Team AckoNov 15, 2023
The State Government of Telangana has formulated a new health scheme for its employees, journalists, pensioners and their dependent family members. They can make use of the cashless hospitalisation at the Network Hospitals (NWH). The new scheme replaces the current medical reimbursement facility and comes with added benefits such as post-hospitalisation cover and treatment of chronic diseases. Read ahead to know about the Government of Telangana Employee and Journalist Health Scheme’s (EJHS) eligibility criteria, coverage and benefits.
Through the Employee and Journalist Health Scheme, State Government employees and State Government pensioners along with their dependant family members can avail cashless treatment at various empanelled hospitals. Under the supervision of the government, the Aarogyasri Health Care Trust will implement the scheme.
The new health scheme replaces the existing medical reimbursement scheme and offers several new benefits such as post-treatment care and treatment of chronic diseases. Serving and retired state government employees, as well as journalists from Telangana, are the beneficiaries of the scheme.
With the main objective of providing cashless treatment or hospitalization to employees, journalists and their dependent family members, the EJHS offers various features and benefits. Below are the details:
|EJHS Coverage||Features and Benefits|
|In-Patient Treatment||Treatment for pre-defined therapies of identified diseases.Free out-patient evaluation for pre-defined therapies.Cashless service for the post-discharge medication of up to 10 days and up to 30 days coverage of complications post-discharge.|
|Follow-Up Services||Services up to 1-year.Package includes consultations, investigations, drugs, etc. for 1-year for the listed therapies.|
|Out-Patient Treatment||Treatment of listed chronic (long-term) diseases at select hospitals.|
|Hospital Stay (Ward)||Slab A & B (Employee Pay Grade – I to XVII): Semi-PrivateSlab C (Employee Pay Grade – XVIII to XXXII): Private|
|Coverage (Financial)||Eligible Sum: No upper limit.No Contribution by Employee/Pensioner.|
Under the EJHS all serving, retired employees and journalists along with their family members can avail cashless treatment. And, the beneficiaries can avail cashless hospitalisation for the listed therapies for identified diseases. Those treatments for non-identified diseases as per the EJHS will not be covered. Also, certain beneficiaries are not covered under the scheme. Here is the list of beneficiaries not covered under the EJHS:
Those covered under any of the Central Government Health Schemes (CGHS).
Employees working in Aarogya Bhadratha of Police Department, Railways, ESIS, RTC and Aarogya Sahayatha of Prohibition and Excise Department.
Casual and daily wage workers.
Law officers such as Public Prosecutors, State Prosecutors, Advocate General, State Counsels and Government Pleaders.
Biological parents if adopted parents exist or vice versa.
AIS pensioners and officers.
Also, read: Arogya Sanjeevani Health Insurance
Under the EJHS of Telangana, State Government employees, journalists (retired or serving) and their dependent family members are covered. The eligibility criteria are further classified as below:
|Serving Employees/Journalists||Regular State Government Employees.Provisionalised Employees of Local Bodies.|
|Retired State Government Employees/Journalists||Service Pensioners.Family Pensioners without Dependents.Re-Employed Service Pensioners.|
|Dependent Family Members||Dependent Parents (Either Adopted/Biological).One Legally Wedded Spouse.Dependent Legitimate Children (Adopted/Step Children).Family Members of Service Pensioners.|
The EJHS further classifies ‘Dependent Family Members’ as:
Parents: Dependent on the employee/journalist for their livelihood.
Unemployed Sons: Below 25 years.
Unemployed Daughters: Unmarried/Divorced/Widowed/Deserted.
Children with Disabilities: Those are deemed unfit for employment.
Under the EJHS, employees need not enrol in the scheme, however, pensioners have to enrol themselves and their dependent family members. Below are the details:
Under the EJHS for state government employees and pensioners, there is no separate enrollment process for serving employees. The Drawing and Disbursing Officer (DDO) will furnish the employees’ data (including Aadhaar) to the finance department through the Comprehensive Financial Management System (CFMS).
This data is then shared with the Aarogyasri Health Care Trust by the finance department to generate health cards and made available on the EHS website. This health card can be downloaded, printed and used by employees and their dependent family members.
