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YSR Aarogyasri Health insurance Scheme Benefits , Coverage and Eligibility

Written by - Akshatha Sajumon

January 23, 2023 9 minutes

Andhra Pradesh has a lot of low-income group people, and they have limited access to health care provisions. To combat this, Andhra Pradesh State Government has Launched Dr YSR Aarogyasri Scheme, whose inauguration was done by CM YS Jagan Mohan Reddy. This is the second welfare scheme that the government launched in 2007. Aarogyasri Health Care Trust administers this scheme. The families who do not have enough income can get health services free of cost.

The main purpose of the scheme is to provide free treatment to patients for specific ailments in any hospital located in the state.

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

  1. AP YSR Aarogyasri scheme: brief overview

AP YSR Aarogyasri is a health insurance scheme in the state of Andhra Pradesh, India. It provides financial assistance to economically weaker sections of the population for treatment of serious illnesses, such as cancer, heart disease, and kidney failure. The scheme covers both inpatient and outpatient treatment at network hospitals, and also covers certain procedures such as organ transplants. The scheme is implemented by the government of Andhra Pradesh in partnership with private hospitals.

  1. COVID-19 Coverage in YSR Aarogyasri Health Scheme

Covid-19 was considered highly contagious during its peak in 2020 and 2021. While the virus impact seems to be slowing down, some of its symptoms still include dry cough, fever, breathing problems, etc. The YSR Aarogyasri health scheme covers 15 medical procedures including:

  1. Medical Management of Acute Respiratory Failure (with ventilator)
  2. Septic Shock Intensive Care Management
  3. Medical Management of Acute Severe Asthma with Acute Respiratory Failure
  4. Medical Management of Acute Respiratory Failure (without ventilator)
  5. Medical Management of ARDS with DIC (Blood & Blood Products) (D65) in Paediatrics
  6. Medical Management of ARDS
  7. Medical Management of Pneumonia
  8. Medical Management of ARDS with DIC (Blood & Blood Products) (D65)
  9. Medical Management of Acute Bronchitis with Pneumonia and Respiratory Failure.
  10. Medical Management of ARDS with multi-organ failure (R65.1)
  11. Medical Management of Confirmed Covid-19 (Stable)
  12. Medical Management of Confirmed Covid-19 with Comorbidities- HTN, DM, COPD, HIV. Chr. Liver Disease, Chr. Enal Disease
  13. Medical Management of ARDS with multi-organ failure in Paediatrics
  14. Medical Management of COPD with Respiratory Failure (Infective Exacerbation)
  15. Medical Management of Suspected Covid-19 (Stable)

Benefits of Aarogyasri health scheme

Some of the benefits of the YSR Arogyasri Scheme are:

Cashless healthcare 

Cashless healthcare means that patients don’t have to pay out-of-pocket for certain medical treatments. Under the Aarogyasri health scheme in India, eligible patients can receive cashless healthcare benefits for certain treatments.

In-patient care

In-patient care in Aarogyasri health scheme in India refers to medical treatment given to a patient who is required to stay overnight in a hospital. Eligible patients can receive cashless inpatient care for certain treatments.

Out-patient treatment

There are network hospitals and health camps where one can avail the services for the treatment completely cashless. 

Pre-existing disease cover

Suppose the scheme member has the disease before applying for the scheme, then that disease is also covered under the plan. This benefit is not available in other health insurance schemes which are commercial.

Follow-up treatment cover

Treatments that need follow-up after hospitalization and need money are also covered under this scheme. 

Family floater cover

This scheme provides benefits to the whole family, known as family-floater Health Insurance Cover: One does not need to make different plans for each family member. People who have applied for this scheme get a financial cover of Rs. 5 Lakh per year per family. Those who need medical help can apply for this aid if they are part of the registered family. 

Treatments covered in YSR Aarogyasri scheme

Dr YSR Aarogyasri scheme.covers treatment from simple to critical. Below are some of the major treatments that can be taken at empanelled hospitals 

  • General Surgery
  • ENT Surgery
  • Ophthalmology
  • Gynaecology & Obstetrics
  • Orthopedic Surgery And Procedures
  • Surgical Gastroenterology
  • Cardiothoracic Surgery
  • Pediatric Surgeries
  • Genitourinary Surgeries
  • Neuro Surgery
  • Surgical Oncology
  • Medical Oncology
  • Radiation Oncology
  • Plastic Surgery
  • Polytrauma
  • Prostheses
  • Critical Care
  • General Medicine
  • Infectious Diseases
  • Paediatrics
  • Cardiology
  • Nephrology
  • Neurology
  • Pulmonology
  • Dermatology
  • Rheumatology
  • Endocrinology
  • GastroEnterology
  • Psychiatry

Treatments not covered in YSR Aarogyasri health scheme

Some of the treatments not covered in YSR Aarogyasri health scheme are:

  • Treatments related to elective procedures
  • Cosmetic surgery
  • Infertility treatments
  • Non-essential treatments
  • Pre-existing diseases
  • Certain types of cancer treatment
  • Treatment of lifestyle diseases
  • Organ transplants
  • Treatments requiring prolonged hospital stay

Eligibility criteria to apply for YSR Aarogyasri

The criteria are quite simple as below:

  • Families native to Andhra Pradesh and Telangana can apply for this scheme. 
  • Those whose family income is below Rs. 5 Lakh can apply.
  • It is a must that they should possess white ration cards. 
  • Members of Antodaya Anna Yojana can apply for the scheme.
  • Those who are applying should have 35 acres of dry and wet land. 
  • People under this scheme should pay municipal property tax for less than 3000 Sft (334 sq. yds)

How to register for AP YSR Aarogyasri health scheme?

