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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 Earlier they were provided with a medical reimbursement facility which has been replaced by this scheme.
The primary objective of the EHS is to provide a cashless hospitalisation facility to employees, pensioners, and their family members. We have enlisted 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 |
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. |
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
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 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
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:
Log on to the EHS website and key in your employee ID as Username with the password to login as an employee.
Click on Login which directs you to a page wherein you need to fill all the necessary information and save it.
Now go to ‘print application’ and take out a print out for reference purpose
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.
The Employee Health Scheme provides cover for chronic outpatient treatment to the employees/pensioners of the State Government of Andhra Pradesh. The facility is available during weekdays between 2 pm and 4 pm and includes the following:
Doctor Consultation
Lab Investigation
Medicines
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.
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
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’.
You can find out the medical reimbursement status of your EHS card using the instructions below:
Go to the EHS- YSRAHCT 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.
Past employees of the Andhra Pradesh government who have retired from service or draw pension can also register for EHS health card.
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
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 - YSRAHCT 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 printout of the application form.
Sign the form and upload the signed form online.
Again, take a printout 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.
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 |
|
Once you register for the scheme, your application is processed and scrutinized, following which temporary EHS - YSRAHCT 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.
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
To know whether your medical expenses have been reimbursed, follow the steps below:
Visit the EHS section on the Aarogyasri Health Scheme portal.
Select ‘Pensioner’s Menu’ and click on ‘Pensioners Medical Reimbursement Status’.
You will be redirected to a new page. Confirm the online or offline reimbursement initiation.
Ener the Trust Number and DME number and proceed to know the status.
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, the retirees, pensioners, or their family members do not need to be involved in the claims process.
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. Follow the steps below for details on the employee health scheme hospital list.
Visit the EHS section on the Aarogyasri Health Scheme portal.
Select ‘List of Empanelled Hospitals for EHS’ present at the bottom of the page.
You will be redirected to a new page. Select your state, district, and specialty from the drop-down menu.
When you click on search the system will display the list of hospitals 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 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 that 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.
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 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.
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.
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): Rs.90
Slab B (Pay Grade V to XVII): Rs.90
Slab C (Pay Grade XVIII to XXXII): Rs.120
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