EHSAP

Employee Health Scheme

The Employee Health Scheme (EHS) is a government-run health scheme in Andhra Pradesh, providing cashless treatment at network hospitals for government employees, pensioners, and their families under the Dr. YSR Aarogyasri Healthcare Trust.

State Composite

States / UT: Andhra Pradesh

Nodal department: Department Health, Medical and Family Welfare

Scheme for: Individual

Scheme profile

Scheme open date: 2007-02-01

Categories: Health & Wellness

Tags: Health Coverage, Government Employees, Cashless Treatment, Pensioners, Hospitalisation

Details

The Dr YSR Aarogyasri Health Care Trust, under the auspices of the Government of Andhra Pradesh, has implemented the Employee Health Scheme (EHS) with the primary objective of providing quality healthcare to all State Government Employees. The scheme covers government employees, pensioners and their dependent family members, who are eligible for cashless treatment at empanelled hospitals or Network Hospitals (NWH).

The EHS has replaced the erstwhile medical reimbursement process and offers new features such as post-hospitalisation medical care and treatment of chronic diseases. This scheme is applicable to both serving and retired employees of the state government of Andhra Pradesh. It is aimed at providing comprehensive healthcare services to the beneficiaries and ensuring their well-being by offering high-quality medical services.

Benefits

  • [ [ { "children": [ { "text": "In-Patient Treatment: The Employee Health Scheme (EHS) aims to provide cashless hospitalization to eligible beneficiaries such as employees pensioners and their dependents. The scheme covers listed therapies for identified diseases providing end-to-end cashless services until 10 days post-discharge including coverage of complications up to 30 days post-discharge. Additionally free out-patient evaluation is available for listed therapies." } ] }
  • { "children": [ { "text": "Follow-Up Service: The EHS provides follow-up services up to 1-year including consultation investigation drugs etc on listed therapies. The scheme offers packages that cover a range of services for eligible beneficiaries." } ] }
  • { "children": [ { "text": "Out-Patient Treatment for Chronic Diseases: The scheme covers treatment of pre-defined chronic diseases at notified hospitals. This is aimed at ensuring the well-being of beneficiaries suffering from chronic illnesses." } ] }
  • { "children": [ { "text": "Hospital Stay: Depending on their pay grade

In-Patient Treatment: The Employee Health Scheme (EHS) aims to provide cashless hospitalization to eligible beneficiaries such as employees, pensioners, and their dependents. The scheme covers listed therapies for identified diseases, providing end-to-end cashless services until 10 days post-discharge, including coverage of complications up to 30 days post-discharge. Additionally, free out-patient evaluation is available for listed therapies.

Follow-Up Service: The EHS provides follow-up services up to 1-year, including consultation, investigation, drugs, etc., on listed therapies. The scheme offers packages that cover a range of services for eligible beneficiaries.

Out-Patient Treatment for Chronic Diseases: The scheme covers treatment of pre-defined chronic diseases at notified hospitals. This is aimed at ensuring the well-being of beneficiaries suffering from chronic illnesses.

Hospital Stay: Depending on their pay grade, eligible beneficiaries are provided with hospital stays in either semi-private or private wards. Slab A (Pay Grades – I to IV) is entitled to a semi-private ward, Slab B (Pay Grades – V to XVII) is entitled to a semi-private ward, and Slab C (Pay Grades – XVIII to XXXII) is entitled to a private ward.

Financial Coverage: The EHS provides financial coverage of up to Rs. 2 lakhs per episode of illness, If packages exceed the ₹2 Lakhs limit, the above sum does not apply; Claims above ₹2 Lakhs are directed for settlement to the CEO of the Aarogyasri Trust

Eligibility

  1. Serving employees:
  • All regular State Government employees. A State Government employee will have the meaning as defined under Fundamental Rules.
  • Provincialised employees of local bodies.
  1. Retired employees:
  • All Service Pensioners
  • Family pensioners
  • Re-employed service pensioners

Application Process

Online

Employees:

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 3: 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 4: 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 printout.

Step 5: 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.

Pensioners:

Retired employees or pensioners can register for the EHS service online by following the instructions before they can log in to the EHS web portal.

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 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 in 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 printout of the application form.

Step 7: Sign the printout of the application form and upload the signed document back online.

Step 8: Now, take a printout of the signed application form and submit it 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 the correct details.

Clarifications

Additional points from the scheme information published on myScheme (not legal advice).

What is the financial coverage offered by the Andhra Pradesh government under EHS?
The financial coverage offered by EHS is up to Rs. 2 lakhs per episode of illness for state government employees, pensioners, and their dependent family members.
How do I check the status of my EHS application?
You can check the status of your EHS application online through the official website. Follow the step-by-step guide provided on the website to check the status.
How do I find my EHS ID?
You can find your EHS ID by contacting the 104-Seva Kendra by dialing 104, or by contacting the respective Sub Treasury Office (STO)/Assistant Program Officer (APO).
How do I check the medical reimbursement status for pensioners in Andhra Pradesh?
Pensioners can check the status of their medical reimbursement by following the same process as state government employees
What is the contribution ratio of the State Government versus the employee towards EHS?
The contribution ratio for EHS is 60:40, with the State Government contributing 60% and the employee contributing 40%.
How much is the monthly contribution for EHS for different pay grades?
The monthly contribution for Slab A (Pay Grade I to IV) and Slab B (Pay Grade V to XVII) is Rs. 90, while the monthly contribution for Slab C (Pay Grade XVIII to XXXII) is Rs. 120
Do I need to apply for EHS coverage after hospitalization?
No, you do not need to apply for EHS coverage after hospitalization. The network hospital takes care of the process within 10 days of discharge.

References

Apply

Apply now

Opens the official application or programme portal in a new tab. If in doubt, confirm details on the ministry site.

Documents Required for Government Schemes

Most government schemes require basic documents for verification. While the exact requirements vary, common documents include:

  • Aadhaar Card
  • Income Certificate
  • Caste Certificate (if applicable)
  • Residence Proof
  • Bank Account Details
  • Educational Certificates (for student schemes)

How to Apply for Government Schemes?

The application process for government schemes may be online or offline depending on the scheme. In most cases, you can follow these steps:

  1. Check eligibility criteria
  2. Collect required documents
  3. Fill the application form
  4. Submit the application online or at the relevant office
  5. Track application status