Employee Health Scheme by Government of Andhra Pradesh

The Employee Health Scheme (EHS) by the Government of Andhra Pradesh is a pioneering initiative aimed at ensuring the well-being of its employees and their families. Under this scheme, state employees and their dependents gain access to comprehensive healthcare services, relieving them of financial burdens associated with medical treatments. In this article, we will discuss the benefits, coverage, exclusions, enrollment process, claim process, and EHS card.and also understand the significance of health insurance plans for affordable and accessible healthcare facilities for all.

Overview of the Employee Health Scheme

Below is a table outlining the basic components of the Employee Health Scheme:

Also, check: Aarogyasri Telangana scheme

What is Andhra Pradesh Employee Health Scheme (EHS)?

The Employees Health Scheme has been designed to offer cashless medical treatment to State Government employees, retirees, and their dependents. This scheme is intended to ipso facto replace the current medical reimbursement system outlined in the 'Andhra Pradesh Integrated Medical Attendance Rules, 1972 (APIMA Rules, 1972)', while also providing additional benefits such as post-operative care and treatment for chronic diseases that don't necessitate hospitalisation, all within empaneled hospitals.

Features and benefits of Employee Health Scheme (EHS)

Intending to furnish cashless hospitalisation services to employees, retirees, and their dependents, the EHS presents a range of features and advantages. Here are the specifics:

• In-patient treatment: Treatment for specified therapies targeting identified diseases. Comprehensive cashless service from admission to 10 days post-discharge, including coverage for post-discharge medications and complications for up to 30 days. Free outpatient assessments for specified therapies.
• Follow-Up Service: This service is extended up to 1 year, including consultation, diagnostics, medications, etc., for therapies listed in packages.
• Out-patient treatment for chronic diseases: Treatment for predefined chronic ailments at designated hospitals.
• Hospital accommodation: 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 limit: Rs. 2 lakh per episode of illness, with no cap on the number of episodes. This limit doesn't apply if predetermined packages exceed Rs. 2 lakh. Claims exceeding Rs. 2 lakh will be managed by the CEO of Dr. YSR Aarogyasri Health Care Trust.

Eligibility criteria for EHS by Andhra Pradesh Government

To avail the benefits of the Employee Health Scheme, individuals must meet the following eligibility criteria:

Enrollment process for the Employee Health Scheme for employees

Given below is the registration process for state government employees to avail EHS services:

Step 1: Access the EHS web portal.

Step 2: Enter your Employee ID in the 'Username' field along with your password. Log in as 'Employee' and proceed by clicking on 'Login'.

Step 3: You'll be redirected to a new page where you must input all required details into the respective mandatory fields. After completing this, click on 'Save'.

Step 4: Once all fields are filled, opt to 'Print Application' to retain a soft copy for your records or take a printout.

Step 5: Finally, click on 'Submit Application' to complete the registration process.

The application will be forwarded to the employee's designated Drawing and Disbursing Officer (DDO). Following verification by the DDO, the EHS Health Card will be generated. To obtain the card, you must log in to the EHS web portal using your username and password.

Also, check: How to register for ABHA health ID

Employee enrollment status check

Below is the process to know the status of the employee enrollment status online:

Step 1: Visit the EHS portal and navigate to the Employee section. Click on 'Search Employee Enrollment Status'.

Step 2: Input the required details such as employee name, date of birth, department name, and the respective DDO on the new page. Click on 'Search'.

Step 3: If the employee is already enrolled, the status will indicate 'Application Approved'.

Step 4: If the employee is not yet enrolled in EHS, the status will display as 'Not Enrolled'.

Step 5: To enroll, click on 'Enrol' on the same page. You may be prompted to provide your email ID and contact number to receive the username and password. Click on 'Save Details'.

Out-patient treatment for chronic ailments

The EHS provides outpatient care for chronic illnesses to active employees of the Andhra Pradesh state government. These services are accessible on weekdays from 2 pm to 4 pm and comprise:

• Medical consultations
• Diagnostic tests (including laboratory and radiology services).
• Pharmacy services
• Annual health assessments for employees aged 40 and above.

List of chronic OP treatment

Registration process for EHS pensioners

Retired employees or pensioners can enroll for EHS services online by adhering to the following instructions before accessing the EHS web portal:

• Aadhaar card: Provide a clear scan of your Aadhaar Card ensuring your photo and Aadhaar Number are clearly visible.
• Photograph: Submit a scan of a passport-sized color photograph measuring 45mm x 35mm, complying with ICAO standards and not exceeding 200Kb in size.
• Disability certificates: Include scanned copies of any disability certificates if applicable.
• Spouse’s pensioner ID/Employee ID: If your spouse is employed in the State Government or is a Service Pensioner, provide a scanned copy of their ID.
• Date of birth certificate: Provide a scan of the date of birth certificate for dependent family members under 5 years of age.

Enrollment application form for pensioners

Given below are the details that are required to fill in the EHS enrollment application form for pensioners:

• Pension Payment Order (PPO) Number
• Aadhaar Card number
• Aadhaar enrollment ID
• Date of birth as per PPO
• Gender
• Marital status
• Date of retirement
• Category (SC, ST, BC, Minorities, Others)
• Disability details
• Nationality
• Address and contact details
• Ration card number
• Identification marks
• Head of the department
• Pay grade
• Photo
• Date of birth certificate
• Employee ID/Pensioner ID

What is the EHS card?

The Employee Health Scheme card is given to all the beneficiaries enrolled under the schemes with the Government of Andhra Pradesh. After completing the registration process outlined, you'll have the opportunity to obtain temporary health cards for yourself and your dependent family members. Upon review of your application, temporary cards will be generated. To print these temporary cards, you must log in using your User ID and password.

Steps to download the EHS Health Card

After your application has been sanctioned and you've received confirmation via SMS or email, you can proceed to download the card online. Follow the steps outlined below to understand the AP EHS Health Card download procedure:

Step 1: Navigate to the EHS Portal and select 'Download Health Card'.

Step 2: In the ensuing window, input your 'User ID' and click 'Go' to initiate the generation of the EHS health card.

The Employee Health Scheme by the Government of Andhra Pradesh stands as a beacon of healthcare accessibility for state employees and their families. Through its comprehensive coverage, cashless treatments, and commitment to quality healthcare, the scheme embodies the government's dedication to the welfare of its workforce.