ehs.ap.gov.in/EHSAP/loginAction.do?actionFlag=loginPage&theme=navyblue#).
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.
Once logged in, go through the instructions on the page and fill the enrolment form with the necessary details.
Upload the supporting documents and verify the information before submitting the application.
Proceed to take a printout of the application form.
Sign the application form and upload the signed document form online.
Take a printout of the form with the signature and submit it with your respective STO/APPO.
An acknowledgement will be shared either on the given phone number or mail.
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 |
To know whether medical expenses have been reimbursed, follow the steps below:
Visit the EHS section on the Aarogyasri Health Scheme portal (https://ysraarogyasri.ap.gov.in/web/guest/ehs)
Scroll down to the ‘Pensioner’s’ section and click on ‘Pensioners Medical Reimbursement Status’
On the new page, confirm the online or offline reimbursement initiation
Enter the Trust Number and DME number to know the EHS reimbursement status
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.
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:
Visit the EHS portal and click on ‘Download Health Card’
You will be redirected to a new page. Enter your User ID and click on ‘Go’. Your EHS health card is generated.
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.
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:
Visit the EHS section on the Aarogyasri Health Scheme portal (https://ysraarogyasri.ap.gov.in/web/guest/ehs).
Select the ‘List of Empanelled Hospitals for EHS’ option present at the bottom of the page.
Select your state, district, and speciality from the drop-down menu.
When you click on ‘Search’, the system will display the cashless EHS hospital list as per your preference.
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 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
For those residing in Andhra Pradesh and working as government employees in the state, registration in the Employee Health Scheme can ensure that you get the medical treatment for yourself and your family members. However, if you reside in any other part of India and are on a hunt for a customised health policy, health insurance available on Bajaj MARKETS is a good choice.
Choose a sum insured starting from ₹2 Lakh to as high as ₹50 Lakh that cover you and your family and put all your worries about hospitalisation expenses aside with cashless treatment available at a network of more than 6500 hospitals PAN India. Not only this, but the claims are also 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 Bajaj MARKETS today and ensure you are prepared for any health complications that may occur in the future to make sure your family gets the best care possible.
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.
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.
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.
You can check the EHS application status online. Follow the step-by-step guide to check the EHS application status as explained above.
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
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