AP EHS Health Cards Employees Cashless Treatment EHS Scheme Employees Health Scheme

ANDHRA PRADESH GOVERNMENT HEALTH CARDS FOR EMPLOYEES AND TEACHERS FOR CASHLESS TREATMENT through EHS (Employee Health Scheme) Complete Information. 

Employees Health Scheme is formulated to provide cashless treatment to the employees, pensioners of the State Government and their dependent family members, which will ipso facto replace the existing medical reimbursement system under the 'Andhra Pradesh Integrated medical Attendance Rules, 1972 (APIMA Rules, 1972)', with additional benefits such as post-operative care and treatment of Chronic diseases, which do not require hospitalization and treatment in empanelled Hospitals
AP EHS Health Cards Employees Cashless Treatment EHS Scheme Employees Health Scheme

AP EHS Health Cards Employees Cashless Treatment EHS Scheme Employees Health Scheme

Employees Health Scheme is formulated to provide cashless treatment to the employees, pensioners of the State Government and their dependent family members, which will ipso facto replace the existing medical reimbursement system under the 'Andhra Pradesh Integrated medical Attendance Rules, 1972 (APIMA Rules, 1972)', with additional benefits such as post-operative care and treatment of Chronic diseases, which do not require hospitalization and treatment in empanelled Hospitals.

The Scheme is intended to benefit Serving employees and Retired employees of the state.

Dr.YSR Aarogyasri Health Care Trust:Dr.YSR  Aarogyasri Health Care Trust will implement the EHS Scheme under the supervision of Government of Andhra Pradesh.

Steering Committee under the chairmanship of Chief Secretary to Government will review the implementation of the Employee Health Scheme from time to time. The Steering Committee will meet as frequently as required, discuss, monitor and review the Scheme, benefit packages, grievances, quality of medical care including the modalities of an Employees Health Trust. 

The General Administration (Services & HRM) Department will issue orders forming the Steering Committee with 50% members from employees and pensioners associations, and 50% members from Government.

EHS Scheme Structure - Implementation Procedure - Process Flow

  • All the Eligible Employees will enroll in EHS Scheme. Accordingly, the authorities will accept the EHS applications of the Employees and issue EHS Health Cards.
  • The EHS Eligibility Guidelines of the EHS Scheme is Explained Here (Click Here)
  • Govt will deduct EHS (Employee Health Scheme) Subscription monthly as per the Slab Rates.
  • All the employees who are paying EHS Subscription and enrolled in EHS Scheme are eligible for in-patient treatment through EHS Scheme in EHS Network Hospitals throughout the State.
  • Whenever the In-patient treatment is required for EHS Subscribers, they can approach the EHS Network Hospitals for in-patient treatment, upon showing their EHS Health Card and can avail treatment. 

EHS Employee Health Scheme Benefit Coverage -Treatments

In-Patient Treatment: The scheme will provide Inpatient treatment for the listed therapies for identified diseases under all specialties in the empanelled hospitals. 

Package includes the following services: 
End-to-end cashless service offered through a NWH from the time of reporting of a patient till ten days post discharge medication, including complications if any up to thirty (30) days post-discharge, for those patients who undergo a "listed therapy(ies);
Free OP evaluation of patients for listed therapies who may not undergo IP treatment including consultation and investigations

EHS Follow-up Services:
Follow-up services are provided for a period of one year through fixed packages to the patients whoever requires long term follow-up therapy in order to get optimum benefit from the procedure and avoid complications. Follow-up package includes consultation, investigations, drugs etc., for one year for listed therapies.

EHS Outpatient Treatment for identified chronic diseases:
OP treatment for pre-defined long-term (chronic) diseases will be provided in notified hospitals.

Employee Health Scheme EHS Hospital Stay - Facilities Provided

The eligibility for Hospital Stay is as follows as per the Pay Slabs
Slab-A (consisting of employees with Pay Grades from I to IV), and 
Slab B (consisting of employees with Pay Grades from V to XVII) will be semi-private ward, and for Slab- C (consisting of employees with Pay Grades from XVIII to XXXII) will be private ward.

EHS Employee Health Scheme Financial Coverage 

The employees, pensioners and their dependent family members will be eligible for a sum of Rs.2.00 lakhs (Rupees two lakhs only) per episode of illness with no limit on the number of episodes as existing in APIMA Rules, 1972. 

However, in the cases where the cost of treatment exceeds Rs.2.00 lakhs, cashless treatment will continue. No network hospital shall deny the treatment in such cases.

The limit of Rs.2.00 lakhs will not apply in cases where predetermined package rates are above Rs.2.00 lakhs.

Chief Executive Officer, Dr.YSR Aarogyasri Health Care Trust will settle the claims which exceed Rs.2.00 lakhs, following the standard claims settlement process after obtaining the approval of the Technical Committee constituted by the Government.

Employee Health Scheme Financing Procedure

50% of total amount will be borne by Government and 50% by the employee / pensioner contribution.
The monthly contribution will be Rs.225/- (for Slab A consisting of employees with Pay Grades from I to IV, and Slab B consisting of employees with Pay Grades from V to XVII) and Rs.300/- (for Slab C consisting of employees with Pay Grades from XVIII to XXXII). 

The Pay Grades for the three Slabs under other Pay Scales, such as University Grants Commission Pay Scales, will be those equivalents to the corresponding Pay Grades under the State Government. The contribution for service pensioners or family pensioners will be according to the present Pay Grade of the post from which the pensioner retired from service.

If both of the spouses are Government employees or Service Pensioners, contribution by any one of the spouses is sufficient. In such a case, the applicant shall give a declaration to the effect that the other spouse is a Government employee / Service Pensioner, duly indicating the Employee Code / Pensioner Code of the other spouse.
The expenditure in running the Scheme and Scheme experience will be reviewed at the end of six months and revision of contribution effected accordingly.

EHS Scheme - Employee Health Scheme - GO's - Orders

Order Number - Subject of the Order GO No Details Link
G.O.Ms.No.184, Dated: 14-08-2012.
Health Medical and Family Welfare – Aarogyasri Health Care Trust – Implementation of ‘Employees Health Care Fund Scheme (EHF) – Orders – Issued - FEATURES OF EMPLOYEES HEALTH CARE FUND SCHEME (EHF)		 G.O.Ms.No.184, Dated: 14-08-2012. Click Here
G.O.Ms.No. 186 Dated: 14-08-2012.
‘Employees Health Care Fund Scheme’, EHF – Operational Guidelines – Orders		 G.O.Ms.No. 186 Dated: 14-08-2012. Click Here
GO.174 Dated 1.11.2013
Health, Medical and Family Welfare - Employees Health Scheme - Providing Cashless medical treatment to the State Government Employees, Pensioners and their dependent family members - Notification of the 'Employees Health Scheme (EHS) - Orders — Issued.		 GO.174 Dated 1.11.2013 Click Here
GO.175 Dated 1.11.2013
Health, Medical and Family Welfare — Employees Health Scheme (EHS) — Operational Guidelines for Issue of Health Cards – Orders – Issued.		 GO.175 Dated 1.11.2013 Click Here
GO.176 Dated 1.11.2013
Health, Medical and Family Welfare – Employees Health Scheme – Notification and adoption of ‘Final Therapy Prices’ - Orders – Issued.		 GO.176 Dated 1.11.2013 Click Here

All Latest Updated Orders on EHS Scheme

Author:: APTEACHERS Posted On Monday, September 03, 2012
Categories::