EHS - Employee Health Scheme by Government of Andhra Pradesh: Eligibility, Coverage & Benefits (2024)

Team AckoApr 30, 2024

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 reimbursem*nt 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.

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 reimbursem*nt 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:

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:

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.

Also, read: Including Parents in Employer’s Insurance

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 Reimbursem*nt Status:

To know the medical reimbursem*nt 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 Reimbursem*nt Status’.

• Step 2: You will be redirected to a new page. Here, you will have to select if the reimbursem*nt 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.

Also, read: Arogya Sanjeevani Health Insurance

Pensioners:

The State Government of Andhra Pradesh has replaced the existing Medical Reimbursem*nt 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:

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 Reimbursem*nt Status:

To know the medical reimbursem*nt 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 Reimbursem*nt Status’.

• Step 3: On the new page, select to confirm if the reimbursem*nt 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: COVID-19 Health Insurance

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.

How to Update Details in the Employee Health Scheme?

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.

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 – [emailprotected]

• For Medical Reimbursem*nt Status and Issues:

  • Phone Number – 8333817363 Or: 0863-2259861 (Ext: 329)

  • Email ID – [emailprotected]

• 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

Conclusion

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 reimbursem*nts 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.

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Frequently Asked Questions About Andhra Pradesh Employee Health Scheme:

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