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

Andhra Pradesh is a state in India that is situated in the south-eastern region of India. To serve the issue of quality healthcare services, the state government implemented Dr YSR Aarogyasri. It primarily serves the healthcare needs of low-income families.

What is Dr YSR Aarogyasri?

The YSR Aarogyasri Scheme is a health insurance scheme started by the Andhra Pradesh State Government in 2007 by then-chief minister Dr. Y S Rajasekhar Reddy. The Aarogyasri Health Care Trust is currently in charge of this scheme. It enables low-income families to obtain high-quality healthcare services without having to pay for them.

Highlights of Dr YSR Aarogyasri

Features And Benefits of AP YSR Aarogyasri Scheme 2020?

In Andhra Pradesh and Telangana, the Dr.YSR Aarogyasri health insurance policy is highly beneficial for availing high-quality healthcare services. The following are the features and benefits of the scheme:

1. Hospitalization (in-care patient)

   All the diseases that require hospitalization and are listed under the scheme are covered.

2. Out-Patient Treatment

   These treatments can be availed in a cashless manner at health camps and network hospitals.

3. Cashless Service

   The scheme provides a financial cover of INR 5 lakh per year per family to the scheme's beneficiaries. Registered family members can use this cover if they need medical assistance.

4. Coverage For Pre-existing Diseases

   This plan provides coverage for diseases that a beneficiary may have previously been diagnosed with before enrolling under the scheme. This is not a feature included in many commercial health insurance plans.

5. Coverage For Follow-up treatments

   The Dr YSR Aarogyasri plan also covers such procedures that require follow-up procedures after hospitalization.

1. Family-floater Health Insurance Cover

   The scheme provides health coverage to every member of the family so you don't have to buy separate health insurance plans for every member of the family.

Treatments Covered Under YSR Aarogyasri Scheme (Inclusions)

Treatments covered under this scheme are as follows:

Here is the complete list of treatments covered under the Dr YSR Aarogyasri Scheme

What Is Not Covered under the Dr YSR Aarogyasri Scheme (Exclusion)?

Certain procedures are not covered under the Dr YSR Aarogyasri Scheme. The following is a list of treatments that are not covered under the scheme. In these instances, the beneficiary will be responsible for the costs of these medical procedures:

• Knee replacement surgeries
• Gamma-knife procedures in neurosurgery
• Medical treatment related to bone marrow
• Leprosy
• Filaria
• Assisted devices for cardiac failures
• Cardiac and liver transplantations
• Malaria
• HIV/AIDS
• Tuberculosis
• Infectious diseases
• Gastroenteritis
• Jaundice
• Etcetera

Eligibility For YSR Aarogyasri Scheme

The eligibility criteria for Aarogya Scheme are as follows:

• The applicant should be a Native of Andra Pradesh and Telangana.
• Applicants have a family income of less than 500K INR.
• Applicants have a white ration card.
• Applicants must not own land of more than 35 acres.
• Applicants have not more than 1 car.
• Applicants must come under municipal property tax-paying families.
• Applicants that pay income tax of up to 500K can be the beneficiaries of this scheme.

Registration of YSR Aarogyasri Scheme

You can follow these steps to register yourself under this scheme:

Online Procedure

• Go to official Website
• Login with your ID & Password
• Fill the application form
• Upload documents
• Submit the application form
• Take the printout

Offline Procedure

• Go to the official website
• Click on the YSR Aarogya Health Card performa
• Download the scheme application form
• Take the printout
• Fill the application form
• Submit the application form physically to the concerned department
• Verification of the application form
• The beneficiary will get the YSR Health Card

Required Documents to Apply YSR Aarogyasri Scheme

The following documents will be required at the time of enrolment for the scheme:

• Aadhar card
• Address proof
• BPL certificate
• Income Proof

Dr YSR Aarogyasri Health Card and its features

In the states of Andhra Pradesh and Telangana, this Health Card provides access to cashless medical services at empanelled hospitals. It has a unique card number, a photo of the cardholder, and other information about the beneficiary. Here are some of the features of the YSR Aarogyasri Health Card:

• Reimbursement of INR 500k
• If the expense exceeds 500K, an additional benefit of 50K INR
• Coverage for serious illness treatment of INR 200K
• 938 Medical and surgical treatments are covered under the scheme

How to download the Arogyasri App?

