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Salient Features of the Employee Health Scheme
The scheme will provide inpatient treatment for the listed therapies (which are at present 1885)
under all specialties in the empanelled hospitals.
Necessary follow-up treatments of surgical or medical
Arogyamithra belonging to AHCT (Aarogyasri Health Care Trust) in the empanelled hospital (Network Hospital) will
guide and facilitate the movement of EHS Patient (Employee/Pensioner/Dependent Family Member) from the time of
registration till the time of discharge.
The network hospital will earmark one of their staff as EHS
liaison assistant to liaise with EHS patients.
OP treatment for pre-defined long-term (chronic) diseases will be
provided in notified hospitals.
The employees, pensioners and their dependent family members will be eligible for a sum of Rs.2.00 lakhs (Rupees two lakhs only) per episode of illness with no limit on the number of episodes. However, in the cases where the cost of treatment exceeds Rs.2.00 lakhs, cashless treatment will continue.
The limit of Rs.2.00 lakhs will not apply in cases where predetermined
package rates are above Rs.2.00 lakhs.
Chief Executive Officer, Aarogyasri Health Care Trust will settle the claims
which exceed Rs.2.00 lakhs
Payments under the scheme will be based on approved package prices
The period from the date of reporting to hospital to 10 days after the
date of discharge from the hospital will be treated as part of the
The package will include the entire range of investigations, medicines,
implants, consumables, diet, post-operations / post-treatment complications
and follow up care arising from the therapeutic intervention.
If both of the spouses are Government employees or Service
Pensioners, contribution by any one of the spouses is sufficient.
The following standard schedule of Rates are approved for Employee Health Scheme
1. Stay in Semi Private ward Rs.1,200/- per day in non-NABH accredited hospitals and Rs.1,500/- per day in NABH accredited hospitals.
2. Stay in Private ward Rs.1,500/- per day in non-NABH accredited hospitals and Rs.2,000/- per day in NABH accredited hospital.
(NABH=National Accreditation Board for Hospitals)