The State Government of Andhra Pradesh has formulated a health scheme for its serving/retired employees and their dependent family members to avail cashless treatment at several empanelled hospitals across the state. The scheme replaces the current medical reimbursement facility and boasts of new features such as treatment of chronic diseases and post-hospitalisation care. Read on to know about the Government of Andhra Pradesh’s Employee Health Scheme eligibility, coverage and benefits.

EHS – Employee Health Scheme by Government of Andhra Pradesh: Eligibility, Coverage & Benefits - Acko

What is Employee Health Scheme (EHS – YSRAHCT)?

With the primary objective of providing health care for all and high-quality medical services to State Government Employees, the Dr YSR Aarogyasri Health Care Trust under supervision of the Government of Andhra Pradesh will implement the Employee Health Scheme (EHS). The scheme covers Andhra Pradesh government employees, pensioners and their dependent family members who can avail cashless treatment at empanelled hospitals or Network Hospitals (NWH).

It replaces the current medical reimbursement process and beneficiaries can avail new features such as post-hospitalisation medical care and treatment of chronic diseases. Beneficiaries include serving and retired employees of the state government of Andhra Pradesh.

Features and Benefits of Employee Health Scheme:

With an aim to provide cashless hospitalisation to employees, pensioners and their dependents, the EHS offers several features and benefits. Below are the details:

EHS CoverageFeatures and Benefits
In-Patient TreatmentTreatment for Listed Therapies for identified diseases*

End-to-End Cashless Service Till 10 Days Post-Discharge Medication and Coverage of Complications up to 30 Days Post-Discharge.

Free Out-Patient Evaluation For Listed Therapies.
Follow-Up ServiceServices Up to 1-year

Packages include consultation, investigation, drugs, etc. on listed therapies.
Out-Patient Treatment For Chronic DiseasesTreatment of pre-defined chronic diseases at notified hospitals.
Hospital StaySlab A (Pay Grades – I to IV): Semi-Private Ward

Slab B (Pay Grades – V to XVII): Semi-Private Ward

Slab C (Pay Grades – XVIII to XXXII): Private Ward
Financial CoverageEligible Sum: Rs.2 Lakhs per episode of illness with no limit on the number of episodes.

The eligible sum is not applicable where predetermined packages are above Rs.2 Lakhs.

Claims exceeding Rs.2 Lakhs will be settled by the CEO of Dr. YSR Aarogyasri Health Care Trust.

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

The EHS covers state government employees and their dependents; however, it does not cover certain beneficiaries. Below is the list of beneficiaries not covered under 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:

Under the EHS, serving and retired state government employees and their dependents are covered. They can avail cashless hospitalisation for identified diseases at empanelled hospitals. In a further classification, the Employee Health Scheme for Andhra Pradesh state government is divided as:

Eligible BeneficiariesDetails
Serving State Government EmployeesAll regular State Government Employees.

Provisionalised Employees of Local Bodies.
Retired State Government Employees/PensionersAll Service Pensioners.

Re-Employed Service Pensioners.

Family Pensioners Without Dependents.
Dependent Family MembersDependent 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.

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

  • Parents: Dependent on the employee for their livelihood.
  • Unemployed Daughters: Unmarried/Widowed/Divorced/Deserted.
  • Unemployed Sons: 25 Years and below.
  • Disabled Children: Those with a disability who are unable to find employment.

How To Enrol for the Employee Health Scheme?

The EHS services are offered to all state government employees of the State of Andhra Pradesh. To know the enrollment process of the Employee Health Scheme, follow the procedures mentioned below:

Employees:

Below is the registration process for serving state government employees to avail EHS services:

EHS Employee Registration Process:

  • Step 1: Visit the web portal of EHS.
  • Step 2: Enter your Employee ID in the ‘Username’ section and the password. Log in as ‘Employee’ and click on ‘Login’.
  • Step 2: You will be directed to a new page, where you need to enter the required details of all the mandatory fields, then click on ‘Save’.
  • Step 3: Once you have filled all the fields, click on ‘Print Application’ to keep a soft copy of the application as a reference or you could take a print out.
  • Step 4: Now, click on ‘Submit Application’.

