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
Exclusion
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
link- https://ehs.ap.gov.in
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.