Dr YSR Aarogyasri Health Insurance Scheme – Check Benefits, Coverage, Eligibility & List of Diseases Covered under Aarogyasri

Updated on Oct 17, 2023

Looking to invest in health insurance? Know all about Dr YSR Aarogyasri health insurance scheme, its benefits, what it covers and who is eligible for the Dr. YSR Aarogyasri health plan.

Access to health insurance should be everyone’s right. To make this reality possible, state governments in India are making particular efforts to ensure that health insurance is reachable and accessible to every single person in their respective state. Dr YSR Aarogyasri Health Insurance Scheme is one such example. The scheme is run by the Andhra Pradesh state government to cater specifically to the healthcare needs of the economically weaker sections of the society.

Here we discuss the scheme in detail, talking about its benefits, coverage areas and eligibility criteria. Read on.

What is Dr. YSR Aarogyasri Scheme?

As mentioned earlier, this scheme is run by the Andhra Pradesh state government, specifically to help the economically weaker sections of the society avail of health insurance benefits. The scheme is named after the state’s Chief Minister Dr YSR Reddy who launched it in the year 2007.

Also Read: Best health insurance company in India

YSR Aarogyasri Scheme Details

Listed below are the key details of the scheme for your better understanding:

Key Features and Highlights of Dr. YSR Aarogyasri scheme

Dr. YSR Aarogyasri Health insurance plan is specially designed to cater to the health needs of low-income families in the state of Andhra Pradesh. The plan has been a huge success mostly because of its distinct highlights as mentioned below:

• Collective Healthcare Access to Every Eligible Resident

The scheme offers universal healthcare access to every family and individual who is eligible under the plan.  It makes sure that every resident of Andhra Pradesh irrespective of their income group receives the best medical treatment in the state.

• All-inclusive Coverage for Wide-Ranging Treatments  

The scheme ensures comprehensive protection against several health treatments which comprises diagnostic tests, surgeries, as well as other healthcare services. The plan also encompasses treatments for maternity care, critical care, cardiology, oncology, and more.

• Cashless Treatment in Network Hospitals

Dr. YSR Aarogyasri plan beneficiaries can avail of cashless treatment in the wide network of hospitals in the state. This is an excellent facility for the beneficiaries as they are not required to make any payments from their pockets. They can avail of the cashless facility for getting treatment of diseases during emergencies and under normal circumstances.

• Protect Beneficiaries from Disastrous Healthcare Expenses

When a health emergency strikes, the treatment expenses pose a threat to the financial equilibrium of a family. By covering the expenses of costly medical treatments, Dr. YSR Aarogyasri scheme ensures the monetary protection of the beneficiaries.

• Gives Emphasis on Preventive Care

The plan offers coverage against preventive screenings and health check-ups. The preventive check-up detects illnesses at an early stage and helps in getting early treatment. This lowers the possibility of diseases reaching an advanced stage. This way, the plan promotes preventive care.

• Specialized Medical care 

Under the Dr. YSR Aarogyasri scheme, beneficiaries have access to focused medical treatment which includes critical illnesses, surgeries, organ transplants, cardiac treatment, and more. This makes sure that the beneficiaries receive the advanced and best treatments for such critical medical conditions.

• Post-Treatment Rehabilitation Services

Along with offering advanced treatments, Dr. YSR Aarogyasri scheme also recognizes the significance of post-hospitalization treatments. Hence, the scheme covers services like physiotherapy, speech therapy, etc., to support the recovery of beneficiaries.

• Transparency in Claims/Billing 

The policy encourages transparency in treatment costs and billings. It supports beneficiaries from getting trapped by expensive and overcharged healthcare services.

• Backed by the State Government  

Since the Dr. YSR Aarogyasri scheme is backed by the government, it makes the scheme reliable. It also reflects the commitment on the part of the Andhra Pradesh State government to care for the well-being of its citizens.