Employees can upload the photograph of theirs or their dependent family members or even update dependent family members through the EJHS web portal. Below is the login instructions:
Step 1: Visit the official web portal of the Employees Health Scheme.
Step 2: On the top right, click on ‘Sign-in’ and select ‘Employees’.
Step 3: Your Employee ID is the Username and the same Username as the first-time password. You may be asked to enter a new password for future logins.
Below is the patient process flow for serving employees under the EJHS:
Step 1: Employee visits any of the networks of empanelled hospitals.
Step 2: The patient will be registered at the NWH (Network Hospital) by Aarogyamithra.
Step 3: If the patient has a permanent health card, then a biometric verification will be enabled and sent for preliminary diagnosis at the hospital.
Step 4: If the patient does not have a permanent health card, they will be also sent for preliminary diagnosis.
Step 5: Based on the diagnosis, the patient will either be treated as out-patient or in-patient.
Step 6: If advised to be hospitalised, then in-patient registration will be initiated.
Step 7: E-pre authorisation will be sent to the concerned team.
Step 8: Required surgery or treatment will be initiated at the NWH.
Step 9: Patient will be discharged as required and if needed, follow-up will be advised.
Step 10: The hospital will initiate the claim process for the hospitalisation of the patient.
Below is a step-by-step guide to adding beneficiaries to the EJHS:
Step 1: Visit the official web portal of the Employee Health Scheme of the Government of Telangana.
Step 2: Click on ‘Sign-in’ found on the top-right corner of the page.
Step 3: Enter your Username and Password.
Step 4: In the new page, click on ‘Registration’ found on the top-left of the page and click on ‘Initiate New/Rejected Beneficiaries’.
Step 5: You will be directed to a new page ‘Beneficiaries Worklist’. Click on ‘Add New Beneficiary’.
Step 6: Enter details of the beneficiary and attach Date of Birth (DOB) certificate and photo if the DOB is below 5-years. If the DOB is above 5-years old, then you will have to attach their Aadhaar card and photograph.
Step 7: Click on ‘Save’. You also have the option to reset.
Step 8: A pop-up window will confirm the beneficiary is saved successfully. Click on ‘Ok’.
Step 9: Once you click on Ok, you will be directed to the ‘Beneficiary List’ page, you can either remove or edit the details of the newly added beneficiary.
Step 10: Click on ‘Submit’ after checking all information provided is correct.
Step 11: A pop-up window will confirm that the addition of a beneficiary is completed successfully.
If you would like to download the employee declaration form from EJHS, then visit the EJHS web portal and click on the ‘Declaration Form by Employee’ found on the page. You can also download the declaration form for reactivation of beneficiaries.
The State Government of Telangana has implemented the Journalist Health Scheme through the Aarogyasri Medical Care Trust. Journalists working for the state government are eligible to avail the services.
The District Public Relations Officer (DPRO) will enrol the journalist in the Journalists Health Scheme implemented by the Government of Telangana through the Aarogyasri Medical Care Trust. Once the journalist submits the application to the DPRO, and upon approval, the application will be verified by the Information and Public Relations Officer (IPRO). Once the final approval is processed by the IPRO, the Journalists Health Card will be generated.
Below is the login instructions under the Journalists Health Scheme (JHS):
Step 1: Visit the web portal of the Journalist Health Scheme and click on ‘User Login’ on the top-right corner of the page.
Step 2: Enter the Username and Password to gain access to your account.
Step 3: In the new page, you can perform several activities such as adding beneficiaries, downloading health cards, etc.
Below are the steps to get Journalists Health Card:
Step 1: Visit the JHS web portal and log in with the Username and Password.
Step 2: In the new page, click on ‘Registration’ and click on ‘Download Health Card’.
Step 3: After you click on ‘Download’ you will be directed to a new page with the details of the beneficiaries. You have the option to view the card.
Step 4: Click on ‘Print’ to download your Journalist Health Card.
The Telangana Government has replaced the existing medical reimbursement facility with the Employee Health Scheme, which covers pensioners and their dependent family members. Below is the enrollment process for retired employees or pensioners of the State Government of Telangana:
Aadhaar Card: A scanned copy of yours and your dependent family members’ Aadhaar Card.