The application will be sent to the employee’s respective Drawing and Disbursing Officer (DDO). Once the DDO verifies the application, the EHS Health Card will be generated. You need to login to the EHS web portal with your username and password to download the card.

Chronic Out-Patient Treatment:

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

  • Doctor’s consultation.
  • Investigations (laboratory services and radiology services).
  • Pharmacy
  • Yearly health checkup for employees who are aged above 40 years.

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:

The State Government has directed all DDOs in Andhra Pradesh to collect the data of all state government employees online through web-based applications in order to implement the scheme and issue Health Cards. Sometimes there may be a situation wherein the employee needs to edit or correct or update information about them or their family members. In such instances, follow the procedure below:

  • 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.

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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.

Example: EHS Pensioner Application Form:

DetailsData to Enter
PPO NumberPension Payment Order (PPO) Number
NameAs per PPO
Aadhaar Card NumberAs per Aadhaar
Aadhaar Enrollment NumberAadhaar enrollment ID as it appears in the acknowledgement slip.
DOBDOB as per PPO
SexWrite your Gender (Male/Female)
Marital StatusCurrent Marital Status
Date of RetirementEnter the date on which you retired
CommunitySelect the community such as SC, ST, BC, Minorities, Others
Disability DetailsType of Disability and Percentage of Disability
NationalityWrite your Nationality
Contact Details
AddressResidential Address and ensure you update the current Email ID and Mobile Number
Identification Details
Ration Card NumberIf you hold a ration card, provide your ration card number.
Identification MarksTwo visible identification marks along with its exact location on your body.
Posting Details
HODName of the last Head of Department you were working for.
DistrictName of the last district you were working for.
Pay GradeEnter the pay grade of the post from which pensioner (you) retired.
STO/APPOEnter STO/APPO code and name of the office from where you are receiving the pension.
Attachments Needed
PhotoSoft copy of the passport size photograph (ICAO compliant) of the employee/pensioner and each of the dependent family members. (Size will be 35 mm wide x 45 mm height).
Aadhaar CardScan a copy of your Aadhaar Card/Enrollment Number with the number and photo clearly visible.
DOB CertificateIn the case of a dependent family member is a child who is less than 5-years old.
Disability CertificateIn case any of the members is disabled.
Family Member Details
Name, Relationship, Aadhaar Number
Employee ID/Pensioner ID of Spouse

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

Also, read: Do’s and Don’ts of Buying Health Insurance Policy

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 – [email protected]
  • For Medical Reimbursement Status and Issues:
  • 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

Frequently Asked Questions About Andhra Pradesh Employee Health Scheme:

Below are some of the common questions asked about the EHS:

How do I check my EHS approval?

The Government of Andhra Pradesh has made the process of checking the status of the EHS application easier online. Follow the above mentioned step-by-step guide to check the EHS applications status.

How do I find my EHS ID?

You can call the 104-Seva Kendra by dialling 104 to know the User ID to login to the EHS web portal or you can contact the respective Sub Treasury Office (STO)/Assistant Program Officer (APO).

How do I check the medical reimbursement status for pensioners in Andhra Pradesh?

If you are a retired state government employee of Andhra Pradesh then you can follow the above-mentioned process to check the status of the reimbursement.

What is the financial coverage of the EHS offered by the Andhra Pradesh government?

The state government employees, pensioners and their dependent family members are eligible for financial coverage of Rs.2 lakhs per episode of illness. There is a limit to the number of episodes as per the APIMA Rules, 1972.

What is the contribution of the employee and the state government towards the EHS?

The state government will contribute 60% while the employee/pensioner will contribute the balance 40%. The monthly contribution will be:

>Slab A (Pay Grade I to IV): Rs.90
>Slab B (Pay Grade V to XVII): Rs.90
>Slab C (Pay Grade XVIII to XXXII): Rs.120.

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