• Easily Accessible and Efficient 

Dr. YSR Aarogyasri scheme allows applicants to enroll in the scheme via online and offline processes. The plan is well-designed and easily accessible. It puts healthcare within the easy reach of the eligible applicants.

Overall, the Dr. YSR Aarogyasri scheme allows peace of mind to the beneficiaries by giving them the facility to avail quality healthcare services in times of health emergencies.

6 Benefits of Dr. YSR Aarogyasri Health Insurance Scheme

Here are the prime benefits offered under the scheme by the state to its policyholders:

1. Cashless medical facilities: This is one of the most important benefits offered under this scheme. A financial cover of Rs. 5 lakh per family is provided to the policyholders or beneficiaries under the scheme every year. This cover can be used in case of medical emergencies to avail cashless hospitalization benefit under the scheme.
2. Family-floater plan: Another benefit of the scheme is that it assures health insurance benefits for the entire family, covering each family member under its Family-Floater Health Insurance Cover. This also means that there is no need to buy individual health insurance plans for each member separately (which would be unnecessarily costly and time-consuming). One cover suffices the healthcare needs of all.
3. Covers emergency hospitalization: In case of any medical emergency that may arise an instant (unprepared) need for immediate hospitalization, the scheme comes of great help and use to the beneficiaries. All hospitalization costs can be covered under the financial cover provided as part of the scheme.
4. Pre-existing diseases covered too: Most health insurance plans may not provide financial coverage for pre-existing diseases. However, Dr YSR Aarogyasri scheme assures financial coverage to the beneficiaries for certain pre-existing diseases as well, meaning those for which the treatment had been going on for the beneficiary before they were enrolled in the scheme.
5. OPD treatment covered: Not just in-patient hospitalization expenses but even day care treatment procedures at the OPD are covered under the scheme. Cashless treatment for OPD treatments is available at the insurer’s network hospitals and health care camps/day care centers.
6. Follow-up visits covered too: Certain treatments may require OPD follow-up visits or small procedures after hospital discharge. The scheme covers such follow-up visits and procedures as well.

Also Read: What is Health Insurance with OPD Cover?

List of Diseases Covered Under YSR Aarogyasri Scheme

Dr. YSR Aarogyasri scheme is an all-encompassing health policy that covers a great number of treatments that are generally not covered under many health insurance plans. You also get a good number of hospitals that are enlisted under the plan for cashless treatment:

Below is a list of treatments available under Dr. YSR Aarogyasri scheme:

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Other Treatments Covered Under Dr. YSR Aarogyasri Scheme

General Surgeries Covered Under Dr. YSR Aarogyasri Scheme

Below is the list of general surgeries covered by the scheme:

• Orthopedic Surgeries for treatment of fractures, joint reconstruction, spinal cord compression, intra-articular fracture, etc.
• Ophthalmology treatments like eye care, glaucoma surgery, cataract surgery, corneal transplants, and more.
• ENT Surgery like adenoidectomy and tonsillectomy, Septorhinoplasty, etc.
• Gynecology and Obstetrics surgeries like ovarian cyst removal, risky pregnancy, obstetric surgeries, and more.
• Treatment for gastrointestinal conditions like bowel obstructions, ulcers, surgeries for rectal prolapse, etc.
• Bone marrow transplants for leukemia
• Plastic Surgery for burn treatment, traumatic injuries, deformities, etc.
• Coronary balloon angioplasty
• Open radical prostatectomy
• Superficial parotidectomy (non-malignant)
• Surgery to cure Lumbar hernia
• Laparoscopic surgical treatment, etc.

Exclusions of YSR Aarogyasri Health Scheme

Like other health insurance plans, some treatments are excluded under Dr. YSR Aarogyasri scheme as mentioned in the table below. For treatment of the below procedures, the beneficiary has to incur the expenses on their own:

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How To Enrol

To enroll for the Dr. YSR Aarogyasri scheme via offline mode, applicants must visit the enrolment office carrying the documents needed. Once the documents are verified, the applicants will receive a health card of the scheme called the ‘YSR Aarogyasri health card’. They will require the card in the future for availing of cashless treatments.

