Dr YSR Aarogyasri Health Insurance Scheme: Benefits, Coverage & Eligibility

Dr YSR Aarogyasri Health Insurance Scheme was launched in 2007 with the aim to provide universal health coverage to families living below the poverty line in Karnataka. Managed by the Aarogyasri Health Care Trust, the scheme is designed to meet the health needs of poor patients while providing cashless treatment services.

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      The YSR Aarogyasri Health Scheme provides several benefits and one of the most used benefits is its cashless treatment in the government hospitals of Andhra Pradesh. The Arogyasri Health Care Trust issues an Aarogyasri card that allows easy management of the scheme. The beneficiary can avail of the benefits after showing this card at the government hospitals under the YSR Aarogyasri health scheme.

      AP YSR Aarogyasri Scheme: Brief Overview

      Here is a brief overview of the Aarogyaari health scheme of Andhra Pradesh.

      Scheme Name

      Dr YRS Aarogyasri Health Scheme

      Launched By

      Dr. YSR Rajashekar Reddy, CM of Andhra Pradesh

      Year

      2007

      Applicants Allowed to avail benefits of the scheme

      Residents of Andhra Pradesh only

      Primary Objective

      Cashless healthcare treatment to low-income families in Andhra Pradesh

      Official Website

      https://www.ysraarogyasri.ap.gov.in/

      COVID-19 Coverage in YSR Aarogyasri Health Scheme

      The whole world is going through a pandemic so let us begin by telling you about the coverage this scheme provides for Covid-19. It is a highly contagious virus and has symptoms like dry cough, fever, breathing problems, etc. YSR Aarogyasri health scheme has included 15 new medical management procedures that will be covered under the scheme and they are as follows:

      • Septic Shock Intensive Care Management
      • Medical Management of Acute Respiratory Failure (with ventilator)
      • Medical Management of Acute Respiratory Failure (without ventilator)
      • Medical Management of Acute Severe Asthma with Acute Respiratory Failure
      • Medical Management of Acute Bronchitis with Pneumonia and Respiratory Failure.
      • Medical Management of ARDS
      • Medical Management of ARDS with DIC (Blood & Blood Products) (D65)
      • Medical Management of ARDS with DIC (Blood & Blood Products) (D65) in Paediatrics
      • Medical Management of ARDS with multi-organ failure (R65.1)
      • Medical Management of ARDS with multi-organ failure in Paediatrics
      • Medical Management of Confirmed Covid-19 (Stable)
      • Medical Management of Confirmed Covid-19 with Comorbidities- HTN, DM, COPD, HIV. Chr. Liver Disease, Chr. Enal Disease
      • Medical Management of COPD with Respiratory Failure (Infective Exacerbation)
      • Medical Management of Pneumonia
      • Medical Management of Suspected Covid-19 (Stable)

      Moving on to the other benefits of the AP YSR Aarogyasri Health Scheme.

      Benefits of Aarogyasri Health Scheme

      The YSR Aarogyasri Health Scheme is highly beneficial for low-income earning families and provides several benefits. Here are the benefits provided by this scheme:

      Cashless Healthcare

      There is a financial cover of Rs 5 lakh per year to the beneficiary and his/her family. This cover can be utilized by any registered family member.

      In-Patient Care

      The listed diseases under the scheme as well as the hospitalization are covered.

      Out-Patient Treatment

      Cashless treatment is provided to the beneficiary for the listed diseases at health camps as well as in the network hospitals.

      Pre-Existing Disease Cover

      If the beneficiary is suffering from any disease before registering for the Aarogyasri Health Scheme will be provided cover. This feature is not provided under many of the other health insurance policies

      Follow-up Treatment Cover

      The follow-up treatments after the hospitalization eat up a good chunk of money. Aarogyasri Health Scheme provides coverage for that as well.

      Family Floater Cover

      Under the Aarogyasri health scheme, the whole family will be provided coverage. The buyer does not have to purchase a separate health insurance plan for each member of the family. 

      Treatments Covered in YSR Aarogyasri Scheme

      Several treatments ranging from standard to critical treatments are covered in this Scheme. They are as follows:

      General Surgery

      Critical Care

      ENT Surgery

      General Medicine

      Ophthalmology

      Infectious Diseases

      Gynaecology & Obstetrics

      Paediatrics

      Orthopedic Surgery & Procedures

      Cardiology

      Surgical Gastroenterology

      Nephrology

      Cardiothoracic Surgery

      Neurology

      Paediatric Surgeries

      Pulmonology

      Genitourinary Surgeries

      Dermatology

      Neurosurgery

      Rheumatology

      Surgical Oncology

      Endocrinology

      Medical Oncology

      GastroEnterology

      Radiation Oncology

      Psychiatry

      Plastic Surgery

      Prostheses & Polytrauma

      There are some of the new procedures included in the YSR Aarogyasri Health Scheme. They are as follows:

      Superficial Parotidectomy(Non-malignant)

      Laparoscopic HemiThyroidectomy

      Excision of Meckel’s Diverticulum

      Rectovaginal fistula Management without Colostomy

      Rectopexy Open with Mesh for Rectal Prolapse

      Myringoplasty

      Septorhinoplasty

      Exenteration of Orbit

      Glaucoma Surgery

      Joint reconstruction/intra articular fractures

      Bone tumor surgery reconstruction with internal fixation

      Coronary Balloon Angioplasty with Drug-eluting stent

      Surgical management of Empyema Thoracis

      Lumbar Hernia repair In Paediatric Patients

      Excision of Ureterocele with Ureteric Implantation

      Open radical Prostatectomy

      Bladder neck reconstruction for Incontinence

      Laparoscopic Surgical treatment for Duodenal Perforation

      Treatments Not Covered in YSR Aarogyasri Health Scheme

      There are some of the treatments that are not covered in this scheme. They are as follows:

