Employee Health Scheme (EHS) Andhra Pradesh: Cashless Medical Treatment

The Employee Health Scheme (EHS) is an initiative by the Dr. YSR Aarogyasri Health Care Trust under the Government of Andhra Pradesh. It aims to provide cashless medical treatment to state government employees, pensioners, and their dependent family members. The scheme has replaced the medical reimbursement process and offers post-hospitalization care and treatment for chronic diseases at empanelled hospitals or Network Hospitals (NWH).

This scheme ensures that both serving and retired state government employees receive quality healthcare services without financial strain.

Benefits

  • In-Patient Treatment: Provides cashless hospitalization for employees, pensioners, and dependents. Covers listed therapies for identified diseases, including complications up to 30 days post-discharge and free out-patient evaluation for selected therapies.
  • Follow-Up Services: Covers consultation, investigation, and medication for up to one year after treatment.
  • Chronic Disease Treatment: Provides out-patient treatment for pre-defined chronic illnesses at notified hospitals.
  • Hospital Stay: Room entitlement varies by pay grade:
    • Slab A (Pay Grades I-IV): Semi-private ward
    • Slab B (Pay Grades V-XVII): Semi-private ward
    • Slab C (Pay Grades XVIII-XXXII): Private ward
  • Financial Coverage:
    • ₹2 lakhs per illness episode
    • Claims exceeding ₹2 lakhs are reviewed and settled by the CEO of the Aarogyasri Trust

Eligibility

1. Serving Employees

  • All regular State Government employees as per Fundamental Rules.
  • Provincialized employees of local bodies.

2. Retired Employees

  • Service pensioners
  • Family pensioners
  • Re-employed service pensioners

Exclusions

  • Employees covered under other insurance schemes (CGHS, ESIS, Railways, RTC, Aarogya Bhadratha, Aarogya Sahayatha).
  • Law officers (Advocate General, State Prosecutors, Government Pleaders, Public Prosecutors).
  • Casual and daily-wage workers.
  • Biological parents if adopted parents exist.
  • Independent children.
  • All India Services (AIS) Officers and Pensioners.

Application Process

Online (For Employees)

  1. Visit the official EHS Web Portal.
  2. Login using Employee ID and password.
  3. Enter the required details and click Save.
  4. Click Print Application for reference.
  5. Click Submit Application.
  6. The application is sent to the Drawing and Disbursing Officer (DDO) for verification.
  7. After verification, the EHS Health Card is generated and available for download.

Online (For Pensioners)

  1. Visit the EHS Web Portal.
  2. Login with Username and Password (contact STO/APPO if details are unavailable).
  3. Fill out the Enrollment Form (including department and district details).
  4. Attach supporting documents and verify all details.
  5. Click Submit and print the application form.
  6. Sign the form, upload the signed document, and submit it to STO/APPO.
  7. An acknowledgment SMS/email is sent. If errors occur, the application must be resubmitted.

Documents Required

  • Aadhaar Card
  • Recent Passport Size Photograph (ICAO compliant, max 200KB)
  • Disability Certificate (if applicable)
  • Spouse’s Pensioner ID/Employee ID (if applicable)
  • Date of Birth Certificate (for dependent children under 5 years)

Frequently Asked Questions

  1. What is the financial coverage offered by the Andhra Pradesh government under EHS?
    The scheme provides ₹2 lakh per illness episode, with additional coverage for cases exceeding this limit upon approval by the Aarogyasri Trust CEO.
  2. How do I check the status of my EHS application?
    You can check the application status on the EHS Web Portal by logging in with your Employee ID or Pensioner ID.
  3. How do I find my EHS ID?
    Your EHS ID can be found on your EHS Health Card or by contacting STO/APPO or the EHS Helpline.
  4. How do I check the medical reimbursement status for pensioners in Andhra Pradesh?
    Pensioners can track their medical reimbursement status on the EHS Web Portal or contact the respective STO/APPO office.
  5. What is the contribution ratio of the State Government versus the employee towards EHS?
    The State Government funds the scheme entirely, and employees do not contribute towards EHS.
  6. How much is the monthly contribution for EHS for different pay grades?
    There is no monthly contribution required from employees or pensioners.
  7. Do I need to apply for EHS coverage after hospitalization?
    No, the EHS scheme provides cashless treatment, so pre-registration is required to avail of benefits at empanelled hospitals.

Sources And References

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top