Alternatively, the applicants can also join the scheme online mode by logging in to the official Aarogyasri portal using their Login ID and Password, which can be acquired from the nearest MeeSeva center. Along with joining the scheme, beneficiaries can access several other scheme details by logging in to the portal.

There are other routes of direct registration wherein the beneficiary can use the first point of contact mentioned below:

• Health Camps provided by Network Hospital (NWH)
• Direct registration at a network hospital
• Vaidya Mitra counters at Primary Health Care (PHC)
• Recommendation from a Certified Medical Compliance Officer (CMCO)

How to register for the Dr. YSR Aarogyasri Scheme

Beneficiaries can use the below-mentioned points of contact for direct registration to the scheme:

• Health Camp organized by the PHCs or Network Hospital (NWH)
• Vaidya Mitra counters at Primary Health Care (PHC)
• Direct registration at an NWH via referrals
• Referral from Certified Medical Compliance Officer (CMCO)

Eligible applicants can enroll in the scheme by visiting the enrolment center with the necessary documents. The documents submitted by the applicant get verified and a YSR Aarogyasri health card is given to the beneficiaries to avail of cashless treatments.

Applicants can also get the enrolment procedure done by logging in to the official website of Arogyasri. To do so, they would require credentials like username and password. To get the credentials, applicants may visit the nearest MeeSeva center.

Here are the steps to follow for online and offline registration under the scheme.

Online Process

• First, ensure that you are eligible for the plan
• Visit the official portal of the plan at https://www.ysraarogyasri.ap.gov.in/
• Use your credential to log in to the site (received via MeeSeva centers)
• Look for the YSR Aarogyasri application form
• Duly fill out the form
• Submit the form along with the necessary documents like Aadhar, income certificate, caste certificate, etc.
• Take a printout of the acknowledgment message after submission

Offline Process

• Visit the nearest scheme enrolment center
• Seek help from the enrolment officer to register for the process
• Submit the required documents like Aadhar, income certificate, caste certificate, etc.
• Duly fill out the form and submit it
• You might be required to give biometric data like fingerprints, iris scans, etc.
• Once the verification process is complete, you will receive a unique ID number
• Finally, you will receive a health card as proof of enrolment
• You can use this card to access cashless medical treatment

Documents Needed to enroll for Dr. YSR Aarogyasri Scheme:

An applicant would require the following documents to enroll:

• Address proof
• Aadhaar card
• Income proof or ITR

Who are Eligible for YSR Aarogyasri?

The following people can apply for Dr YSR Aarogyasri Health Insurance Scheme:

1. Those who possess white ration card
2. Those who fall under the category of municipal property tax-paying families
3. Those who are a native of Andhra Pradesh and Telangana
4. Those who possess less than 35 acres of land
5. Those with a total family income of < Rs. 500,000
6. Those who have only 1 car
7. Those who pay an income tax of up to Rs. 500,000

Also Read: 5 Best Health Insurance Policies for Senior Citizens

YSR Aarogyasri Hospitals List

A number of hospitals are empaneled under the Dr YSR Aarogyasri Health Insurance Scheme. These are called network hospitals and provide cashless hospitalization benefits to the beneficiary under the scheme. Here we present a list of the network hospitals covered under the scheme:

Also Read: Mukhyamantri Amrutum Yojana Eligibility, Coverage, and Benefits

What is Dr. YSR Aarogyasri Health Card: 

YSR Aarogyasri Health Card serves as proof of enrolment for beneficiaries to avail medical assistance during a medical emergency. The health card is offered to beneficiaries to access cashless treatment in the network hospitals in Telangana and Andhra Pradesh under the Dr. YSR Aarogyasri scheme. This health card contains a number and a photo of the beneficiary. It also contains other details associated with the beneficiary.