An online application can be used to access various details about Dr YSR Aarogyasri Yojana. For Android devices, the Aarogyasri App can be downloaded from the Play Store. The following are the steps to get the app:

• Step 1. Go to "Google Play Store"
• Search "Aarogyasri Trust"
• Tap on Install

Andhra Pradesh Government's Dr YSR Aarogyasri COVID-19 Coverage

Thousands of people have died due to the COVID-19 outbreak around the world. COVID-19 is a major health problem that harms a person's respiratory system. He or she may have symptoms such as a dry cough, breathing difficulties, fever, and so on. COVID-19 is also extremely contagious, thus patients are kept in isolation. The Dr. YSR Aarogyasri plan now includes 15 new procedures to address this health issue. The following is a list of the treatments available:

• Intensive care management of Septic Shock
• Medical Management of Acute Bronchitis with Pneumonia and Respiratory Failure
• 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 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 of COVID - 19 with Comorbidities - HTN, DM, COPD, HIV, Chr. Liver Disease, Chr. Renal Disease
• Medical Management of COPD with Respiratory Failure (Infective Exacerbation)
• Medical Management of Pneumonias
• Medical Management of suspected COVID - 19 (Stable)

How To Claim The YSR Aarogyasri Scheme?

Due to the active functioning of the Dr. YSR Aarogyasri portal, the claim process for this scheme has become hassle-free. The following is the claim process for both beneficiaries and hospitals:

Claim Process For Beneficiaries

Beneficiaries of the Dr.YSR Aarogyasri scheme do not have to go through a lengthy claim process to receive medical treatment. YSR Aarogyasri Health Cards are given to beneficiaries at the time of enrollment. To receive treatment at an empanelled hospital, they simply need to show their health card to a Vaidya Mitra. He or she will collect the information from the card and the treatment will begin.

If a beneficiary does not have a YSR card, he or she can give the Vaidya Mitra the YSR Aarogyasri Health Card number. It's a good idea to take a picture of the health card. In the rare instance where there is no verification that a patient is a beneficiary of the Dr.YSR Aarogyasri scheme, the information can be obtained by contacting the Aarogyasri Trust.

Claim Process For Hospitals

In the case of planned surgical treatments, the hospital should seek pre-authorization. Only if the following conditions are met by the hospital authorities can a claim be fulfilled by the Dr.YSR Aarogyasri healthcare trust:

• The hospitals have pre-authorization to perform a treatment that is on the approved treatment list.
• The claim is intimated as early as possible
• The claim amount should be less than the pre-authorization limit
• For the settlement of the claim, photographic documentation of treatment is provided.

The Dr.YSR Aarogyasri site is used to settle all the claims. This portal can also be used to collect claim documents, claim intimation, and review claim documents, etc. After receiving a claim following verifications are carried out:

• Identity of the Patient
• Evidence of the Treatment
• Claim amount concerning the authorized amount
• Case management as per pre-authorization

Dr.YSR Aarogyasri Health Care Trust Toll-Free/Helpline Number And Address

Beneficiaries can contact the Dr.YSR Aarogyasri Health Care Trust if they have any questions or queries. For this, use the following contact information:

Aarogyasri Helpline Number:

• 1800-599-1111
• PAN India helpline number 104 can also be used to get a resolution for your queries.

Contact Number:

• 0863 - 2222802 / 2259861

Dr.YSR Aarogyasri Address:

• D.No. 25-16-116/B, Chuttugunta, Behind Gautam's Hero Showroom, Guntur, Andhra Pradesh, India - 522004.

Details for grievance resolution related to Dr.YSR Aarogyasri:

• Contact number: 8333817424/23/20/07 (Office Timings)
• Extension: 0863-2259861 (Ext:326)
• Email address: ap_grievance@ysraarogyasri.ap.gov.in

Contact details related to medical reimbursement status and issues:

• Contact number: 8333817363
• Extension: 0863-2259861 (Ext:329)
• Email address: ap_mr@ysraarogyasri.ap.gov.in

Health Insurer Network Hospitals