Telangana Employees Health Cards Guidelines | TS EHS GO.32

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Modified guidelines on Employees Health Cards, Employees Health Scheme new guidelines,

Telangana Health Cards Guidelines
Employees Health Scheme to provide cashless treatment for the listed therapies in the empanelled hospitals, to all the Government employees, pensioners and their dependent family members in replacement of the medical reimbursement system under APIMA Rules, 1972
Employees Health Scheme to provide cashless treatment for the listed therapies in the empanelled hospitals, to all the Government employees, pensioners and their dependent family members in replacement of the medical reimbursement system under APIMA Rules, 1972. In this regarding government of telangana has issued G.O.Ms.No.32 on today onwards and  modified guidelines have been issued on Telangana Employees Health Cards.

Health Cards GO.32;  Dated:3-11-2014 Highlights
1. EHS is meant for cashless medical treatment to the state Government Employees, Pensioners and their dependent family members.
2. No monthly premium
3. No "Screening Committee" for EHS
4. No financial upper limit
5. Out Patient for chronic diseases will be provided in notified Govt hospitals only(separate guidelines will be issued by T Govt.)


Subject: Health, Medical and Family Welfare Department - Employees Health Scheme - Providing Cashless medical treatment to the State Government Employees, Pensioners and their dependent family members - Further Orders - Issued.

HEALTH, MEDICAL and FAMILY WELFARE (A2) DEPARTMENT
G.O.MS.No.32; Dated:03-11-2014

Reference:

  • 1. G.O.Ms.No.174, HM & FW (M2) Department, dt.01-11-2013
  • 2. G.O.Ms.No.175, HM & FW (M2) Department, dt.01-11-2013
  • 3. G.O.Ms.No.176, HM & FW (M2) Department, dt.01-11-2013


ORDER:
In the G.O. 1st read above, the erstwhile Government of Andhra Pradesh have formulated Employees Health Scheme to provide cashless treatment for the listed therapies in the empanelled hospitals, to all the Government employees, pensioners and their dependent family members in replacement of the medical reimbursement system under APIMA Rules, 1972. In the G.O.2nd read above operational guidelines for issue of health cards were issued and in the G.O.3rd read above, the package prices for the listed therapies were notified.

2. Consequent on reorganization of Andhra Pradesh into the States of Telangana and Andhra Pradesh, the Chief Minister of Telangana reviewed the implementation of the Employees Health Scheme in the meeting held on 21-10-2014 in the light of the representations made by the representatives of Employees / Pensioners Associations and decided that the Scheme be implemented with the following modifications:

  1. 1. The total cost on implementation of Employees Health Scheme shall be borne by the Government and no contribution will be collected from the employees/ pensioners.
  2. 2. There shall be no upper limit on the financial coverage and the total cost of treatment of the patient for the enlisted therapies will be covered under the Scheme.
  3. 3. Treatment for all the enlisted procedures will be provided in all the network hospitals (both private and Government) empanelled with Aarogyasri Health Care Trust. However position will be reviewed after six months so as to ensure a minimum of 60% participation by Government Hospitals in terms of amount. To achieve that, if required, certain procedures may be reserved for Government hospitals which have required infrastructure for such procedures.
  4. 4. Out patient for Chronic Diseases will be provided in the notified Government Hospitals only and the guidelines for chronic OP treatment shall be issued separately.
  5. 5. There is no need for ‘steering committee’ for the Scheme.
  6. 6. Inclusion of other categories of employees will be examined after implementation of the Scheme for six months.

3. Accordingly Government hereby direct that the “Employees Health Scheme” shall be implemented with effect from 01-11-2014 with the modifications mentioned in para-2 above.

4. Accordingly all fresh cases of treatments with effect from 01-11-2014 shall be governed by above scheme and all such cases shall not be eligible for any reimbursement. However all cases of treatment commenced prior to 01-11-2014 shall be eligible for reimbursement as per Rules for reimbursement.

5. This order issues with the concurrence of Finance Department vide their No.388/PFS/14, dt.24-10-2014.


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2 comments:

  1. FOR PENSIONERS ONE SUB OFFICE SECTION WILL BE OPENED AT EVERY PENSION OFICE TO RUN OFFICIAL TRANSACTIONS FOR OLD PENSIONERS.TO DEAL WITH HEATH CARD ISSUING EPISODE.THE OLD PEOPLE WHO ARE GETTING PENSION NOT ABLE MOVE FUTHER TO NET CAFES TO HAVE DOWNLOADINGS OF HEATHCARDS DUE TO LACK OF THEIR MODERN COMPUTER .MOREOVER,WHO HAVE NOT APPLIED SO FAR FOR HEATH CARDS.FEELING LOT OF DIFFICULTY TO GET IN TOUCH WITH THE DOWNLOADING PROCESS.OF HEALTHCARDS BY DIALING PH.NO.104.SO,THE TELANGANA GOVT.,AUTHORITIES ARE REQUESTED TO ARRANGE ONE OFFICIAL SECTION IN EVERY PENSION OFFICE TO TACKLE WITH PROBLEMS OF OLD PENSION PEOPLES IN GENERAL AND SPECIFIC FACING BY THEM.

    ReplyDelete
  2. Now one yr is going to lapse to know about opening of one Sub Office section at pension office to run official transactions for old pensioners. No such office is so far opened. The office superintendents have no patience to provide any information as and when required to the pensioners. They are throwing burdain on your office web portal to collect information of Health cards. It is very strange to comment about the office. The superintendents of the offices of APPO must feel responsibility to attend the pensioners keeping in view their inability in computer knowledge. My ID No. P256717131. On this ID I am unable to get down load my health card. I am trying for it since last one year. Still I am unable to get it due to lack assistance from the PPO office as I am always advised to contact your APPO. There is no information available in the APPO to guide me. Thus the pensioner is in pathetic condition to get his Health Card. Two complaints lodged. In vain. Contacted Forget your Password. It has provided four new passwords on four occassions. But data is not opened. Still I am going on trying. No use. Now what is the sollution to it?
    So I appeal to the Telengana Govt. to make it easy to get Health Cards to the pensioners and issue Laminated Cards through APPOs for immediate solutions.
    Rajgopal.

    ReplyDelete

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