డాక్టర్ వైఎస్ఆర్ ఆరోగ్యశ్రీ పథకం

Introduction

• Andhra Pradesh Government started Dr. YSR Aarogyasri Scheme to provide health insurance for the people of the State.
• Scheme is implemented through PPP (Public Private Partnership) model for better health services.
• Dr. YSR Aarogyasri Scheme which was earlier known as Aarogyasri Scheme is implemented by Aarogyasri Health Care Trust, Government of Andhra Pradesh and provides universal coverage of health.
• The scheme provides cashless health benefit cover for 3255 Listed Therapies (surgeries, procedures and medical treatments) in 31 categories.
• Scheme shall provide financial security against health expenses and quality health care through identified network of health care providers (Network Hospitals).
• Scheme shall benefit 129.44 lakh poor families of Andhra Pradesh.
• Under the scheme eligible family is provided with financial insurance cover of Rs.5,00,000/- per year.
• Scheme provides cashless treatment for listed therapies through free investigation, diagnostic test, food, medicines, transport facility and follow-ups.
• The pre-authorization for treatment is given within 24 hours by the Trust and claims are paid to network hospitals by Trust.
• Out-patients shall be provided free screening and consultation in health camps and network hospitals under scheme.
• In-patients shall be provided treatment  for ‘Listed Therapies’ through network hospitals from time of reporting till 10 days post discharge medication. In case of complications 30 days post discharge medication.

Implementation Process

• A patient can access the treatment through various modes:
  • Directly visiting nearby government hospital or listed private hospitals and approach Aarogya Mithra counter.
  • PHC (Primary Health Centres) referrals.
  • Health camp referrals.
  • Call Centre (104) registration.
  • Emergency admission.
• Biometric registration of patient will be done in network hospitals by Vaidya Mithra.
• After evaluation of patient, if found suffering from Listed Therapies, MEDCO (Medical Co-ordinator) shall submit for pre-authorization and upload relevant documents.
• Network hospital will provide complete treatment after pre-authorization. Enhancement of package price is possible in exceptional cases.
• Claim by Network hospital will be done after 10 days of satisfactory discharge.
• Trust shall settle claims from hospitals only for diseases mentioned in the package.
• The following diagram shows the implementation process.

Benefits of Scheme

• Financial Insurance cover of Rs.5,00,000/- per year.
• Below mentioned services will be provided free of cost after admission in hospital :-
  • Free Admission.
  • Doctor Consultation. (Every Day).
  • Nursing Services. (Per Day).
  • Necessary Medical Tests.
  • Necessary Medicines.
  • Surgery (Operation) or Treament.
  • Breakfast, Lunch. (Two Meals).
  • Medicine for 10 Days after Discharge.
  • Necessary Charges for Going Home after Discharge.
• Compensation Loss of Wages @Rs.225/- per day subjected to a maximum of Rs. 5000/- per month before discharge from hospital.
• Allowance of Rs.5000/- to pregnant women for normal and caesarean section deliveries.

Eligibility for the Scheme

• Should be resident of Andhra Pradesh.
• Rice Card Holders.
• Families eligiible for below mentioned card are also eligible under Dr. YSR Aarogyasri :-
  • YSR Pension Kanuka.
  • Jagananna Vidya Deevena Card.
  • Jagananna Vasathi Deevena Card.
• For Other Families below mentioned criteria will be apply for eligibility :-
  • Landowners holding less than 12 Acre of Wet Land or less than 35 Acre of Dry Land or Total of less than 35 Acres both Wet and Dry Land.
  • Annual Income less than or upto Rs. 5 Lakh.
  • Families filing income tax return upto the annual income of Rs. 5 Lakh.
  • Any Employee other than permanent Government Employee or Pensioner whose annual income is less than or upto Rs. 5 Lakh.
  • Municipal Tax payee households residing in the area less than 3000 Sq. Ft.
  • Families not haing more than one personal car.

Essential documents needed for Scheme

• Aadhar Card.
• Income Certificate.
• Income Tax Returns.
• Address Proof.
• Mobile Number.
• Any one of the below mentioned card :-
  • Rice Card.
  • YSR Pension Kanuka Card.
  • Jagananna Vidya Deevena Card.
  • Jagananna Vasathi Deevena Card.

How to apply for Scheme

• There is no need to apply for the Scheme separately as all the BPL /Ration Card holders whose record is maintained by Civil Supplies Department of Government of Andhra Pradesh in the BPL database are eligible to avail the benefits of the Scheme.
• The eligible person can directly visit nearby Government/ Empanelled Hospital where he will be assisted by Aarogya Mithra/ Vaidhya Mithra at Aarogyasri Helpdesk in Hospital and will be given required treatment and guidance needed by patient.

Treatments/Facilities under Dr. YSR Arogyasri Scheme

• Cardiac and Cardiothoracic Surgery.
• Cardiology.
• Cochlear Implant Surgery.
• Critical Care.
• Dermatology.
• Endocrinology.
• ENT Surgery.
• Epidemic Disease.
• Gastroenterology.
• General Medicine.
• General Surgery.
• Genito Urinary Surgeries.
• Gynaecology and Obstetrics Surgery.
• Infectious Diseases.
• Medical Oncology.
• Nephrology.
• Neurology.
• Neurosurgery.
• Ophthalmology Surgery.
• Organ Transplantation Surgery.
• Orthopedic Surgery and Procedures.
• Pediatric Surgeries.
• Pediatrics.
• Plastic Surgery.
• Poly Trauma.
• Psychiatry.
• Pulmonology.
• Radiation Oncology.
• Rheumatology.
• Surgical Gastro Enterology.
• Surgical Oncology.

Important Links

• Dr. YSR Aarogyasri Scheme Portal.
• Dr. YSR Aarogyasri Scheme Covered Treatments.
• Dr. YSR Aarogyasri Scheme List of Empanelled Hospitals.
• Dr. YSR Aarogyasri Scheme Guidelines.
• Dr. YSR Aarogyasri Scheme Frequently Asked Questions.
• Dr. YSR Aarogyasri Scheme App.

Contact Details

• Dr. YSR Aarogyasri Scheme Helpline Number :- 104.
• Dr. YSR Aarogyasri Heatlh Care Trust Contact Number :-
  • 0863 2259861. (Ext:215)
  • 0863 2341611.
  • 0863 2341622.
  • 0863 2341633.
  • 0863 2341644.
  • 0863 2341655.
• Dr. YSR Aarogyasri Scheme Helpdesk Email Id :-
  • ap_grievance@ysraarogyasri.ap.gov.in.
  • ap_ehf@ysraarogyasri.ap.gov.in.
  • ap_mr@ysraarogyasri.ap.gov.in.
• Dr YSR Aarogyasri Heatlh Care Trust, Governmentof Andhra Pradesh
  Door No – 241, MGM Capital Building,
  Near NRI Junction, Beside Little Village Restaurant,
  Chinnakakani, Mangalagiri,
  Guntur Dist - Pin : 522508.