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

The YSR Aarogyasri plan is a unique healthcare plan implemented by the Andhra Pradesh Government (AP) through the YSR Aarogyasri Healthcare Foundation. The program provides financial assistance to families below the poverty line to meet their catastrophic health needs in order to achieve universal medical coverage for BPL families in terms of obtaining adequate medical care and financial protection. Written by Dr. YSR Aarogyasri.

The YSR Aarogyasri program aims to provide high-quality healthcare services in the state and help poor families pay for high medical expenses. It is a public-private partnership (PPP) model in the field of health insurance tailored to the health needs of impoverished patients.

 The program provides end-to-end cashless services for specific diseases under the second and third levels through the government and government networks. Private sector service provider. The YSR Aarogyasri program aims to benefit outpatient consultation and primary care through free screenings conducted in medical camps and network hospitals, as part of the program’s implementation. Since no other state or government agency provides universal health insurance to the poor, the applicability of the plan is unique.

Information, education and communication (IEC) activities in health camps, consultation, discovery and treatment of common diseases in health camps, and outpatient services in-network hospitals are complementing the government’s health system in primary care and preventive care.

The main goal of the Chief Minister of Andhra Pradesh, Dr. YS Rajashekar Reddy, is to provide financial assistance to low-income families in the state so that they can obtain quality health care services and launched a health plan in 2007. This plan is called YSR Aarogyasri Health Plan. It is managed by Aarogyasri Health Care Trust. The YSR Aarogyasri health plan offers variety of benefits, one of the most widely used benefits is cashless treatment in Andhra Pradesh government hospital.

The Arogyasri Health Care Trust issues an anArogyasri card, which makes it easy to manage the plan. Beneficiaries can enjoy benefits after presenting this card at government hospitals under the YSR Aarogyasri health plan.

Objective of YSR Aarogyasri

To provide equity of access and free quality hospital care to the BPL families by purchasing quality medical services through a self-funded reimbursement mechanism from the identified network of health care providers.

To give financial security against catastrophic health expenditure.

To strengthen the government hospitals through demand-side financing.

To provide universal coverage of health for both rural and urban poor of Andhra Pradesh.

Ailments Covered Under YSR Aarogyasri

The serious diseases affecting the kidney, heart, brain, burns, cancer and accident cases are covered under this scheme. A total of 2,434 Surgeries or Therapies in 30 categories are covered under the YSR Aarogyasri scheme. The list of 2,434 “Listed Therapies” and 30 categories is provided on the YSR Aarogyasri website.

The existing government medical infrastructure from Primary Health Care, Community Health Care, Area Hospital, Specialty Hospitals and District Hospital can provide free treatment for other diseases. The patients can choose the hospital for treatment. The hospitals covered under this scheme are provided on the YSR Aarogyasri website under the ‘Hospitals’ option.

Beneficiaries Under YSR Aarogyasri

All the BPL families of AP identified by the BPL ration cards that the Civil Supplies Department issues are eligible to obtain benefits under this scheme. Every person whose name and photo appear on the BPL ration card, including the Annapurna and Anthyodaya Anna Yojana beneficiaries, white ration card (TAP and RAP) suffering from any diseases covered under this scheme are eligible to avail treatment.

All the BPL families with valid white ration cards are automatically covered under YSR Aarogyasri from the day of implementation of this scheme. There is no need for applying separately for this scheme. The beneficiaries will have to contact the empanelled hospitals or Vaidyamithra (help desks) in hospitals for availing treatment under this scheme.

Benefits Provided Under YSR Aarogyasri

All the BPL families are provided free hospital service under this scheme. Coverage of up to Rs.5 lakh for each family per year is provided under this scheme. The beneficiaries can obtain free medical services from the identified hospitals through a reimbursement mechanism.

The YSR Aarogyasri scheme package includes the following services:

End-to-end cashless service offered through the network hospitals from the time of reporting of a patient till ten days post-discharge medication, for the patients who undergo the specified therapies, including complications if any up to thirty days post-discharge.

