COMPLETE INFO ABOUT EHS CARD IN AP

Andhra Pradesh's State Government has designed a healthcare program for its active and retired workers and their dependents, providing cashless medical treatment at numerous affiliated hospitals throughout the state. This plan replaces the existing medical reimbursement system and includes additional features such as coverage for chronic illnesses and post-hospitalization care. Keep reading to learn more about the eligibility requirements, coverage, and advantages of the Andhra Pradesh Employee Health Scheme.

What is Employee Health Scheme (EHS – YSRAHCT)?

To ensure access to quality healthcare for all, the Government of Andhra Pradesh has entrusted the implementation of the Employee Health Scheme (EHS) to the Dr. YSR Aarogyasri Health Care Trust. The scheme is designed to provide cashless medical treatment to Andhra Pradesh government employees, pensioners, and their dependents at empanelled hospitals or Network Hospitals (NWH). With the EHS, the existing medical reimbursement process is replaced, and beneficiaries can now avail additional benefits like post-hospitalisation care and coverage for chronic illnesses. The scheme is exclusively meant for serving and retired employees of the state government of Andhra Pradesh.

Features and Benefits of Employee Health Scheme:

The EHS has been designed to offer numerous benefits and features, providing cashless hospitalisation to the employees, pensioners, and their dependents. Below are the details of the benefits:

In-Patient Treatment

The EHS provides cashless hospitalisation for listed therapies of identified diseases, along with end-to-end service coverage until 10 days after discharge, including medication and complications coverage for up to 30 days post-discharge. Additionally, beneficiaries can avail of free out-patient evaluation for the listed therapies.

Follow-Up Service

The listed therapies packages offered under the EHS include services such as consultation, investigation, medication, and more, with coverage up to one year.

Out-Patient Treatment For Chronic Diseases

The EHS offers treatment for pre-defined chronic diseases at designated hospitals.

Hospital Stay

Under the EHS, beneficiaries falling under Slab A (Pay Grades I to IV) are eligible for semi-private ward accommodation, while those in Slab B (Pay Grades V to XVII) are eligible for semi-private ward accommodation. Those in Slab C (Pay Grades XVIII to XXXII) are eligible for private ward accommodation.

Financial Coverage

Beneficiaries of the EHS can claim up to Rs. 2 Lakhs per episode of illness, with no limit on the number of episodes. However, this eligible sum does not apply to predetermined packages that exceed Rs. 2 Lakhs. For claims exceeding Rs. 2 Lakhs, the settlement will be done by the CEO of Dr. YSR Aarogyasri Health Care Trust

What is Not Covered Under the EHS of the Government of Andhra Pradesh?

Although the EHS covers state government employees and their dependents, there are certain beneficiaries that are not covered under the scheme. Here is a list of beneficiaries not eligible for the EHS:

Those covered under the Central Government Health Scheme (CGHS).

Railways, Road Transport Corporation, ESIS, Aarogya Sahayatha of Prohibition, Aarogya Bhadratha of Police Department and Excise Department.

Law officers such as public prosecutors, government pleaders, state counsels, state prosecutors and advocate generals.

Biological parents if adopted parents exist.

Casual and daily wage workers.

Independent children.

AIS officers and pensioners.

Eligibility Criteria of EHS – YSR AHCT:

The EHS provides cashless hospitalisation for identified diseases at empanelled hospitals to serving and retired state government employees and their dependents. The scheme is further divided into the following categories for the Andhra Pradesh state government:

Serving State Government Employees

The Andhra Pradesh state government's Employee Health Scheme covers all regular state government employees, as well as provisionalised employees of local bodies.

Retired State Government Employees/Pensioners

Dependent Parents (either biological or adopted, not both).One Legally Wedded Spouse (Serving and Retired Employee)Dependent Legitimate Children (Step-Children and Adopted Children).Dependents of Family Pensioners.

Dependent Family Members

Under the Andhra Pradesh state government's Employee Health Scheme, the following beneficiaries are eligible:

Dependent parents (either biological or adopted, but not both)

One legally wedded spouse of serving and retired employees

Dependent legitimate children (including step-children and adopted children)

Dependents of family pensioners.

