Dr YSR Aarogyasri Health Insurance Scheme

What is the Dr YSR Aarogyasri Health Insurance Scheme?

Dr YSR Arogyasri is a health insurance scheme launched by the state government of Andhra Pradesh in 2007. Dr YSR Arogyasri was launched by the then Chief Minister of Andhra Pradesh Dr YS Rajasekhara Reddy. Presently. Aarogyasri Health Care Trust administers Dr YSR Arogyasree Swasthya Bima Yojana. It allows low-income families to receive high-quality medical treatment without spending any money.

Highlights of the Dr YSR Aarogyasri Health Insurance Scheme

Coverage benefits Offered Under Dr YSR Aarogyasri Health Insurance Scheme

Dr YSR Aarogyasri can be very beneficial for the people who come from low-income families in Andhra Pradesh. Below-mentioned are the coverage benefits offered under the Dr YSR Aarogyasri scheme:

• Hospitalization Benefit (in-patient care)

All medical conditions listed under the DR YSR Aarogyasri scheme and require hospitalization are covered.

• Out-Patient Treatment

Health camps and network hospitals provide outpatient treatment in a cashless manner.

• Cashless Service

Dr YSR Aarogyasri offers its beneficiaries a financial cover of INR 5 lakh per family per year. Registered family members who require medical assistance can use this health cover in network hospitals to get cashless medical treatment.

• Coverage For Pre-existing Diseases

Dr YSR Arogyasree also covers the pre-existing diseases of the beneficiary without any waiting period. This feature is not included in many commercial health insurance plans.

• Coverage For Post-hospitalization treatments

Dr YSR Aarogyasri scheme also covers the post-hospitalization follow-up procedures.

• Family Health Insurance

Dr YSR Aarogyasri health insurance scheme offers a family health insurance plan to every member of the family. This means you don't have to buy separate health insurance for each family member separately.

Treatments Covered Under Dr YSR Aarogyasri Scheme or Inclusion of Dr YSR Aarogyasri Health Insurance Scheme

There are various treatments covered under the Dr YSR Aarogyasri health insurance Scheme. Below mentioned is the complete list of the treatments covered under the Dr YSR Aarogyasri Scheme:

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

What is Not Covered Under Dr YSR Aarogyasri Health Insurance Scheme or Exclusion in Dr YSR Aarogyasri Health Insurance Scheme

There are specific treatments which are not covered under Dr YSR Aarogyasri Health Insurance Scheme. Below is a list of treatments not covered under Dr YSR Aarogyasri Health Insurance Scheme. This means the beneficiary has to pay the cost of these treatments himself.

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

Eligibility Criteria for Dr YSR Aarogyasri Health Insurance

Below are the eligibility criteria for Dr YSR Aarogyasri Health Insurance Scheme:

• The applicant must be an Andhra Pradesh or Telangana native.
• The family income of the applicant should be under INR 5 lakhs.
• An applicant should have a white ration card.
• The applicant should not have land which cannot be more than 35 acres.
• The applicant must not have more than one car.
• Applicants must belong to families who pay municipal property taxes.
• The beneficiaries of Dr YSR Aarogyasri should pay an income tax of up to INR 5 lakh.

Registration Process for Dr YSR Aarogyasri Health Insurance Scheme

Below are both the types of registration processes (online and offline) to register yourself under the Dr YSR Aarogyasri Health Insurance Scheme:

Online Procedure

• Go to the official Website of the Dr YSR Aarogyasri health insurance Scheme
• Login with your login credentials
• Fill out the application form and upload the required documents
• Submit the application form
• Take the printout of the form after the submission

Offline Procedure

• Go to the official website of the Dr YSR Aarogyasri Health Insurance Scheme
• Click on the "YSR Aarogya Health Card performa."
• Download the Dr YSR Aarogyasri application form
• Take the printout of the form
• Fill and submit the application form to the concerned department
• The concerned department will verify the application form
• Once the verification is done, The beneficiary will get the "YSR Health Card."

Documents Required to Apply for Dr YSR Aarogyasri Health Insurance Scheme

Below mentioned are the documents required that you need to submit to get enrolled under the Dr YSR Aarogyasri Health Insurance Scheme:

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

What is Dr YSR Aarogyasri and its Features?