Free out-patient evaluation of patients for the specified therapies who do not undergo treatment for the specified therapies.

All the pre-existing cases under the listed therapies are covered.

Transportation and food of the patient are also covered.

Other benefits of Aarogyasri Health Scheme

The YSR Aarogyasri Health Scheme is highly beneficial for low-income earning families and provides several benefits. Here are the benefits provided by this scheme:

Cashless Healthcare

There is a financial cover of Rs 5 lakh per year to the beneficiary and his/her family. This cover can be utilized by any registered family member.

In-Patient Care

The listed diseases under the scheme as well as the hospitalization are covered.

Out-Patient Treatment

Cashless treatment is provided to the beneficiary for the listed diseases at health camps as well as in the network hospitals.

Pre-Existing Disease Cover

If the beneficiary is suffering from any disease before registering for the Aarogyasri Health Scheme will be provided cover. This feature is not provided under many of the other health insurance policies

Follow-up Treatment Cover

The follow-up treatments after the hospitalization eat up a good chunk of money. Aarogyasri Health Scheme provides coverage for that as well.

Family Floater Cover

Under the Aarogyasri health scheme, the whole family will be provided coverage. The buyer does not have to purchase a separate health insurance plan for each member of the family.

Treatments Covered in YSR Aarogyasri Scheme

Several treatments ranging from standard to critical treatments are covered in this Scheme. They are as follows:

General SurgeryCritical Care
ENT SurgeryGeneral Medicine
OphthalmologyInfectious Diseases
Gynaecology & ObstetricsPaediatrics
Orthopedic Surgery & ProceduresCardiology
Surgical GastroenterologyNephrology
Cardiothoracic SurgeryNeurology
Paediatric SurgeriesPulmonology
Genitourinary SurgeriesDermatology
Surgical OncologyEndocrinology
Medical OncologyGastroEnterology
Radiation OncologyPsychiatry
Plastic SurgeryProstheses & Polytrauma

There are some of the new procedures included in the YSR Aarogyasri Health Scheme. They are as follows:

Superficial Parotidectomy(Non-malignant)Laparoscopic HemiThyroidectomy
Excision of Meckel’s DiverticulumRectovaginal fistula Management without Colostomy
Rectopexy Open with Mesh for Rectal ProlapseMyringoplasty
SeptorhinoplastyExenteration of Orbit
Glaucoma SurgeryJoint reconstruction/intra articular fractures
Bone tumor surgery reconstruction with internal fixationCoronary Balloon Angioplasty with Drug-eluting stent
Surgical management of Empyema ThoracisLumbar Hernia repair In Paediatric Patients
Excision of Ureterocele with Ureteric ImplantationOpen radical Prostatectomy
Bladder neck reconstruction for IncontinenceLaparoscopic Surgical treatment for Duodenal Perforation

Treatments Not Covered in YSR Aarogyasri Health Scheme

There are some of the treatments that are not covered in this scheme. They are as follows:

Knee replacement surgeriesMalaria
Gamma-knife procedures in neurosurgeryHIV/AIDS
Medical treatment related to bone marrowTuberculosis
Leprosy & FilariaInfectious diseases
Assisted devices for cardiac failuresGastroenteritis
Cardiac and liver transplantationsJaundice

Elgibility Criteria

The eligibility criteria for the AP YSR Aarogyasri health scheme are as follows:

  • The applicant should be a local of Andhra Pradesh and Telangana.
  • The annual income of the applicant’s family should be less than Rs 5 lakh.
  • They should hold a white ration card.
  • The applicant must not have a land more than 35 acres. (Wet & Dry)
  • The applicant must have less than 3000 square feet of area.
  • One must fall under Municipal Property Tax-paying Families.
  • The applicant cannot own more than 1 car.
  • A private sector employee and an honorary remuneration employee can be the beneficiary of this scheme.
  • Families that file for an income tax of up to Rs 5 lakh can be the beneficiary of this scheme.

How to Register for AP YSR Aarogyasri Health Scheme?

