Team AckoSept 11, 2023
Aarogya Raksha literally translates to ‘the protection of health’, “Aarogya” means health and “Raksha” translates to protection. The aim of this health insurance scheme is to provide quality health care services to one and all, irrespective of the income group they belong to. In this article, we will take a look at the details about Aarogya Raksha health insurance plan.
Aarogyaraksha is a health insurance scheme launched by Andhra Pradesh Chief Minister N Chandrababu Naidu on 1st January 2017. The aim of NTR Aarogya Raksha is to provide health insurance coverage for everyone. Thus, Aarogya Raksha covers both – Below Poverty Line and Above Poverty Line families.
Arogya Raksha is a one-of-a-kind health insurance scheme that facilitates beneficiaries to avail quality health care.
Cashless Facilities : The beneficiaries of Aarogyaraksha do not have to worry about paying for the entire cost of a medical emergency. This scheme provides cashless facilities across empanelled hospitals.
Numerous Empanelled Hospitals: One of the most advantageous features of the scheme is both – government and private hospitals are empanelled under the plan. This is highly beneficial for the patient as he/she can spend less time in travelling during a medical emergency and treatment can begin sooner.
Large Scope of Coverage: A wide range of diseases is covered with Aarogya Raksha. This includes more than 1059 treatments. This mitigates the chances of a patient being denied treatment for a particular ailment.
Coverage For Follow-up Treatments: This is a unique feature that is available with the Aarogya Raksha scheme. It provides coverage for follow-up treatments as these can cost a large sum of money to the patient and his/her family.
Ayurvedic Treatment Coverage: If a beneficiary wishes to avail Ayurvedic treatment in a Government Hospital, it will be covered under the scheme. Treatment availed in any Quality Council of India/National Accreditation Board on Health accredited hospital is covered.
Aarogya Raksha is available in three plans based on the number of beneficiaries covered. The sum insured of the plan ranges from Rs. 1 lakh to 10 lakhs. Here are the details:
Plan A: The exit age of this plan is 35 years and covers the account holder, two dependent children, and a spouse. The premium of this plan is between Rs. 2000 to 14500.
Plan B: The exit age of this plan is 70 years and covers the account holder, two dependent children, and a spouse. The premium of this plan is between Rs. 3000 to 25500.
Plan C: The exit age of this plan is 70 years and covers the account holder, two dependent children, dependent parents, and a spouse. The premium of this plan is between Rs. 5000 to 62500.
Situations that are not covered under an insurance policy are called Exclusions. An insurance company is not liable to pay the policyholder for exclusions. In case a claim is still being raised for such exclusions, it will be rejected. Here are the exclusions of the Aarogya Raksha health scheme:
Cost of vaccination or inoculation unless required as a treatment after an animal bite
Plastic or cosmetic surgery unless required as a result of an accident. A cosmetic surgery done for aesthetic purposes without an accidental injury is not covered.
Change of gender surgeries
Expenses related to spectacles, contact lenses, or hearing aids
Dental surgery is required as a result of an accident. A dental treatment done for aesthetic purposes without an accidental injury is not covered.
Expenses related to psychiatric and psychosomatic disorders
Infertility or sterility
Expenses related to medical treatment arising out of excessive use of intoxicating substances
Expenses related to the treatment of AIDS
Cost of vitamins and tonics unless prescribed by a certified medical professional as a part of treatment
Stem Cell implantation/surgery
Injuries due to war
All Above Poverty Line (APL) and Below Poverty Line (BPL) families belonging to Andhra Pradesh are eligible to enrol under this health scheme. There are no criteria set on the minimum income of a family.
Irrespective of the method of registration the beneficiary will require the following documents along with an active contact number that is linked to the Aadhaar card:
Also, check: Arogya Sanjeevani Health Insurance
The enrolment process of Aarogya Raksha Scheme, is fairly easy. New registration or renewal can be done quickly with the right set of documents. The registration process can be done in two ways – from the insurance company or by visiting the local kiosk. Following are the details of both:
You can register as a new beneficiary in the following two ways:
From an insurance company: Visit your preferred insurance company’s website (for example United India Insurance Co. Ltd) and navigate to the Aarogya Raksha webpage. You will see the Aarogya Raksha Application Forms. Fill out the details and complete the process by making payment. Your insurer will now guide you on downloading Aarogya Raksha Health Card.
By visiting the local kiosk: You need to carry your Aadhaar card and an active cell phone which is linked to the Aadhaar card. These will help the kiosk operator to complete your registration process. The operator will ask for your Aadhaar number and then you will receive the One Time Password. Please share this OTP with the Kiosk operator. The operator will print your Aarogya Raksha health card after the registration process is complete.