Dr YSR Aarogyasri Health Card grants access to cashless treatment at Andhra Pradesh and Telangana network hospitals. It has information about the beneficiary, a unique card number, and a cardholder's picture. The YSR Aarogyasri Health Card has the following features:

• The beneficiary or cardholders can avail of the reimbursement of INR 5 Lakhs
• Dr YSR Aarogyasri offered an additional benefit of 50K If the expense exceeds INR 5 Lakhs
• Dr YSR Aarogyasri offers Coverage for severe illness treatment of INR 2 Lakhs
• Dr YSR Aarogyasri covered 938 Medical and surgical treatments

How to download the Arogyasri App?

You can download its online application app to get various information about the Dr YSR Aarogyasri Yojana. You can download this App from "Google Play Store" for Android devices. Below mentioned are the steps to download the Aarogyasri App:

Step 1. Go to "Google Play Store"

Step 2. Search "Aarogyasri Trust"

Step 3. Tap on the Install button

Step 4. Open the App to use it

COVID-19 Coverage Under Dr YSR Aarogyasri Health Insurance Scheme

The outbreak of COVID-19 has caused thousands of deaths worldwide. COVID-19 is a severe illness that affects the respiratory system of the person. He may have symptoms like dry cough, shortness of breath, fever etc. Due to the high contagiousness of COVID-19, patients need to keep themselves in isolation. To overcome this health condition, Dr YSR Arogyasri scheme now includes 15 new treatments. Given below is the list of treatments covered under Dr YSR Aarogyasri Health Insurance Scheme:

• Medical Management of Acute Respiratory Failure (With Ventilator)
• Medical Management of Acute Bronchitis with Pneumonia and Respiratory Failure
• Medical Management of ARDS
• Medical Management of Acute Respiratory Failure (Without Ventilator)
• Medical Management of Acute Severe Asthma With Acute Respiratory Failure
• Medical Management of ARDS with Multi-Organ failure (R65.1)
• Medical Management of ARDS with DIC (Blood & Blood Products) (D65)
• Medical Management Of ARDS with multi-organ Failure in Pediatrics
• Medical Management of ARDS with DIC (Blood & Blood Products) (D65) in Pediatrics
• Medical Management of COPD with Respiratory Failure (Infective Exacerbation)
• 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 suspected COVID - 19 (Stable)
• Medical Management of Pneumonias
• Intensive care management of Septic Shock

Claim Process of Dr YSR Aarogyasri Health Insurance Scheme

Dr YSR Aarogyasri offers its beneficiaries a hassle-free claim process. Below mentioned is the claim process for both beneficiaries and hospitals:

Claim Process For Beneficiaries

The beneficiaries of the Dr YSR Aarogyasri Scheme do not need to go through a lengthy claim process to get medical treatment. Beneficiaries receive YSR Aarogyasri health cards at the time of enrollment under the scheme. They only have to present their health card to the Vaidya Mitra for medical care in the empanelled hospital. The treatment will be started by collecting the necessary information from the card.

The beneficiaries can provide their YSR Aarogyasri health card number to Vaidya Mitra if they do not already have a YSR Aarogyasri card. Taking a picture of a health card is a brilliant idea. When there is no way left to verify the patient's information under the Dr YSR Arogyasri scheme, the information can be obtained by contacting the Aarogyasri Trust.

Claim Process For Hospitals

In case of planned hospitalization, patients will have to submit a pre-authorization letter. The hospital will request a pre-authorization letter for the planned surgical procedures. Dr YSR Aarogyasri Healthcare Trust will fulfil the claims only if the hospital administration fulfils the following requirements:

• In the case of Planned Hospitalization

1. The hospital needs a pre-authorization letter to perform a procedure on the approved treatment list.
2. The claim should be intimated as early as possible.
3. The claim amount should be less than the sum insured amount (pre-authorization amount).
4. Photographic documentation of the treatment is needed for the claim settlement.

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

• Patient Identification
• Treatment Evidence
• Case management as per pre-authorization
• Claim amount sync with the pre-authorized amount

Dr YSR Aarogyasri Health Care Trust Hospital List

Many hospitals empanelled under Dr YSR Aarogyasri Health Insurance Scheme offer cashless medical treatment to the beneficiary in case of a medical emergency. Below is the list of network hospitals that offer cashless medical treatment under the Dr YSR Aarogyasri Scheme:

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

The beneficiaries can contact the Dr YSR Aarogyasri Health Care Trust by using the below mentioned contact details:

Dr YSR Aarogyasri Helpline Number:

• 1800-599-1111
• PAN India helpline number is 104

Dr YSR Contact Details:

• 0863-2222802 / 2259861

Dr YSR Aarogyasri Address:

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

Grievance details related to Dr YSR Aarogyasri:

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

Contact details related to claim reimbursement status and issues:

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