Dr. YSR Aarogyasri Health Insurance Scheme: Cashless Medical Treatment in Andhra Pradesh

The Dr. YSR Aarogyasri Health Insurance Scheme was launched in 2007 by the Government of Andhra Pradesh to provide financial assistance to low-income families. The scheme follows a Public-Private Partnership (PPP) model and offers end-to-end cashless services for secondary and tertiary care treatments through a network of government and private hospitals.

Objectives

  • Ensure free quality hospital care and equitable access for BPL families.
  • Provide financial security against catastrophic health expenses.
  • Strengthen government hospitals through demand-side financing.
  • Offer universal health coverage for urban and rural poor in Andhra Pradesh.

Benefits

  • Hospital Care: Covers in-patient treatment for listed illnesses.
  • Out-Patient Care: Free treatments through health camps and network hospitals.
  • Cashless Services: Annual coverage of ₹5,00,000 per family.
  • Pre-Existing Disease Coverage: Covers illnesses before enrollment.
  • Follow-Up Care: Covers post-hospitalization treatments.
  • Family Health Insurance: Entire family can use the covered amount under a single policy.

Free Services Under The Scheme

  • Free admission to hospitals.
  • Doctor consultations (daily).
  • Nursing services.
  • Medical tests.
  • Medicines.
  • Surgery or treatment.
  • Free meals (breakfast & lunch).
  • 10 days of post-discharge medicines.
  • Transport charges for returning home after discharge.

Specialties & Treatments Covered

  • ENT Surgery
  • General Surgery
  • Ophthalmology
  • Glaucoma Surgery
  • Gynaecology & Obstetrics
  • Orthopaedic Surgery & Procedures
  • Cardiothoracic Surgery
  • Paediatric Surgeries
  • Neurosurgery
  • Surgical Oncology
  • Medical Oncology
  • Radiation Oncology
  • Plastic Surgery
  • Critical Care
  • General Medicine
  • Infectious Diseases
  • Cardiology
  • Nephrology
  • Neurology
  • Pulmonology
  • Gastroenterology
  • Psychiatry

Eligibility

  1. All Rice Card Holders are eligible.
  2. Families eligible for YSR Pension Kanuka Card and Jagananna Vidya and Vasathi Deevena Card.

For other families, eligibility criteria include:

  • Landowners holding:
    • Less than 12 acres of wetland
    • Less than 35 acres of dry land
    • Total less than 35 acres (wet & dry)
  • Households with an annual income of ₹5,00,000 or less (salary certificate proof).
  • Income tax filers with an annual income up to ₹5,00,000 (income tax return proof).
  • Employees earning ₹5,00,000 or less, including:
    • Outsourcing/contract/part-time employees
    • Sanitary workers
    • Honorarium-based government employees
    • Private sector employees
  • Municipal Property Tax payers for properties less than 3,000 SFT (334 Sq. Yds).
  • Households with only one personal car.

Exclusions

The scheme does not cover:

  • Knee replacement surgeries
  • Gamma-knife procedures in neurosurgery
  • Bone marrow treatments
  • Leprosy
  • Filaria
  • Assisted devices for cardiac failures
  • Cardiac and liver transplants
  • Malaria, HIV/AIDS, Tuberculosis
  • Infectious diseases (e.g., gastroenteritis, jaundice)

Application Process

Online

  • No separate enrollment required—all BPL families with a valid white ration card are automatically covered.
  1. Visit the Dr. YSR Aarogyasri Health Insurance Scheme official website.
  2. Login using your ID and password.
  3. Fill the online application form and attach the required documents.
  4. Review and submit the application. Keep a printout for reference.
  5. To avail benefits, visit:
    • PHC/CHC/Area Hospital/District Hospital
    • Any government hospital near you
    • Health camps (carry your White Card/Health Card and medical reports).
    • Directly visit network hospitals in case of emergency.

An ArogyaMithra is available at hospitals, PHCs, CHCs, and health camps to register patients and guide them for cashless treatment.

Documents Required

  • Aadhaar Card
  • Address Proof
  • Income Certificate
  • BPL Certificate

Frequently Asked Questions

  1. What is Dr. YSR Aarogyasri Scheme?
    It is a health insurance scheme providing cashless treatment for low-income families in Andhra Pradesh.
  2. How much financial coverage is provided under the scheme?
    The scheme offers ₹5,00,000 per family per year.
  3. Who are the beneficiaries under the scheme?
    All Rice Card holders, YSR Pension Kanuka Card holders, and Jagananna Vidya and Vasathi Deevena Card holders.
  4. What are the ailments covered under the scheme?
    The scheme covers specialties like cardiology, neurology, nephrology, oncology, plastic surgery, and more.
  5. How do I know if I am suffering from covered diseases?
    Visit any government hospital, PHC, CHC, or network hospital for free screening.
  6. What about coverage for other diseases?
    The scheme covers pre-existing diseases but excludes some conditions like tuberculosis, malaria, and HIV/AIDS.
  7. What is the role of government hospitals?
    Government hospitals serve as screening centers and provide free treatment under the scheme.
  8. Who implements the scheme?
    The scheme is implemented by the Dr. YSR Aarogyasri Health Care Trust under the Government of Andhra Pradesh.
  9. Who pays the premium?
    The State Government of Andhra Pradesh covers the premium costs.
  10. Is there an enrollment process?
    No, all eligible BPL families with white ration cards are automatically covered.
  11. Can all hospitals in Andhra Pradesh provide treatment under this scheme?
    No, only empanelled government and private hospitals can provide treatment.
  12. Is there any person to assist beneficiaries in hospitals?
    Yes, ArogyaMithras are available in all PHCs, CHCs, government hospitals, and network hospitals to assist with registration and cashless treatment.
  13. How can I recognize an ArogyaMithra?
    ArogyaMithras wear uniforms with ID cards and are stationed at hospitals to assist beneficiaries.
  14. What other services do ArogyaMithras provide?
  • Help in registration and admission.
  • Guide patients on treatment procedures.
  • Assist in referral to network hospitals.
  1. How can I avail the benefits under the scheme?
  • Visit any PHC, CHC, Area Hospital, District Hospital, or empanelled hospital.
  • Present your White Card/Health Card.
  • Consult with an ArogyaMithra for free treatment registration.

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