The EHS further classifies the meaning of Dependent Family Members by:

In addition to the beneficiaries mentioned earlier, the following dependents are also eligible for coverage under the Andhra Pradesh state government's Employee Health Scheme:

Parents who are dependent on the employee for their livelihood.

Unemployed daughters who are unmarried, widowed, divorced, or deserted.

Unemployed sons who are 25 years old or younger.

Disabled children who are unable to find employment due to their disability.

How To Enrol for the Employee Health Scheme?

If you are a state government employee in the state of Andhra Pradesh and wish to enroll in the Employee Health Scheme, please follow the procedures outlined below:

• Visit the official website of the Dr YSR Aarogyasri Health Care Trust.
• Navigate to the EHS section of the website.
• Download the enrollment form for the scheme.
• Fill out the form with the necessary information, including your personal details and those of your dependents.
• Submit the completed form along with the necessary supporting documents to your respective Drawing and Disbursing Officer (DDO).
• Once the enrollment is processed and approved, you will receive a health card for yourself and each of your enrolled dependents.
• You can use this health card to avail cashless treatment at any of the empanelled hospitals under the scheme.

The Employee Health Scheme (EHS) provides chronic out-patient treatment to serving employees of the state government of Andhra Pradesh for identified chronic diseases. The services are available on weekdays between 2 pm to 4 pm and include the following:

1. Doctor's consultation
2. Investigations, including laboratory and radiology services
3. Pharmacy services
4. In addition, employees aged above 40 years are eligible for a yearly health checkup.

List of Chronic OP Procedures:

Hypertension

Hyperthyroidism

Hypothyroidism

Rheumatoid Arthritis

Bronchial Asthma

Parkinson’s Disease

Type 1 and 2 DM

COPD

SLE and other Connective Tissue Disorders

Gout

CAD-Medical

Convulsive Disorder

Inflammatory Bowel Disease

Psychosis and Other Chronic Psychiatric Problems

Stroke

Vascular Occlusive Disorder of Extremities

Osteoarthritis

Psoriasis

Chronic Hepatitis

Cirrhosis

Cardiac Failure

Nephrotic Syndrome

Chronic Kidney Disease

Arrhythmias

Step-by-Step Employee Login Instructions:

In order to implement the Employee Health Scheme and issue Health Cards, the State Government has instructed all DDOs in Andhra Pradesh to gather the data of all state government employees online using web-based applications. However, if there is a need to edit, correct, or update information about the employee or their family members, the following procedure should be followed:

Step 1: Visit EHS Web Portal and log in using Employee ID as User ID, and the same User ID as a first-time password.

Step 2: You will be able to upload photographs and update dependent family members.

Search for Employee Enrollment Status:

Below is the process to know the status of the employee enrollment status online:

Step 1: Visit the EHS portal and under the Employee category, click on ‘Search Employee Enrollment Status’.

Step 2: On the new page, enter ‘Employee Name’, Date of Birth, Name of the Department and the respective DDO and click on ‘Search’.

Step 3: If the employee is already enrolled under the scheme, then the status would reflect as the application is approved.

Step 4: In case the employee is not enrolled under the EHS, then the status will reflect as ‘Not Enrolled’.

Step 5: On the same page, you need to click on ‘Enrol’. You may be asked to enter your email ID and contact number to send the Username and Password. Click on ‘Save Details’.

Employee Medical Reimbursement Status:

To know the medical reimbursement status of the EHS, serving state government employees need to follow the steps below:

Step 1: Visit the EHS service link and under the Employee menu, click on ‘Employee Medical Reimbursement Status’.

Step 2: You will be redirected to a new page. Here, you will have to select if the reimbursement was initiated online or offline.

Step 3: Enter the ‘Trust Number’.

Step 4: Enter the DME number and click on ‘Search’ and you will be able to view details such as Employee Name, Patient Name, DME no. along with the status.

Pensioners:

The State Government of Andhra Pradesh has replaced the existing Medical Reimbursement process with the Employee Health Scheme. Below is the registration process for pensioners or retired employees of the state government:

EHS Pensioners Registration Process:

Retired employees or pensioners can register to the EHS service online by following instructions before you can log in to the EHS web portal.