Photographs: A scan of a 45mm x 35mm ICAO compliant passport size photograph of ‘Self’ and ‘Dependent Family Members’. The size of the photograph should not exceed 200Kb.
Disability Certificates: Scan copies of both yours and dependent family members.
Spouse’s Employee/Pensioner ID: A scanned copy of spouse’s employee or pensioner ID in case working in the State Government or is a service pensioner.
DOB Certificates: Scan copies of Date of Birth Certificates of family members who are less than 5-years of age.
Step 1: Visit the EJHS web portal and click on ‘Sign-in’ appearing on the top-right corner of the page.
Step 2: Log in with your Username and Password. If you do not have the details, you can contact Sub. Treasury Officer (STO)/Assistant Program Officer (APO) or you can call EJHS toll-free number 104 to know your Username and Password.
Step 3: Once you have logged in to the web portal, open the enrolment form and fill all the mandatory fields including your head of department, STO/APO and the respective district.
Step 4: Attach all supporting documents and add beneficiaries such as your dependent family members.
Step 5: Click on ‘Save’ and then click on ‘Submit Application’. You will receive an SMS with details of the Health Card Enrollment ID.
Step 6: Print the application form, sign it and scan the signed application form.
Step 7: Upload the signed application form and click on ‘Submit Application for Approval’.
Step 8: You will receive an SMS with the confirmation of the submission and its pending approval by the STO/APO. Once approved, you will receive a confirmation that the Health Card is ready.
Once you have completed the enrollment process, follow the below steps to get your pensioner’s health card:
Step 1: Log in to the EJHS Web Portal and click on ‘Sign-in’ located on the top-right corner of the page.
Step 2: Enter your Username and Password (You can contact the Seva Kendra by dialling 104 to know your User ID and Password).
Step 3: Click on ‘Download Health Card’, print and laminate the document. You can use this document for verification purposes.
You can also get a laminated temporary health card from any of the Mee Seva Centers. The government has capped the cost at Rs.25 per card.
With the main aim to provide cashless treatment for serving and retired employees/journalists, the concerned Network Hospital will raise the claim with the Health Trust. The claim will be settled and the payment will be made to the hospital. All payments will be processed through the Trust portal after scrutinising the documents submitted by the Network Hospital (NWH).
The Employee and Journalist Health Scheme is implemented by the Aarogyasri Health Care Trust under the supervision of the Telangana government. The objective of the scheme is to provide cashless treatment to employees, journalists, pensioners and their dependent family members. With this objective, there is no contribution made by the employees/journalists/pensioners. The entire cost of implementing the scheme is borne by the Government.
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Registered hospitals or nursing homes in Telangana established for the treatment of diseases and injuries and health care are known as Health Care Providers. The State Government has authorised several hospitals and nursing homes to offer cashless hospitalisation under the EJHS.
There are more than 200 empanelled hospitals located across the state. For the complete list of empanelled hospitals for EJHS, click here.
A registered hospital or nursing home situated in the state of Telangana can apply to be a part of the empanelled hospitals.
For the online application form for empanelment, visit the ‘Empanelment Online Application’ section of the EJHS Web Portal.
Below are the toll-free number and contact details of the EJHS Telangana:
Toll-Free Number: 104 (24/7)
Aarogyasri Health Care Trust
Road No. 46, Jubilee Hills,
Hyderabad – 500033
Phone No. – 040-23547107Fax Number – 04023555657
Mobile Number – +91-8333817408/8333817470
Phone No. – 040-23547107
Email ID: [email protected]
Below are some of the common questions about the Employee and Journalist Health Scheme (EJHS):
Yes. Stepchildren of serving or retired employees are eligible to avail benefits of the scheme.
Yes. Either biological or adopted parents or children can be beneficiaries of the scheme, but not both.
No. In-laws are not eligible to avail benefits of the scheme.
No. An unemployed son attaining the age of 25 is not eligible to avail the benefits of the scheme. However, if the son is disabled and unable to work for his livelihood, he can avail the benefits by producing his disability certificate.
The total cost of implementing the health scheme will be borne by the State Government of Telangana. There is no contribution either from the employee or the pensioner.
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