What Is the Aarogyasri Scheme? A Complete Guide for Beneficiaries

Quick Overview:

• Aarogyasri is a government-sponsored health insurance programme, which is a free and cashless scheme of treatment for families with low income.
• It operates under the names Dr YSR Aarogyasri in Andhra Pradesh and Aarogyasri Telangana in Telangana.
• The scheme includes major surgeries and critical illnesses, among other things, which mainly cover secondary and tertiary medical care.
• Through the Aarogyasri card, beneficiaries are able to access treatment in government and empanelled private hospitals.
• Every family member who is eligible is covered through a single household coverage.
• The plan assists in cutting down-of-pocket medical costs incurred by families that are economically disadvantaged.
• It focuses on making sure that quality healthcare can be accessed in a timely manner without incurring financial strain.

Aarogyasri Scheme is one of the biggest and most popular state-sponsored health insurances in India that is designed to offer free and cashless medical care to families that are economically disadvantaged. Introduced to help decrease the economic cost of severe diseases, the scheme has been changed over the years and is currently being used as Dr YSR Aarogyasri in Andhra Pradesh and as Aarogyasri Telangana in Telangana. The initiative guarantees quality healthcare by using a network of empanelled private hospitals and governmental hospitals.

Overview of Aarogyasri Health Insurance Scheme

What is the Aarogyasri Scheme?

The Aarogyasri scheme is a government-sponsored health care programme, which offers cashless treatment of certain medical and surgical procedures. It is mainly targeting the Below Poverty Line (BPL) families and other deserving low-income groups so that they are not deprived of treatment because of financial reasons.

The beneficiaries are treated with an Aarogyasri card, which serves as an eligibility document at the empanelled hospitals.

Dr YSR Aarogyasri Health Scheme Explained

The redesigned and extended variant of the initial Aarogyasri scheme carried out in the Government of Andhra Pradesh is known as Dr YSR Aarogyasri. The programme is named after the former Chief Minister of the state, Dr Y. S. Rajasekhara Reddy, who pioneered the programme. The plan tremendously expanded coverage to cover more treatments, better networks of hospitals and enhanced accessibility for the beneficiaries.

Objectives of the Aarogyasri Scheme

The main objectives of the scheme are:

• Provision of free and quality healthcare to poor families.
• Minimising out-of-pocket healthcare costs.
• Ensuring timely access to life-saving treatments
• Enhancing the public and private healthcare delivery systems.

Key Features of the Aarogyasri Scheme

Feature	Detailed Explanation
Comprehensive Health Coverage	The Aarogyasri scheme is a broad scheme covering high-cost medical treatment, which involves hospitalisation. It specialises in both secondary and tertiary care, such as major surgeries, treatment of critical illnesses and advanced medical care, such as cardiac care, cancer treatments, neurological treatments, renal care and trauma services. Normal outpatient procedures and minor ailments are usually not included in order to make the best use of the money on life-threatening diseases.
Cashless Treatment Facility	Treatment in empanelled government and privately operated hospitals is fully cashless and can be availed by the beneficiaries. After this verification, the hospitals forward direct treatment information to the scheme authorities using an Aarogyasri card and this information is approved and settled. This will remove initial payments and provide medical services promptly in case of emergency.
Family Coverage Benefits	It is covered on a family basis rather than on an individual basis. A single Aarogyasri card covers all the eligible members of the family named under the ration card or government database; as a result, the medical benefits are available to the entire household without individual family members having to buy individual policies.
Wide Network of Hospitals	The scheme offers access to a huge network of government hospitals and empanelled private hospitals within the state. This guarantees accessibility to quality health care facilities even in remote or underserved regions.
No Premium Payment	The beneficiaries do not have to pay any premiums in order to enjoy the benefits. The scheme is entirely government-funded, which makes it affordable to weaker economic groups.
Pre-Defined Treatment Packages	The treatment is subject to standardised packages that contain expenses associated with surgery, hospital stay, medication, diagnostics, and subsequent treatment. This assists in keeping it transparent and avoiding overcharging by hospitals.
Support for Follow-Up Care	The scheme entails the provision of post-treatment follow-up services in approved cases regarding the main hospitalisation as stipulated by the scheme.
End-to-End Digital Process	The scheme applies digital systems to verify beneficiaries, authorise treatments, and settle claims, and this aids in minimising delays and better monitoring of services.
Dedicated Help Desks at Hospitals	Aarogyasri help desks are provided at empanelled hospitals to guide the beneficiaries in matters of eligibility verification, documentation, and coordination of treatment.
Focused on Vulnerable Sections	The programme is specifically tailored to shield low-income and economically disadvantaged families against huge health costs so that they have fair access to quality healthcare.

Benefits of Aarogyasri Health Scheme

Access to Quality Healthcare Facilities

Beneficiaries are entitled to treatment in a broad network of government hospitals and empanelled privately owned hospitals. This guarantees quality medical care, improved infrastructure, and specialised physicians irrespective of the financial status of the patient.

Cashless and Hassle-Free Treatment

The scheme provides cashless treatment in empanelled hospitals, and the beneficiaries do not have to arrange money in case of an emergency. All approvable expenses are paid directly between the scheme and hospital authorities.

