Telangana EHS – Employees Health Scheme
Telangana Employees Health Scheme (EHS) is a government initiative providing robust health insurance and medical benefits for employee well-being. With an extensive network of hospitals, it ensures access to quality healthcare for government employees. The program offers health coverage, including medical reimbursement and prescription benefits. EHS prioritizes employee wellness, offering services to enhance health. Enrollment is easy, and the scheme stands as a cornerstone of the Government Health Program. This employee welfare scheme emphasizes the importance of health, with a dedicated list of EHS Hospitals ensuring comprehensive healthcare services. the network of healthcare providers listed in the EHS Hospitals List, and enjoy streamlined medical reimbursement
TS EHS / JHS Portal Details
The State Government of Telangana has formulated a new health scheme it will provide cashless treatment to State Government Employees , Pensioners and Journalists and their dependent family members . The New Scheme Employees Health Scheme was replaces the existing Medical reimbursement System under under the ‘Andhra Pradesh Integrated medical Attendance Rules, 1972 with additional benefits (G.O MS No 174, HM&FW (M2) Dept., Dated 01.11.2013) with effect from 05.12.2013. In this scheme Employees, Pensioners and their family members can avail cashless treatment in various empanelled hospitals. This scheme was under the supervision of Aargoyasri Health Care Trust.
Eligibility Criteria for Employees Health Scheme – Who are covered under EHS
- All regular State Government Employees
- Provincialised Employees of Local Bodies
- State Govt Retired Employees / Pensioners and Family Members
- Reemployed Service Pensioners
- Dependent Parents (either adoptive or biological, but not both).
- One legally wedded wife in case of a male employee/ service pensioner.
- Unemployed sons below age of 25 years
- Unemployed daughters,who are unmarried or widowed or divorced or deserted.
- Disabled children deemed unfit for employment
Who are not covered under the Telangana EHS
(As per G.O.Ms.No.174 HM&FW (M2) Dept dated 01-11-2013)
- Those who are covered under other insurance schemes such as CGHS, R.T.C, ESIS, Railways, Aarogya Bhadratha of Police Department and Aarogya Sahayatha of Prohibition & Excise Department
- Law officers (Advocate General, State Prosecutors, State Counsels, Government Pleaders and Public Prosecutors);
- Casual and Daily paid workers ( Contract / Out Sourcing Employees)
- Biological parents if adopted parents exist;
- All independent children
- AIS officers and AIS pensioners.
How to apply Telangana EHS Health Card
Instructions have been issued in GO MS No 175 HM & F.W (M2) Dept. Dated 01.11.2013 as regarding obtaining Temporary Health Cards and Permanent Health Cards under the Employees Health Scheme (EHS)
Employees and pensioners are required to submit an online application using the prescribed form in EHS Office Website at Mee Seva Centers. The submission should include the following documents:
- Copy of the Service Register (pages 1 and 2 of the old service register or pages 4 and 5 of the new service register) for employees.
- Digital copy of one recent photograph for each beneficiary.
- Copy of the Aadhar Card for each beneficiary or a copy of the Aadhar enrollment receipt.
For pensioners, the following additional documents are required:
- Copy of the Pension Payment Order (P.P.O).
- Copy of the pension identity card.
- Photographs and Aadhar Card copies for each beneficiary or enrollment receipt.
The submitted applications will undergo scrutiny by the Aarogyasri Health Care Trust (AHCT). Once scrutinized, the applications will be forwarded to the Drawing and Disbursing Officers (DDO) for employees and the Sub-Treasury Officers (STO) / Assistant Pension Payment Officers (APPO) for pensioners. These officers will verify and either approve or reject the applications in case of discrepancies.
Once approved, the applications will be sent online for the printing of Head Cards for each individual. The printed cards will be dispatched to the specified card issue centers, as indicated by the applicant. Notification of card availability will be communicated through SMS to employees and pensioners..
To provide immediate access, beneficiaries will be issued Temporary Health Cards, valid for 90 days or until the permanent card is issued, whichever occurs earlier.
How to Works TS EJHS / Patient Process Flow
- The employee visits any of the empanelled hospitals within the approved network (approved by AHCT)
- Aarogyamithra registers the patient at the Network Hospital (NWH).
- If the patient has a permanent health card, bio metric verification is conducted.
- Preliminary diagnosis is initiated based on the health card status at the hospital.
- Patients without permanent health cards are also sent for preliminary diagnosis
- Based on the diagnosis, the patient is either treated as an outpatient or recommended for inpatient treatment
- If the patient is advised to be hospitalized, the inpatient registration process is initiated.
- The hospital submits an electronic per-authorization request to the concerned team for approval.
- Upon receiving authorization, the hospital proceeds with the necessary surgery or treatment as recommended
- After completing the required treatment, the patient is discharged as needed.
- Follow-up recommendations are provided to the patient if necessary.
- The hospital initiates the claim process for the hospitalization of the patient, ensuring reimbursement and financial settlement
This streamlined process outlines the sequential steps from the initial hospital visit to post-treatment follow-up and claim initiation for a cohesive understanding of the patient journey within the Employee Journalist Health Scheme (EJHS)