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Employee Health Scheme Sarkari Yojana – Myscheme

The Employee Health Scheme (EHS) was put into place by the Dr YSR Aarogyasri Health Care Trust under the supervision of the Government of Andhra Pradesh with the main goal of offering high-quality healthcare to all State Government Employees. Government employees, pensioners, and their dependent family members are covered by the program and are entitled to cashless care at Network Hospitals (NWH) or hospitals with which they have an empanelled agreement.

The EHS has taken the place of the previous medical reimbursement system and includes additional features like post-hospitalization medical care and chronic illness management. Both active and retired employees of the Andhra Pradesh state government are covered under this program. It aims to offer beneficiaries comprehensive healthcare services and guarantee their well-being by providing top-notch medical treatment.

Benefits Of Employee Health Scheme:

  1. Patient Care: The Employee Health Scheme (EHS) intends to give eligible beneficiaries, such as employees, pensioners, and their dependents, cashless hospitalization. The program provides end-to-end cashless treatments up to 10 days after discharge and covers problems for up to 30 days after discharge. It covers listed therapies for disorders that have been identified. In addition, complimentary outpatient evaluations are offered for the therapy specified.
  2. Follow-Up Service: The EHS offers follow-up services for the specified therapies for up to a year, including consultation, research, medications, etc. For eligible beneficiaries, the program offers packages that cover a variety of services.
  3. Chronic Disease Outpatient Care: The program pays for outpatient care at designated hospitals for pre-defined chronic conditions. The goal of this is to ensure the welfare of people who have chronic illnesses.
  4. Hospital Stay: Eligible beneficiaries are given hospital stays in semi-private or private wards, depending on their pay grade. Semi-private wards are available to Slab A (Pay Grades I to IV), semi-private wards are available to Slab B (Pay Grades V to XVII), and private wards are available to Slab C (Pay Grades XVIII to XXXII).
  5. Financial Coverage: The EHS offers up to Rs. 2 lakhs in financial assistance for each illness episode; however, if packages are purchased for more money, the aforementioned amount is not applicable. Claims exceeding Rs. 2 lakhs should be addressed for payment to the CEO of the Aarogyasri Trust.

Eligibility For Employee Health Scheme:

  1. Serving personnel: All regular State Government personnel. Employees of the State Government shall be deemed to fall within the scope of the Fundamental Rules. Local organizations’ provincialized staff.
  2. Retired personnel: All Service Pensionerspensioners from families

Exclusions:

  1. Aarogya Bhadratha of the Police Department and Aarogya Sahayatha of the Prohibition & Excise Department;
  2. Law officers, including the Advocate General, State Prosecutors, State Counsels, Government Pleaders, and Public Prosecutors;
  3. Casual and Daily Paid Workers; Biological Parents if Adopted Parents exist;
  4. All India Services (AIS) officers, AIS pensioners, and independent children.

Application Process

 

Employee Health Scheme Application Process

 

Employees:

Step 1: Go to the EHS website: https://www.ehs.ap.gov.in/
Step 2: Enter the password and your Employee ID in the ‘Username’ field. Click “Login” and then “Employee” to log in.
Step 3: You will be directed to a new page where you must complete all the fields with the required data before clicking “Save.”
Step 4: After completing all the fields, click “Print Application” to save a soft copy of the application for your records. Alternatively, you can take a printout.
Step 5: At this point, select “Submit Application.”

The application will be delivered to the appropriate Drawing and Disbursing Officer (DDO) for the employee. The EHS Health Card will be generated after the DDO has verified the application. To download the card, you must first check in to the EHS web portal using your username and password.

Pensioners:

Before logging into the EHS website, retired employees or pensioners can register for the EHS service online by following the instructions.

1st Step: Visit the EHS Web Portal and log in using your Username and Password. If you don’t have the information, call the EHS Toll-Free Number 104 or STO/APPO to find out your User ID.
2nd Step: Log in using your username and password, then read the website’s instructions.
3rd Step: Open the enrollment form and complete all the fields, including those for your district, STO/APPO, and head of the department.
Attach all supporting documentation in step four.
5th Step: Double-check all the information before submitting the application.
6th Step: Press “Submit” and print the completed application.
7th Step: print the application form, sign it, and then upload the signed version of the form online.
8th Step: At this point, print off the completed application and attach it to the appropriate STO/APPO.

Your registered cellphone number and email address will receive an acknowledgement by SMS or email, respectively. If it is rejected because of mistakes, resubmit your application with the updated information.

Documents Required

  • Aadhaar Card: Scan your Aadhaar Card and ensure the photo and the Aadhaar Number are clearly visible.
  • Photograph: A scan of a 45mm x 35mm ICAO compliant passport size colour photograph of 200Kb size.
  • Disability Certificates (if any)
  • Spouse’s Pensioner ID/Employee ID: A scanned copy of the 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.

FAQ For Employee Health Scheme Sarkari Yojana:

  • 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 dialling 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.

Guidelines