Note that you will require a printer for printing the Aarogya Raksha Health Card. Here are the steps to download your health card:
Step 1: Visit Dr.YSR Aarogyasri Healthcare Trust’s official website
Step 2: Click on Aarogya Raksha button
Step 3: Click on ‘Click here to enrol’
Step 4: Enter your Aadhaar number in the box and click ‘Go’
Step 5: Enter Mobile number and click on ‘Send OTP’
Step 6: Enter OTP and click on ‘Verify’
Step 7: Select a family member and click on ‘Download Health Card’
A claim against Aarogyaraksha policy can be made in the following two ways. The government has made sure that a claim will be settled in a smooth and quick manner irrespective of its type.
Cashless Claims: The beneficiary of this scheme must avail treatment from a network hospital only if he/she wishes to file cashless claims. Network hospitals are those health care facilities that are pre-approved to provide cashless treatment to the beneficiaries of Aarogyaraksha insurance. The beneficiary will receive a list of network hospitals for reference. Before starting treatment, the TPA will provide approval and cashless claims can be registered. The beneficiary then needs to pay only the excess amount, if any.
Reimbursement Claim: This is a type of claim where the beneficiary pays for the entire cost of treatment and then approaches the insurer for reimbursement. This claim can be availed at any hospital irrespective of its empanelment. A reimbursement claim is beneficial in a situation where the beneficiary has adequate financial aid and wishes to visit a hospital of his/her choice.
Note that the beneficiary or family members need to intimate the TPA within 24 hours of hospitalization. They should acquire documents like prescriptions, discharge summary, reports and bills, receipts, etc. for the purpose of filing a reimbursement claim.
A follow-up treatment is cashless for the beneficiary, however, hospitals need to send the following information to the insurance company to avail a claim settlement:
Submission of proof for follow-up services once in three months
List of medicines prescribed/given
Acknowledgement of medicines from patients
Photographs show that the patient has Acknowledged the given medicines
Scanned copies of bills and diagnostic tests
Name and code number of the disease as per the package list that the patient is given treatment for
Aarogya Raksha Claim Forms are available to the beneficiaries of the scheme. Please fill all the details correctly and in block letters as the form will be used for claim settlement.
Aarogya Raksha Claim Status can be checked either by calling the customer care number for the plan or by directly getting in touch with the TPA/insurance company.
The Aarogyaraksha policy is valid for approximately one year depending on the date of enrolment. Take a look at the following renewal details:
The process of Arogya Raksha renewal can be done during the last 30 days of the policy period and not before that
This process can be completed between 6 AM and 9 PM.
INDIAN BANK account number is required to view or renew the existing policy
To pay for the Arogya Raksha Policy, a beneficiary can use INDIAN BANK net-banking facility
Many health care facilities form a part of NTR Arogya Raksha Hospitals. Visiting an empanelled hospital allows a patient to avail cashless facilities and faster claims. Aarogya Raksha Hospitals are either government affiliations or private hospitals. Here are the names of empanelled hospitals:
The complete Aarogya Raksha hospital list of Government hospitals is available here.
|Area Hospital-Nandigama , Ah-ngma||Krishna||Dr.M.Majeedabi|
|Area Hospital, Atmakur , Ah-nel||Nellore||Dr.K.Chitanya|
|Area Hospital, Guntakal , Ahg-ant||Anantapur||Dr.Kalyan Chakravarthy|
|Area Hospital, Peddapuram , Ah-pdp||East Godavari||Dr.P.R.S.G.Varma|
|Area Hospital-nagari , Ahn-ctr||Chittoor||Dr.Subhashini|
|Area Hospital, Tadipatri , Aht-ant||Anantapur||Dr.B.Pullaiah|
|Area Hospital-Adoni , Ah-adni||Kurnool||Dr.,B.Linganna|
|Area Hospital-Badrachalam , Ah-bdcm||Badradri||Dr. S. Jayaram Reddy|
|Area Hospital-Bapatla , Ah-bptl||Guntur||Dr. K .Vijaya Laxmi|
|Area Hospital-Chandragiri , Ah-chgri||Chittoor||Dr.Y.Devadas|
|Area Hospital-Cheerala , Ah-crla||Prakasam||Dr D Lokanadham|
|Area Hospital-Golconda , Ah-glnd||Hyderabad||Dr.B.Nagabhushanam|
|Area Hospital-Gudivada , Ah-gdva||Krishna||Dr.T.Soodesh Babu|
|Area Hospital-Gudur , Ah-gdr||Nellore|
|Area Hospital-Guntakal , Ah-gntl||Anantapur|
|Area Hospital-Jangareddy Gudem , Ah-jrgm||West Godavari||Dr.S.V.Sivakumar|
|Area Hospital-Kadiri , Ah-kdri||Anantapur||Dr P.Ramanaiah|
|Area Hospital-Kavali , Ah-kvli||Nellore|
|Area Hospital-Kuppam , Ah-kpm||Chittoor||Dr.T.Nagamanamma|
|Area Hospital-Madanapalli , Ah-mdpl||Chittoor||Dr.Paul Ravi Kumar|
The complete Aarogya Raksha hospital list of private hospitals is available here.
