- Details
- Benefits
- Eligibility
- Exclusions
- Application Process
- Documents Required
- Frequently Asked Questions
- Sources And References
- Feedback
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Andhra Pradesh
Employee Health Scheme
Cashless Treatment
Government Employees
Health Coverage
Hospitalisation
Pensioners
Details
The Dr YSR Aarogyasri Health Care Trust, under the auspices of the Government of Andhra Pradesh, has implemented the Employee Health Scheme (EHS) with the primary objective of providing quality healthcare to all State Government Employees. The scheme covers government employees, pensioners and their dependent family members, who are eligible for cashless treatment at empanelled hospitals or Network Hospitals (NWH).
The EHS has replaced the erstwhile medical reimbursement process and offers new features such as post-hospitalisation medical care and treatment of chronic diseases. This scheme is applicable to both serving and retired employees of the state government of Andhra Pradesh. It is aimed at providing comprehensive healthcare services to the beneficiaries and ensuring their well-being by offering high-quality medical services.
Benefits
- In-Patient Treatment: The Employee Health Scheme (EHS) aims to provide cashless hospitalization to eligible beneficiaries such as employees, pensioners, and their dependents. The scheme covers listed therapies for identified diseases, providing end-to-end cashless services until 10 days post-discharge, including coverage of complications up to 30 days post-discharge. Additionally, free out-patient evaluation is available for listed therapies.
- Follow-Up Service: The EHS provides follow-up services up to 1-year, including consultation, investigation, drugs, etc., on listed therapies. The scheme offers packages that cover a range of services for eligible beneficiaries.
- Out-Patient Treatment for Chronic Diseases: The scheme covers treatment of pre-defined chronic diseases at notified hospitals. This is aimed at ensuring the well-being of beneficiaries suffering from chronic illnesses.
- Hospital Stay: Depending on their pay grade, eligible beneficiaries are provided with hospital stays in either semi-private or private wards. Slab A (Pay Grades – I to IV) is entitled to a semi-private ward, Slab B (Pay Grades – V to XVII) is entitled to a semi-private ward, and Slab C (Pay Grades – XVIII to XXXII) is entitled to a private ward.
- Financial Coverage: The EHS provides financial coverage of up to Rs. 2 lakhs per episode of illness, 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
Eligibility
1. Serving employees:
- All regular State Government employees. A State Government employee will have the meaning as defined under Fundamental Rules.
- Provincialised employees of local bodies.
2. Retired employees:
- All Service Pensioners
- Family pensioners
- Re-employed service pensioners
Exclusions
- Those who are covered under other insurance schemes such as CGHS, ESIS, Railways, RTC, Aarogya Bhadratha of the Police Department and Aarogya Sahayatha of Prohibition & Excise Department;
- Law officers, including Advocate General, State Prosecutors, State Counsels, Government Pleaders and Public Prosecutors;
- Casual and Daily paid workers;
- Biological parents if adopted parents exist;
- All independent children; and
- All India Services (AIS) Officers and AIS pensioners.
Application Process
Online
Employees:
EHS Employee Registration Process:
Step 1: Visit the web portal of EHS.
Step 2: Enter your Employee ID in the ‘Username’ section and the password. Log in as ‘Employee’ and click on ‘Login’.
Step 3: You will be directed to a new page, where you need to enter the required details of all the mandatory fields, then click on ‘Save’.
Step 4: Once you have filled all the fields, click on ‘Print Application’ to keep a soft copy of the application as a reference or you could take a printout.
Step 5: Now, click on ‘Submit Application’.
The application will be sent to the employee’s respective Drawing and Disbursing Officer (DDO). Once the DDO verifies the application, the EHS Health Card will be generated. You need to login to the EHS web portal with your username and password to download the card.
Pensioners:
Retired employees or pensioners can register for the EHS service online by following the instructions before they can log in to the EHS web portal.
Step 1: Visit the EHS Web Portal and log in with your Username and Password. If you do not have the details, contact STO/APPO or dialling EHS Toll-Free Number 104 to know your User ID.
Step 2: Sign in with your Username and Password and read the instructions provided on the website.
Step 3: Open the Enrollment Form and fill in all the details including your head of department, STO/APPO and District.
Step 4: Attach all supporting documents.
Step 5: Ensure you verify all data before submitting the application.
Step 6: Click on ‘Submit’ and take a printout of the application form.
Step 7: Sign the printout of the application form and upload the signed document back online.
Step 8: Now, take a printout of the signed application form and submit it with your respective STO/APPO.
An acknowledgement through SMS or email will be sent to your registered mobile number and email address, respectively. If it is rejected due to errors, then resubmit your application with the correct details.
Documents Required
- Aadhaar Card: Scan your Aadhaar Card and ensure the photo and the Aadhaar Number are clearly visible.
- Photograph: A scan of a 45mm x 35mm ICAO compliant passport size colour photograph of 200Kb size.
- Disability Certificates (if any)
- Spouse’s Pensioner ID/Employee ID: A scanned copy of the spouse In case working in the State Government or is a Service Pensioner.
- Date of Birth Certificate: A scan of the DOB Certificate of dependent family members less than 5 years of age.
Frequently Asked Questions
What is the financial coverage offered by the Andhra Pradesh government under EHS?
The financial coverage offered by EHS is up to Rs. 2 lakhs per episode of illness for state government employees, pensioners, and their dependent family members.
How do I check the status of my EHS application?
You can check the status of your EHS application online through the official website. Follow the step-by-step guide provided on the website to check the status.
How do I find my EHS ID?
You can find your EHS ID by contacting the 104-Seva Kendra by dialing 104, or by contacting the respective Sub Treasury Office (STO)/Assistant Program Officer (APO).
How do I check the medical reimbursement status for pensioners in Andhra Pradesh?
Pensioners can check the status of their medical reimbursement by following the same process as state government employees
What is the contribution ratio of the State Government versus the employee towards EHS?
The contribution ratio for EHS is 60:40, with the State Government contributing 60% and the employee contributing 40%.
How much is the monthly contribution for EHS for different pay grades?
The monthly contribution for Slab A (Pay Grade I to IV) and Slab B (Pay Grade V to XVII) is Rs. 90, while the monthly contribution for Slab C (Pay Grade XVIII to XXXII) is Rs. 120
Do I need to apply for EHS coverage after hospitalization?
No, you do not need to apply for EHS coverage after hospitalization. The network hospital takes care of the process within 10 days of discharge.
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You need to sign in before applying for schemes
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It seems you have already initiated your application earlier.To know more please visit
Apply Now
You need to sign in before applying for schemes
Something went wrong. Please try again later.
It seems you have already initiated your application earlier.To know more please visit
Apply Now
Check Eligibility
Andhra Pradesh
Employee Health Scheme
Cashless Treatment
Government Employees
Health Coverage
Hospitalisation
Pensioners
Details
Benefits
Eligibility
Exclusions
Application Process
Documents Required
Frequently Asked Questions
The Dr YSR Aarogyasri Health Care Trust, under the auspices of the Government of Andhra Pradesh, has implemented the Employee Health Scheme (EHS) with the primary objective of providing quality healthcare to all State Government Employees. The scheme covers government employees, pensioners and their dependent family members, who are eligible for cashless treatment at empanelled hospitals or Network Hospitals (NWH).
The EHS has replaced the erstwhile medical reimbursement process and offers new features such as post-hospitalisation medical care and treatment of chronic diseases. This scheme is applicable to both serving and retired employees of the state government of Andhra Pradesh. It is aimed at providing comprehensive healthcare services to the beneficiaries and ensuring their well-being by offering high-quality medical services.
Was this helpful?
Share
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