Telangana New Employees Health Scheme (NEHS) - Cashless Healthcare for State Employees

Why Was New Employees Health Scheme (NEHS) Introduced

The earlier Employees Health Scheme (EHS)/Employees and Journalists Health Scheme(EJHS) had limited number of empanelled hospitals and a largely manual process for pre-authorization and claim settlement, leading to treatment delays for employees and pensioners seeking care

The new Employees Health Scheme(NEHS) aims to overcome these deficits by providing a digital platform for enrolment, management of dependents, pre-authorisation, treatment authorisation and claim settlement and an expanded network of empanelled hospitals and treatment packages, enabling cashless healthcare to employees and pensioners. Like similar state employee health schemes, such as Tamil Nadu's NHIS and Andhra Pradesh's Dr. YSR Employee Health Scheme, NEHS combines cashless treatment with a fully digital service delivery system.

NEHS - Key Highlights

Who is Eligible for New Employees Health Scheme (NEHS)

• Serving Telangana government employees – they are automatically enrolled through the government's employee database, so they do not need to submit a separate application.
• Telangana government pensioners – this includes both retired employees receiving a service pension and eligible family pensioners.
• Eligible dependent family members – this generally includes the employee's or pensioner's spouse, financially dependent parents, unemployed sons below 25 years of age, and unmarried, unemployed, or divorced daughters, subject to the latest government eligibility rules.

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What New Employees Health Scheme (NEHS) Covers

What NEHS does not Cover

• Medical or surgical treatment that is not included in the list of approved treatment packages of the NEHS;
• Cosmetic or aesthetic procedures that are performed exclusively for cosmetic purposes, unless they are deemed medically necessary;
• The purchase of medicines or medical consumables outside the framework of the NEHS, or without a prescription under the NEHS.

How to Apply for New Employees Health Scheme (NEHS)

Serving Telangana government employees do not need to submit a separate application for the New Employees Health Scheme (NEHS). Their enrollment is carried out automatically through the Drawing and Disbursing Officer (DDO) and the Comprehensive Financial Management System (CFMS). Employees and pensioners, however, must log in to the official NEHS portal to access their Digital Health Card and manage their beneficiary details.

• Step 1 : Visit the NEHS Portal: Visit the official NEHS portal at nehs.telangana.gov.in.
• Step 2 : Log In: Click Employee Login and sign in using your Employee ID and Password, or choose OTP Login and verify your identity using the OTP sent to your registered mobile number.
• Step 3 : Verify Your Details: After logging in, review your personal information and check the details of your eligible dependent family members.
• Step 4 : Download Your Digital Health Card: Go to the dashboard and download your Digital Health Card, which is required to avail cashless treatment at empanelled hospitals.
• Step 5 : Update Dependent Details: Use the portal to add, update, or remove eligible dependent family members whenever required, in accordance with the scheme's eligibility rules.

Documents Required for Applying NEHS

• Employee ID or Pension PPO Number, for identity verification and portal login.
• Recent passport-size photograph of the employee/pensioner and each dependant.
• Date of Birth Certificate, for dependent children below 5 years of age.
• Employee ID or Pensioner ID of the spouse, if the spouse is also a government employee or pensioner.
• Aadhaar details (submitted through the DDO/CFMS process for serving employees).

How to Check Your NEHS Status and Download card

• Step1 : Go to the NEHS official website.
• Step 2 : Click on Employee Login.
• Step 3 : Login by using one of the following methods:
  a) Using Employee ID and Password, or
  b) OTP Login via Employee ID.
• Step 4 : In case of OTP Login, you need to enter the OTP received on your registered mobile number.
• Step 5 : Once logged in, you will be directed to your NEHS Dashboard.
• Step 6 : You can see the status of your beneficiaries and dependent information from the dashboard.
• Step 7 : From the Quick Actions section, click on Download Health Card.
• Step 8 : Download your Digital Health Card

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Claim Process under NEHS

• Visit an empanelled government or private hospital under NEHS.
• Show your NEHS Digital Health Card and a valid identity proof at the hospital's NEHS help desk.
• The hospital verifies your beneficiary details and eligibility through the NEHS portal.
• The hospital submits a pre-authorisation request with your medical records to the concerned authority for approval, if required for the treatment package.
• Once the treatment is approved, you receive cashless treatment for the covered medical package.
• After discharge, the hospital submits the final claim and supporting documents directly to the NEHS authorities for settlement.
• If any expenses are not covered under the approved package, the hospital will inform you separately.

Helpline and Support for NEHS

NEHS and Other Health Schemes

• Central Government Health Scheme (CGHS): A health scheme for Central Government employees, pensioners, and their dependents, offering cashless treatment and OPD services through empanelled hospitals and wellness centres.
• Employees and Journalists Health Scheme (EHS/EJHS): A cashless health scheme for Telangana Government employees, pensioners, journalists, and their eligible dependents.
• West Bengal Health Scheme (WBHS): A cashless healthcare scheme for West Bengal Government employees and pensioners, covering hospitalisation and selected medical services.
• Employees' State Insurance Scheme (ESIC): A social health insurance scheme that provides medical care and cash benefits to eligible employees in the organised sector.