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:
Aspect |
Details |
Scheme name |
Employee Health Scheme (EHS) |
Implemented by |
Government of Andhra Pradesh |
Target Beneficiaries |
State Employees and their dependents |
Objective |
Cashless treatment to the state government employees |
Eligibility criteria |
State Government Employees, Provisionalised Employees of Local Bodies, Service pensioners, Re-employed service pensioners, Family pensioners without dependents, dependant parents |
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. The Andhra Pradesh Employees Health Scheme ensures that beneficiaries receive timely and quality medical care without the financial burden, reflecting the state's commitment to the well-being of its employees and their families.
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.
Read more: Ladli Behna Yojana
Eligibility criteria for EHS by Andhra Pradesh Government
To avail the benefits of the Employee Health Scheme, individuals must meet the following eligibility criteria:
Serving employees |
|
Retired employees |
|
Family and dependents |
|
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 (www.ehs.ap.gov.in login).
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'.
What is not covered under Andhra Pradesh Employee Health Scheme?
The Andhra Pradesh Employees Health Scheme offers extensive medical coverage, but certain treatments and services are not included. Beneficiaries excluded typically include:
- Individuals covered by the Central Government Health Scheme (CGHS)
- Employees from Railways, Road Transport Corporation, ESIS, Aarogya Sahayatha of Prohibition, Aarogya Bhadratha of the Police Department, and the Excise Department
- Legal professionals including public prosecutors, government pleaders, state counsels, state prosecutors, and advocate generals
- Biological parents if adoptive parents are present
- Casual and daily wage workers
- Independent children
- AIS officers and their pensioners
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
Hypertension |
Gout |
Hyperthyroidism |
CAD-Medical |
Hypothyroidism |
Convulsive Disorder |
Rheumatoid Arthritis |
Inflammatory Bowel Disease |
Bronchial Asthma |
Psychosis and Other Chronic Psychiatric Problems |
Parkinson’s Disease |
Stroke |
Type 1 and 2 DM |
Vascular Occlusive Disorder of Extremities |
COPD |
Osteoarthritis |
SLE and other Connective Tissue Disorders |
Psoriasis |
Cardiac Failure |
Chronic Hepatitis |
Nephrotic Syndrome |
Cirrhosis |
Chronic Kidney Disease |
Arrhythmias |
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.
Also, read: ABHA Card
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.
Also, read: Pradhan Mantri Vaya Vandana Yojana
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. It ensures that beneficiaries have access to a wide range of medical services, including hospitalisation, surgeries, and chronic disease management, without financial burden. The Andhra Pradesh Employees Health Scheme also supports post-operative care and treatment for non-hospitalisation conditions, reflecting the state's robust commitment to enhancing the health and well-being of its employees and their dependents.