4 Features of YSR Aarogyasri Health Card

In order to avail cashless hospitalization benefits under the scheme, a health card is issued to the beneficiary. This card gives them instant cashless facility at the various network hospitals listed above. The health card details the beneficiary’s unique card number along with their photograph. Some of the benefits of the YSR health card are:

1. In case of medical expenses higher than Rs. 500,000, the card provides an added benefit of Rs. 50,000 to the cardholder.
2. Around 900+ surgeries and medical procedures are financially covered under the scheme.
3. The cardholder is entitled to a reimbursement of Rs. 500,000 on the medical expense incurred.
4. Critical illnesses amounting to a cost of Rs. 200,000 are covered under the scheme.

To get the Aarogyasri card, apply online on the official website of Dr YSR Aarogyasri Health Insurance Scheme (website mentioned in the blog above).

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How to Download the Health Card of Dr. YSR Aarogyasri Scheme

Here are the five easy steps to follow to obtain a Dr. YSR Aarogyasri Health Card:

• Go to the official website of the scheme at https://www.ysraarogyasri.ap.gov.in
• Next click on the tab of ‘Download Health Card’ on the ‘EHS’ section on the homepage
• Submit your user ID and proceed ahead by clicking on ‘Go’
• Submit all the details as requested on the screen to see the YSR health card
• Save a copy of the card to use in the future as proof

How to Check the Status of Dr. YSR Aarogyasri Health Card  

You can check the YSR Aarogyasri Health Card Status YSR by using the mobile app of the thrust. For this, you can call customer care on the helpline number or by visiting the website.

Process To Download the Aarogyasri App from your Android Phone 

The Dr. YSR Aarogyasri scheme app helps the beneficiaries access various information about the scheme. The app can be downloaded from the PlayStore of your Android phone by following the below steps:

1. On your Android phone, open “Google Play Store”
2. Look for “Aarogyasri Trust”
3. Install the app
4. Once installed, you can use it for different purposes

The process to Claim under the Dr. YSR Aarogyasri Scheme

The claim process of the Dr. YSR Aarogyasri scheme for beneficiaries is smooth and short if done through the official portal of the scheme.

• As a beneficiary, you receive the YSR Aarogyasri Health Cards while enrolling in the scheme
• To avail of cashless treatment, the beneficiary is expected to give the health card to a Vaidya Mitra
• The person will collect the details on the card and will initiate the treatment

In the absence of a physical card, the beneficiary can supply the Vaidya Mitra with his/her Health Card number. You may save a soft copy of the health card on your mobile or save it as a picture in the gallery. However, in the absence of any proof, the beneficiary can gather the details via the Aarogyasri Trust.

Dr. YSR Aarogyasri Health Care Trust Contact Detail:

Here are the contact details of Dr. YSR Aarogyasri Health Care Trust (for beneficiaries):

Aarogyasri Helpline Number: 1800-599-1111

Contact Number: 0863 – 2222802 / 2259861

Dr.YSR Aarogyasri Address:

D.No. 25-16-116/B, Chuttugunta,

Behind Gautam’s Hero Showroom,

Guntur – 522004.

Andhra Pradesh, India

Contact details for grievances:

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

Contact details for reimbursements:

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

Dr. YSR Aarogyasri Scheme Vs. Aayushman Bharat Yojana

Below is a table of comparison based on different factors to distinguish between both the health insurance schemes:

Critical Conditions Covered Under Dr. YSR Aarogyasri Scheme 

• General Medicine
• Pediatrics
• Nephrology
• Pulmonology
• Rheumatology
• Gastroenterology
• Prostheses
• Infectious Disease
• Cardiology
• Neurology
• Dermatology
• Endocrinology
• Psychiatry
• Polytrauma

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Summary

Dr YSR Aarogyasri Scheme is a state-run initiative to help the financially challenged seek healthcare benefits at an affordable price. Avail the benefits under the scheme and secure your financial future as well as that of your loved ones.

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