There are two options to register:

  1. Online procedure

To register for the AP YSR Aarogyasri Health Scheme in India, the following online procedure can be followed:

  • Go to the official website of the scheme
  • Click on the “Registration” tab
  • Fill in the required details, such as personal information and family details
  • Upload necessary documents, such as proof of residence and income
  • Submit the form
  • Wait for confirmation of your registration, which will be sent via email or SMS
  • Once your registration is confirmed, you can use your unique ID to access the scheme’s benefits.
  1. Offline procedure

To register for the AP YSR Aarogyasri Health Scheme in India, the following offline procedure can be followed:

  • Visit the nearest government hospital or primary health center
  • Ask for the Aarogyasri registration form
  • Fill in the required details, such as personal information and family details
  • Attach all the necessary documents, such as proof of residence and income
  • Submit the form along with the documents to the officials
  • Wait for confirmation of your registration, which will be sent via post or SMS
  • Once your registration is confirmed, you can use your unique ID to access the scheme’s benefits.

YSR Aarogyasri health scheme: documents required

Documents required to enroll for YSR Aarogyasri Scheme:

  • Aadhaar card
  • Address proof
  • Income certificate or income tax returns

YSR Aarogyasri health card & its features

Families applying for the Dr YSR Aarogyasri scheme get the YSR Aarogyasri Health Card. People can use this card to avail cashless medical services. This can apply to empanelled hospitals located in Andhra Pradesh and Telangana. This card consists of a unique card number photograph and other details of the holder. A medical emergency acts as an identity proof to apply for benefits.

How to download YSR Aarogyasri health scheme card?

To download the YSR Aarogyasri Health Scheme card in India, the following procedure can be followed:

  • Go to the official website of the scheme
  • Click on the “Download Card” tab
  • Enter your unique ID number and other personal information
  • Click on the “Download” button
  • Your card will be downloaded in a PDF format
  • Print the card or save it on your device for future reference.

YSR Aarogyasri health scheme vs Ayushman Bharat Scheme

The table below highlights the key differences between these two schemes:

YSR Aarogyasri Health SchemeAyushman Bharat Scheme
ImplementationImplemented in Andhra Pradesh stateImplemented across India
CoverageCoverage is limited to certain treatmentsCovers a wide range of treatments
EligibilityEligibility is based on family incomeEligibility is based on Socio-Economic Caste Census (SECC) data

How to claim YSR Aarogyasri scheme?

Follow these steps to claim YSR Aarogyasri scheme:

  • Get your treatment done at any of the empanelled hospitals under the scheme
  • Collect all the original bills, discharge summary and prescriptions from the hospital
  • Submit the bills, discharge summary and prescriptions along with your YSR Aarogyasri Health Scheme card to the hospital
  • The hospital will verify the documents and process the claim
  • Once the claim is processed, you will receive the reimbursement for the treatment in your account
  • If you have any queries or issues, you can contact the hospital or the YSR Aarogyasri Health Scheme helpline for assistance

Claim process for hospitals

The claim process for hospitals under YSR Aarogyasri scheme in India involves submitting original bills, discharge summary, and prescriptions to the hospital along with the patient’s YSR Aarogyasri Health Scheme card. The hospital verifies the documents and processes the claim. Reimbursement is given to the hospital for the treatment provided.

YSR Aarogyasri App: how to download?

To check the details related to Dr YSR Aarogyasri Yojana, one can visit the online application available on the play store.

Step 1: Visit “Google Play Store”.

Step 2: Find “Aarogyasri Trust”.

Step 3:Install the app.

Conclusion

In conclusion, the YSR Aarogyasri Health Scheme in Andhra Pradesh, India is a government-funded initiative that provides cashless healthcare benefits to eligible individuals and families. The scheme covers a range of treatments, but not all, and the eligibility is based on family income. The registration process can be done both online and offline. The scheme also has an easy claim process for the hospitals that are empaneled under the scheme. The scheme aims to provide affordable and accessible healthcare to the people of Andhra Pradesh, and it is a step towards achieving universal health coverage in the state.

FAQ

Is one required to pay a premium for availing the benefits under Dr YSR Aarogyasri’s scheme?

No, you are not required to pay any premium as it was born by the Andhra Pradesh government. This makes the scheme more beneficial for people with low income.

How to check the status of your YSR Aarogyasri Card?

Use YSRAHCT, YSR Health Care Trust’s mobile application, to find the data. Another option is to connect with customer care or a webpage.

During the time of medical emergency, whom should one approach?

There is a Kiosk in the hospital where you can find Vaidya Mitra. They will guide you through the process of hospitalization as well as fetching claims.

What is a Network Hospital?

These healthcare institutes provide medical services to applications under the Dr YSR Aarogyasri scheme.

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