Instructions:

Aadhaar Card: A scan of your Aadhaar Card and ensure your photo and the Aadhaar Number is clearly visible.

Photograph: A scan of a 45mm x 35mm ICAO compliant passport size colour photograph of 200Kb size.

Disability Certificates

Spouse’s Pensioner ID/Employee ID: A scanned copy of 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.

Step-by-Step Pensioner Login Instructions:

With all the required documents, you need to submit the application online. Also, you can approach the STO/APPO along with the documents or can contact the association representatives. Below is the guide to submit and register for the scheme for pensioners:

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 by 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 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 print out of the application form.

Step 7: Sign the print out of the application form and upload the signed document back online.

Step 8: Now, take a print out of the signed application form and submit 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 correct details.

Steps to Enrol for EHS Health Card:

Once you follow the steps to register for the scheme, you have the option to get temporary health cards for you and your dependent family members. After the scrutiny of your application, temporary cards will be generated. You need to log in with your User ID and Password to take the print of the temporary card. This card can be laminated and used as your EHS Health Card. 

Also, you can get a laminated temporary card at any of the Mee Seva Centres. The cost is capped at Rs.25 per temporary card.

How to check Pensioners Medical Reimbursement Status:

To know the medical reimbursement status follow the steps below:

Step 1: Visit the EHS section of the Aarogyasri Health Scheme Web Portal.

Step 2: Under the ‘Pensioner’s menu’, click on ‘Pensioner Medical Reimbursement Status’.

Step 3: On the new page, select to confirm if the reimbursement was done online or offline.

Step 4: Enter the Trust Number and the DME Number and click on ‘Search’ to know the status.

Chronic Out-Patient Treatment:

The EHS offers out-patient treatment of chronic diseases to retired employees of the state government of Andhra Pradesh. Services are available only during the weekdays between 2 pm to 4 pm. Services include:

Consultation.

Investigations (radiology services and laboratory services).

Medicines

Claim Process of EHS:

The main objective of the scheme is to provide cashless treatment to serving and retired state government employees; hence, there is no need to follow the claim process by the employee/pensioner or their dependent family members. The concerned Network Hospital (NWH) will raise the claim after 10 days of discharge of the patient.

Once the claim is raised by the NWH, all claims related processes will be executed by the Trust Portal.

How to Download the EHS Health Card?

Once your application is approved and you have received the approval through an SMS or email, you can download the card online. Follow the steps below to know the AP EHS Health Card download process:

Step 1: Visit the EHS Portal and click on ‘Download Health Card’.

Step 2: In the new window, enter your ‘User ID’ and click on ‘Go’ to generate the EHS health card.

Employee Health Scheme by AP Govt. Hospital List:

The State Government of Andhra Pradesh has empanelled several hospitals across the state to offer cashless treatment to serving and retired state government employees. For more details of the employee health scheme hospital list, click here for NABH hospitals and for NWHs. Follow the steps below:

Step 1: Visit the EHS Section of the Aarogyasri Health Scheme and click on ‘List of Empanelled Hospitals for EHS’ at the bottom of the page.

Step 2: On the new window, select the state, district and speciality. Now click on ‘Search’ to know the list of empanelled hospitals in the district.

EHS Toll-Free Number and Address:

Below are the contact details of the EHS scheme for Andhra Pradesh state government employees:

EHS Toll-Free Number: 104

For Health Card Issues and Grievances Under EHS:

Phone Number – 8333817469/14/06 Or: 0863-2259861 (Ext:326).

Email ID – ap_ehf@ysraarogyasri.ap.gov.in

For Medical Reimbursement Status and Issues:

Phone Number – 8333817363 Or: 0863-2259861 (Ext: 329)

Email ID – ap_mr@ysraarogyasri.ap.gov.in

Contact CEO: 0863-2259861 (Ext: 302)

Dr. YSR Aarogyasri Health Care Trust Address

D.No. 25-16-116/B, Chuttugunta,

Behind Gautam’s Hero Showroom,

Guntur – 522004

Andhra Pradesh

Phone Number – 0863-2222802/2259861