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.
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.
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 Coverage | Features and Benefits |
In-Patient Treatment | Treatment 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 Service | Services Up to 1-yearPackages include consultation, investigation, drugs, etc. on listed therapies. |
Out-Patient Treatment For Chronic Diseases | Treatment of pre-defined chronic diseases at notified hospitals. |
Hospital Stay | Slab A (Pay Grades I to IV): Semi-Private WardSlab B (Pay Grades V to XVII): Semi-Private WardSlab C (Pay Grades XVIII to XXXII): Private Ward |
Financial Coverage | Eligible 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. |
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:
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 Beneficiaries | Details |
Serving State Government Employees | All regular State Government Employees.Provisionalised Employees of Local Bodies. |
Retired State Government Employees/Pensioners | All Service Pensioners.Re-Employed Service Pensioners.Family Pensioners Without Dependents. |
Dependent Family Members | Dependent 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:
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:
Below is the registration process for serving state government employees to avail EHS services:
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.
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:
List of Chronic OP Procedures:
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:
Below is the process to know the status of the employee enrollment status online:
To know the medical reimbursement status of the EHS, serving state government employees need to follow the steps below:
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:
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:
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:
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.
Data to Enter
Pension Payment Order (PPO) Number
Aadhaar Card Number
Aadhaar Enrollment Number
Aadhaar enrollment ID as it appears in the acknowledgement slip.
Write your Gender (Male/Female)
Current Marital Status
Date of Retirement
Enter the date on which you retired
Select the community such as SC, ST, BC, Minorities, Others
Type of Disability and Percentage of Disability
Write your Nationality
Contact Details
Residential Address and ensure you update the current Email ID and Mobile Number
Identification Details
Ration Card Number
If you hold a ration card, provide your ration card number.
Two visible identification marks along with its exact location on your body.
Posting Details
Name of the last Head of Department you were working for.
Name of the last district you were working for.
Enter the pay grade of the post from which pensioner (you) retired.
Enter STO/APPO code and name of the office from where you are receiving the pension.
Attachments Needed
Soft 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).
Scan a copy of your Aadhaar Card/Enrollment Number with the number and photo clearly visible.
In the case of a dependent family member is a child who is less than 5-years old.
In case any of the members is disabled.
Family Member Details
Add details of the family members.
Name, Relationship, Aadhaar Number
Add the relationship with the policyholder.
Employee ID/Pensioner ID of Spouse
Add the employee number or any other applicable ID number.
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.
To know the medical reimbursement status follow the steps below:
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:
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.
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:
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:
Updating information in the Employee Health Scheme (EHS) is an important process to ensure your health coverage is accurate. Here is how you can modify details for yourself or your beneficiaries:
First, access the official EHS website and click on the "Sign In" option at the top. This will take you to the login page. Next, choose if you want to log in as an "Employee" or "Pensioner" from the dropdown menu and enter your unique username and password.
Once logged in successfully, you need to navigate to the "Download Health Card" section. Here look for the "Click Here" link in blue font and click on it. This will display your health card with beneficiary information. Now search for the "Edit Card Details" button and select it.
You will now see edit options next to the name of each family member covered. Click on the 'Edit' button beside the person whose information you intend to update. Make sure you accurately change details such as name, date of birth, relationship status or identification proof as required.
Finally, submit these changes for approval by clicking the "Submit" button. The modified health card with updated beneficiary details will now be available for download.
Below are the contact details of the EHS scheme for Andhra Pradesh state government employees:
The Employee Health Scheme introduced by the Andhra Pradesh government aims to provide quality healthcare to serving and retired state employees along with their dependents. Replacing medical reimbursements with cashless hospitalisation offers increased coverage for chronic illnesses, post-hospitalization care, and financial protection up to Rs. 2 lakhs per episode. This comprehensive health scheme intends to ensure the well-being and welfare of government personnel across pay grades through accessible and affordable medical services. In short, it secures the health and, thus, the future of employees in AP.
Below are some of the common questions asked about the EHS:
The AP government's EHS is a health scheme to provide cashless treatment to serving and retired employees and dependents at empanelled hospitals across the state. The Dr YSR Aarogyasri Health Care Trust implements the scheme under the state government.
All regular employees and provisionalised staff of the Andhra Pradesh state government, retired employees or pensioners of the AP government, and their eligible dependent family members such as parents, spouse, children including step & adopted, or dependents of family pensioners who fulfill the prescribed eligibility conditions, can avail cashless in-patient and out-patient treatment and follow-up services under the Employee Health Scheme.
The Employee Health Scheme offers cashless in-patient treatment, chronic out-patient treatment, follow-up care services for one year post-discharge which includes consultations, tests, and medicines for listed therapies, preventive health check-ups for employees over 40 years of age, and financial protection of up to Rs. 2 lakhs per episode of illness with coverage for complications for 30 days post-discharge along with 10 days of post-hospitalization medication costs.
Pensioners can register on the EHS portal by submitting details, documents and signed applications to their respective STO/APPO office.
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.
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).
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.
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.
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.