If you are eligible for the YSR Aarogyasri Health Scheme, then you can follow the below-mentioned procedure to AP YSR Aarogyasri registration under the scheme.

Online Procedure

To enroll in the scheme online, follow the procedure mentioned below:

  • Visit the official website
  • Login
  • Fill the Aarogyasri health card application form
  • Upload required documents
  • Submit the form
  • Fetch the printout

Offline Procedure

To enroll in the scheme offline, you will have to follow the procedure mentioned below:

  • Visit the official website
  • Click on YSR Aarogya Health Card Performa
  • Download the YSR Aarogyasri Scheme application form
  • Take the printout
  • Fill the form
  • Submit the form physically to the concerned department
  • Once verified, the beneficiary will get the YSR health card.

YSR Aarogyasri Health Scheme: Documents Required

These documents required to enroll are as follows:

  • Aadhar Card
  • Address proof
  • Income certificate
  • BPL certificate

YSR Aarogyasri Health Card & Its Features

Once the applicant enrolls successfully, the family will get the YSR health card. The card holds a unique number, beneficiary’s photo and other important details. The card is used to avail the required cashless benefits at the network hospitals. Here are some of the features of YSR Aarogyasri health card:

  • The cardholder can avail reimbursement of Rs 1.5 lakh
  • If the expenses exceed 1.5 lakh, the cardholder can avail of additional benefits of Rs 50,000.
  • Card provides Rs 2 lakh worth of coverage for serious illness treatment.
  • 938 medical and surgical treatments can be availed under the scheme.

How to Download YSR Aarogyasri Health Scheme Card?

The scheme holders can download the YSR health card by following the below steps:

  • Visit the official website of Dr. YSR Aarogysri Health Care Trust
  • On the home page, there is a section called ‘EHS’. Select it and proceed for ‘Download Health Card’ option.
  • Enter the relevant user Id and click on ‘Go’.
  • Mention the necessary information to get the YSR Aarogyasri Health Card on the screen.
  • Download a soft copy of the card and use it whenever is required.

YSR Aarogyasri Health Scheme Vs Ayushman Bharat Scheme

As per a report of Telangana today, YSR Aarogyasri health scheme is considered a better scheme than Ayushman Bharat Scheme, when compared.

ParametersYSR Aarogyasri Health SchemeAyushman Bharat Scheme
Sum InsuredRs 2 lakh up to Rs 13 LakhRs 5 Lakh
EligibilityDoes not follow SECCFollows Socio-economic caste census data (SECC)
ImplementationWas implemented in 2007, State governments are aware of its working.Ayushman bharat scheme is a new scheme. Not many families are aware of it.

How to Claim YSR Aarogyasri Scheme?

To claim the YSR health scheme, the beneficiary has to show their YSR health card to the Vaidya Mitra so that it can be verified. If the beneficiary does not possess the card, then he/she can provide the card number for recognition.

Claim Process for Hospitals

An authorization must be obtained by the hospital for the surgical treatments. The trust will only accept the claim if the hospital authorities meet the following conditions:

  • Hospitals are allowed to treat the patient for the approved treatments under the scheme.
  • Fill the claim form as soon as possible.
  • The claim amount is less than the pre-authorized limit.
  • Photographic evidence of treatment for claim settlement is there.

Apart from this, the beneficiary can also use the online portal to collect the claim documents, intimate claims etc. The beneficiary will have to verify the following information once the claim is filed:

  • Identity of patient
  • Evidence of treatment
  • Claim amount with respect to the authorized amount
  • Case management concerning for before authorization

YSR Aarogyasri App: How to Download?

YSR Aarogyasri App is helpful in providing comprehensive details about the scheme. The Aarogyasri App is easily available on Google Play Store, which can be access by any android user.

  • Open ‘play store’ on your android phone
  • Search for ‘YSR Aarogyasri’ or ‘YSR Aarogyasri Healthcare Trust

For solved

UPSC ESSAYS click here

GS Paper 1 click here

Gs Paper 2 click here

Gs paper 3 click here

GS paper 4 click here

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