      Knee replacement surgeries

      Malaria

      Gamma-knife procedures in neurosurgery

      HIV/AIDS

      Medical treatment related to bone marrow

      Tuberculosis

      Leprosy & Filaria

      Infectious diseases

      Assisted devices for cardiac failures

      Gastroenteritis

      Cardiac and liver transplantations

      Jaundice

      Elgibility Criteria

      The eligibility criteria for the AP YSR Aarogyasri health scheme are as follows:

      • The applicant should be a local of Andhra Pradesh and Telangana.
      • The annual income of the applicant’s family should be less than Rs 5 lakh.
      • They should hold a white ration card.
      • The applicant must not have a land more than 35 acres. (Wet & Dry)
      • The applicant must have less than 3000 square feet of area.
      • One must fall under Municipal Property Tax-paying Families.
      • The applicant cannot own more than 1 car.
      • A private sector employee and an honorary remuneration employee can be the beneficiary of this scheme.
      • Families that file for an income tax of up to Rs 5 lakh can be the beneficiary of this scheme.

      How to Register for AP YSR Aarogyasri Health Scheme?

      If you are eligible for the YSR Aarogyasri Health Scheme, then you can follow the below-mentioned procedure to AP YSR Aarogyasri registration under the scheme.

      Online Procedure

      To enroll in the scheme online, follow the procedure mentioned below:

      • Visit the official website
      • Login
      • Fill the Aarogyasri health card application form
      • Upload required documents
      • Submit the form
      • Fetch the printout

      Offline Procedure

      To enroll in the scheme offline, you will have to follow the procedure mentioned below:

      • Visit the official website
      • Click on YSR Aarogya Health Card Performa
      • Download the YSR Aarogyasri Scheme application form
      • Take the printout
      • Fill the form
      • Submit the form physically to the concerned department
      • Once verified, the beneficiary will get the YSR health card.

      YSR Aarogyasri Health Scheme: Documents Required

      These documents required to enroll are as follows:

      • Aadhar Card
      • Address proof
      • Income certificate
      • BPL certificate

      YSR Aarogyasri Health Card & Its Features

      Once the applicant enrolls successfully, the family will get the YSR health card. The card holds a unique number, beneficiary’s photo and other important details. The card is used to avail the required cashless benefits at the network hospitals. Here are some of the features of YSR Aarogyasri health card:

      • The cardholder can avail reimbursement of Rs 1.5 lakh
      • If the expenses exceed 1.5 lakh, the cardholder can avail of additional benefits of Rs 50,000.
      • Card provides Rs 2 lakh worth of coverage for serious illness treatment.
      • 938 medical and surgical treatments can be availed under the scheme.

      How to Download YSR Aarogyasri Health Scheme Card?

      The scheme holders can download the YSR health card by following the below steps:

      • Visit the official website of Dr. YSR Aarogysri Health Care Trust
      • On the home page, there is a section called ‘EHS’. Select it and proceed for ‘Download Health Card’ option.
      • Enter the relevant user Id and click on ‘Go’.
      • Mention the necessary information to get the YSR Aarogyasri Health Card on the screen.
      • Download a soft copy of the card and use it whenever is required.

      YSR Aarogyasri Health Scheme Vs Ayushman Bharat Scheme

      As per a report of Telangana today, YSR Aarogyasri health scheme is considered a better scheme than Ayushman Bharat Scheme, when compared.

      Parameters

      YSR Aarogyasri Health Scheme

      Ayushman Bharat Scheme

      Sum Insured

      Rs 2 lakh up to Rs 13 Lakh

      Rs 5 Lakh

      Eligibility

      Does not follow SECC

      Follows Socio-economic caste census data (SECC)

      Implementation

      Was implemented in 2007, State governments are aware of its working.

      Ayushman bharat scheme is a new scheme. Not many families are aware of it.

      How to Claim YSR Aarogyasri Scheme?

      To claim the YSR health scheme, the beneficiary has to show their YSR health card to the Vaidya Mitra so that it can be verified. If the beneficiary does not possess the card, then he/she can provide the card number for recognition.

      Claim Process for Hospitals

      An authorization must be obtained by the hospital for the surgical treatments. The trust will only accept the claim if the hospital authorities meet the following conditions:

      • Hospitals are allowed to treat the patient for the approved treatments under the scheme.
      • Fill the claim form as soon as possible.
      • The claim amount is less than the pre-authorized limit.
      • Photographic evidence of treatment for claim settlement is there.

      Apart from this, the beneficiary can also use the online portal to collect the claim documents, intimate claims etc. The beneficiary will have to verify the following information once the claim is filed:

      • Identity of patient
      • Evidence of treatment
      • Claim amount with respect to the authorized amount
      • Case management concerning for before authorization 

      YSR Aarogyasri App: How to Download?

      YSR Aarogyasri App is helpful in providing comprehensive details about the scheme. The Aarogyasri App is easily available on Google Play Store, which can be access by any android user.

      • Open ‘play store’ on your android phone
      • Search for ‘YSR Aarogyasri’ or ‘YSR Aarogyasri Healthcare Trust’

      Install the App

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