Coverage for the Entire Family

Aarogyasri is family-based coverage, which means that all the members of a family who are eligible to get benefits are covered under the same Aarogyasri card, which gives maximum protection to the whole family.

Reduced Out-of-Pocket Expenses

The scheme is able to provide a significant reduction in direct costs incurred by beneficiaries by covering major treatment costs, hospital stay, diagnostics, and medicines under predetermined packages.

Support During Medical Emergencies

The plan will provide a quick solution in cases of an emergency, as medical treatment will be available at the right time because the procedures of obtaining approval and admission will be simplified, and can save lives in a serious case.

Improved Health Outcomes

The scheme also leads to an improved recovery rate, fewer complications, and an overall improvement in the health outcomes of beneficiaries due to early access to advanced treatment.

Treatments Covered Under Aarogyasri Scheme

Treatment Category	Details of Treatments Covered
General Surgeries Covered	The Aarogyasri plan encompasses a broad scope of general surgery surgeries that involve hospitalisation. These are gastrointestinal surgeries (hernia repair and gall bladder surgery), orthopaedic surgeries (fracture repair and joint surgery), and gynaecological surgeries as defined in the scheme guidelines. Some ENT and urology, as well as general surgical, procedures are covered when they are covered under pre-established treatment packages.
Critical Care Treatments	High-cost and life-saving procedures like cardiac bypass surgery, angioplasty, dialysis-related interventions, oncology therapies (including chemotherapy and radiotherapy) and complex neurosurgeries are covered under the beneficiary programme under the Dr YSR Aarogyasri. These services are offered at empanelled hospitals that have specialised facilities and whose purpose is to treat severe and critical health conditions.
Specialised Medical Procedures	The scheme covers high-technology and highly complicated procedures like organ-related surgery (notified under the scheme), trauma and accident treatment, burn treatment, and other complex treatments that need tertiary intervention. The coverage is only available when the treatments are done at empanelled hospitals and are based on scheme-approved protocols and package guidelines.

Treatments Not Covered Under Aarogyasri Scheme

Exclusion Category	Details / Examples
Excluded Medical Conditions	The plan is not inclusive of small illnesses, regular outpatient visits, routine check-ups, and preventive health care. There is also no exception of cosmetic and aesthetic procedures (such as plastic surgery to improve the look), dental procedures (unless they are a part of trauma or accidental care), or non-life-endangering treatments. Obesity treatment, infertility treatment and elective procedures associated with lifestyle are generally not covered.
Non-Medical Expenses	Expenses that are not directly related to medical care are not reimbursed. This covers food, travel, and accommodation costs to the family or attendants of the patient, telephone bills, personal care products, and other incidental expenses incurred by the patient during the time he or she is in the hospital. Any medical costs that are not covered in the approved hospitalisation are not covered.
Procedures Outside Scheme Scope	Treatments that are not on the official list of approved packages or are done in non-empanelled hospitals are not covered. It does not include experimental or investigational treatments, therapies which have not been approved by the government, or even a consultation outside the empanelled network.
Pre-Existing Conditions (Selective)	Certain pre-existing illnesses may have restrictions unless explicitly listed in the approved packages. Chronic conditions not requiring hospitalisation or not listed in the scheme guidelines may not be covered.
Alternative Treatments	Alternative medicine systems such as Ayurveda, Homoeopathy, or Unani are not covered by treatments under alternative medicine schemes unless specifically indicated in the provisions of such a scheme.
Elective or Optional Procedures	Any other surgeries or procedures that are not emergencies, or mainly performed due to convenience, are not covered, even when they are done in an empanelled hospital.

Eligibility Criteria for Aarogyasri Scheme

Income and BPL Criteria

The scheme primarily targets BPL families identified through government records. Eligibility is linked to socio-economic data maintained by state authorities.

Eligibility for Rural and Urban Families

Both rural and urban households can be eligible, provided they meet income and social welfare criteria prescribed by the state government.

State-Specific Eligibility Guidelines

Eligibility rules may slightly differ between Aarogyasri Telangana and Andhra Pradesh based on local government policies and databases.

Aarogyasri Scheme in Telangana and Andhra Pradesh

The Aarogyasri Scheme is implemented separately in Telangana and Andhra Pradesh after the bifurcation of the state in 2014. Both states have adapted the original program to meet the healthcare needs of their populations while keeping the core objective intact- providing cashless, quality treatment to low-income and Below Poverty Line (BPL) families.

Aarogyasri Telangana Overview

In Telangana, the program continues under the name Aarogyasri Telangana. It is administered by the Telangana Health Department and focuses on providing secondary and tertiary medical care to economically vulnerable households.

The scheme aims to protect families from catastrophic health expenses, ensuring access to timely and high-quality healthcare without financial burden.

Dr YSR Aarogyasri in Andhra Pradesh

In Andhra Pradesh, the program is implemented as Dr YSR Aarogyasri, named after former Chief Minister Dr Y. S. Rajasekhara Reddy. The scheme builds on the original Aarogyasri framework and has been further expanded to improve accessibility, include more procedures, and cover a larger number of beneficiaries.

