Frequently Asked Questions:

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  • What are the benefits covered under the Scheme?
    • 1) In patient treatment:
      · For the listed therapies under all specialties in all the empanelled hospitals.List can be seen on the website
      · Follow-up treatment of Surgical or medical ailments.
      · Packages will include entire range of investigation, medicines, implants, consumable, diet, post operations/post treatment complications and follow-up care.
      · Packages will also include pre-evaluation by patients including consultation and investigations even in the cases which do not finally end up with admission for IP treatment.
      2) Out Patient treatment for Chronic Diseases:
      · OP treatment for Chronic diseases will be provided in notified Government Hospitals and include consultation, investigations and drugs detailed Guidelines will be made available on the website.
      3) Annual Health Checkup:
      · For employees who crossed 40 years of age.
  • What is the financial coverage?
    • The financial coverage under EHS is Rs.2.00 lakhs per episode of illness with no limit on the number of episodes, where the cost of treatment exceeds the above limit, cashless treatment will continue without denial of treatment by the network hospital.  This limit will not apply in cases where pre-determined package rates are above Rs.2.00 lakhs 
  • Will I be reimbursed, if treatment is taken out of the State of Andhra Pradesh?
    • Reimbursement is not allowed w.e.f.01.12.2014, even if, treatment is taken outside A.P. and Telangana States.;
  • What is the difference between Aarogyasri Scheme and Employees Health Scheme and in facilities, ceiling of amount etc?
    • The Aarogyasri Scheme introduced by the erstwhile Government of Andhra Pradesh has been renamed as "Dr. Nandamuri Taraka Rama Rao Aarogya Seva". This Scheme is meant for BPL families and its coverage is Rs.2.50 lakhs per annum for the entire family on floater basis, covering 1038 procedures and the patient is entitled for in-patient treatment in general ward only. 133 procedures are earmarked for treatment exclusively in Government Network Hospitals.
      The Employees Health Scheme is meant to provide cashless treatment to all regular State Govt. employees, pensioners and their dependent family members in all empanelled Network Hospitals (both Govt. & Private) and the financial coverage is Rs.2.00 lakhs per episode of illness with no limit on the number of episodes. Even, if the cost of treatment exceeds Rs.2.00 Lakhs, cashless treatment will continue without denial of treatment by the Network Hospital. The Procedures / Therapies covered are 1885 for the present and treatment will be provided in semi private and private wards as per eligibility. The Scheme also covers treatment for Chronic OP Diseases and annual health checkup for employees who crossed 40 yrs of age in notified Government Hospitals.
  • Is Out-Patient treatment covered in Employees Health Scheme?
    • Outpatient treatment is available only for Chronic diseases in notified Government Hospitals between 2 PM - 4 PM on week days, in special clinics where a consultant Doctor will see the patients. Pharmacist, Radiology and clinical laboratory services with sample collection will be available. Medicines will be supplied to the patient at the Special Clinics as per the prescription given by the Consultant Doctor.
  • Will I be reimbursed, if I were to pay the Hospital?
    • As per Para 2 (I) of G.O.Ms. No.134, HM & FW (I.1) Dept., Dt:29.10.2014, the deductions from the salary / pension of the employees / pensioners towards contribution under the Scheme, shall be effected from the salary/ pension pertaining to November, 2014 payable on 01-12-2014. Medical reimbursement under APIMA Rules, 1972 will not be allowed for the treatment undergone on and after 01-12-2014.