|7 Star Super Speciality Hospital , 7sh-kkd-eg||East Godavari||Dr.S.Veer Reddy|
|Aasha Hospital , Ash-ant||Anantapur||Dr G V Somayajulu|
|Aayush Nri Lepl Healthcare Pvt Ltd , Aysh-bzw||Krishna||Dr K Gopalakrishna|
|Abc Hospitals , Abc-vkp||Vishakhapatnam||Dr Pv Ramesh Babu|
|Abc Hospitals , Abc-vzg||Vishakhapatnam||Dr K Nageshwar Rao|
|Abhaya Kidney Care Mulityspeciality Hospital , Akc-atp||Anantapur|
|Abhilash Netra Vydya Sala , Anvs-kdp||Ysr Kadapa||Dr S Gurumurthy|
|Abhinav Niursing Home , Anh-vzr||Vizianagaram||Aparna Chinta|
|Abhiram Institute Of Medical Sciences , Ams-nel||Nellore|
|Aditya Multi Care Hospital , Amch-vzg||Vishakhapatnam|
|Aditya Multispeciality Hospital , Amh-gnt||Guntur||Dr Krishna Sravanth Pakanati|
|Agraseni Hospital , Ash-knl||Kurnool||Dr Bc Pavan Kumar Singh|
|Ahalya Hospital , Ahly-gnt||Guntur||Dr.Uma Shankar.S.N|
|Ahalya Nursing Home , Anh-gnt||Guntur||Gowri Sankara Krishnarao Sanakkayala|
|Aims For Child Health , Aims-bzw||Krishna|
|Akash Hospital , Ah-blr-dp||Bangalore Rural||Kailash N|
|Akira Eye Hospital , Aeh-rjmy||East Godavari|
|Amar Orthopaedic Hospital , Amr-gnt||Guntur||Surath Amarnath|
|Amara Hospital A Unit Of Amara Raja Infra Private Limited , Ama-chi||Chittoor||Dr Ramadevi Gourineni|
|Amaravathi Hospitals , Amrh-kdp||Ysr Kadapa||Dr K Praveen Kumar Raju|
A medical contingency can be divided into various parts. One of these parts is follow-up treatment. Without proper follow-up, treatment can prove to be less useful. Considering this fact, the Aarogya Raksha scheme includes cashless follow-ups for certain treatments. Here are the details:
The expenses related to diagnostic tests, consultation, medicines, etc. are covered under Aarogyaraksha.
Cashless follow-up treatment begins from 11th day after discharge from the hospital. A patient covered under Aarogya Raksha benefits can continue to receive follow-up services until one year.
It is not required to raise a separate claim for availing follow-up treatment
The follow-up packages are divided into four parts corresponding to four quarters of one year. More amount is dedicated to the first quarter as comparatively more follow-up is required during this time after hospitalization.
These treatments are facilitated by MEDCO along with VAIDYAMITHRA
Also, read: Health Insurance for COVID-19
The Dr.YSR Aarogyasri Health Care Trust is very active in terms of grievances and queries. Here are the details of their contact information.
You can also call 104 to get all your health queries resolved. It works PAN India
0863 – 2222802 / 2259861
D.No. 25-16-116/B, Chuttugunta,
Behind Gautam’s Hero Showroom,
Guntur – 522004.
For Grievances related to Aarogya Raksha, you can use the following details:
Contact number: 8333817424/23/20/07 (Office Timings)
Extension: 0863-2259861 (Ext:326)
Email address: [email protected]
In case you have queries related to Medical Reimbursement Status and Issues, use these details:
Contact number: 8333817363
Extension: 0863-2259861 (Ext:329)
Email address: [email protected]
The beneficiary needs to renew the plan at least 2 times before availing benefits for any pre-existing disease. Thus, the waiting period for the pre-existing disease is 48 months.
The beneficiary needs to wait for 30 days before availing any coverage under the scheme.
The beneficiary of Arogya Raksha can avail treatment for Cataract after 24 months of continuous coverage.
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