NTR Aarogyasri

Before being renamed Dr YSR Aarogyasri, the program in Andhra Pradesh was popularly known as NTR Aarogyasri, after the late Chief Minister N. T. Rama Rao, who initiated the original scheme. While the name has changed, the core objective- providing free, quality healthcare to BPL and low-income families- remains the same.

Key Differences Between Aarogyasri Telangana and Dr YSR Aarogyasri Andhra Pradesh

Aspect	Aarogyasri Telangana	Dr YSR Aarogyasri Andhra Pradesh
Scheme Name	Aarogyasri Telangana	Dr YSR Aarogyasri (formerly NTR Aarogyasri)
Beneficiary Base	Economically weaker sections, BPL families in Telangana	BPL families and other eligible low-income households in Andhra Pradesh
Treatment Coverage	Major surgeries, cardiac care, cancer treatment, dialysis, trauma care	Expanded coverage, including over 1,000 procedures, critical care, oncology, neurosurgery, and organ-related surgeries
Hospital Network	Government hospitals + selected empanelled private hospitals	Government hospitals + a larger network of private empanelled hospitals
Digital System	Fully digital verification and claim process	End-to-end digital process for application, approvals, and claim settlement
Post-Hospitalisation	Limited follow-up care as per guidelines	Includes follow-up consultations, diagnostics, and medicines for approved treatments
Card Name	Aarogyasri card	Aarogyasri card (linked to BPL / government records)

Both schemes aim to reduce catastrophic healthcare costs, provide access to timely treatment, and protect families from financial hardship due to serious illnesses. The differences primarily relate to the scale of coverage, hospital network size, and scope of procedures included.

Documents Required for Aarogyasri Scheme

Aadhaar and Identity Proof

Aadhaar card or any government-issued identity proof is required to verify beneficiary identity.

Income and Residence Proof

Documents showing income status and residence within the state help establish eligibility.

Ration Card or BPL Certificate

A valid ration card or BPL certificate is a key document for enrolling and availing benefits under the Aarogyasri scheme.

How to Apply for an Aarogyasri Card

The Aarogyasri card is essential for availing cashless medical treatment under the Aarogyasri Scheme. The card acts as proof of eligibility and is linked to the beneficiary’s family details in government databases. Eligible families can apply through online or offline channels, depending on convenience and accessibility.

Online Registration Process

1. Visit the Official Portal: Go to the official Aarogyasri website of your state (Andhra Pradesh or Telangana).
2. Beneficiary Verification: Enter details such as Aadhaar number, ration card number, or BPL ID to check eligibility.
3. Fill the Application Form: Provide accurate family details, including names of all members, age, gender, and relation to the head of the family.
4. Upload Documents: Submit scanned copies of necessary documents such as Aadhaar card, BPL certificate, income certificate, and proof of residence.
5. Submit the Application: Review the details carefully and submit the form online. Acknowledgement and Tracking: After submission, an acknowledgement receipt or reference number is generated, which can be used to track application status online.

Offline Enrolment Through Authorities

1. Visit Designated Centres: Eligible beneficiaries can approach Aarogyasri enrollment centres, government hospitals, or local health department offices.
2. Fill Application Form: Obtain the physical application form and fill it with family and personal details.
3. Attach Supporting Documents: Include copies of Aadhaar, BPL certificate, ration card, and residence proof.
4. Submit Form for Verification: Submit the form to the enrollment officer or authority.
5. Verification Process: Authorities verify the documents and eligibility using state government databases.

Verification and Approval Process

• Once the application is submitted, the beneficiary’s details are checked against state records to confirm eligibility.
• Approved applicants are issued an Aarogyasri card, either digitally or physically, depending on the mode of application.
• The card contains family details, a unique identification number, and information needed for availing cashless treatment at empanelled hospitals.
• Beneficiaries can also track their card issuance and status online using the reference number provided during application.

How to Download Aarogyasri Health Card

Steps to Download Aarogyasri Card Online

Beneficiaries can download their digital Aarogyasri card by entering their Aadhaar or their registered mobile number on the official portal.

Checking Card Status

Applicants can track application status online or through local health offices.

Using the Digital Health Card

The digital Aarogyasri card can be shown at empanelled hospitals to avail cashless treatment.

Aarogyasri Claim Process

The Aarogyasri Scheme provides cashless treatment, which means that beneficiaries do not have to pay upfront for approved procedures. The claim process is designed to be simple, transparent, and digital to ensure quick settlement of medical expenses.

Cashless Claim Process for Beneficiaries

1. Eligibility Verification:
• When a beneficiary arrives at an empanelled hospital, the hospital staff verifies eligibility using the Aarogyasri card.
• The card contains family details and confirms that the patient is registered under the scheme.
2. Treatment Approval:
• The hospital submits treatment details, including diagnosis and proposed procedure, to the scheme authorities for approval.
• For predefined procedures under the scheme, approval is usually quick to allow immediate treatment.
3. Admission and Treatment:
• Once approved, the patient is admitted, and treatment begins without any payment from the beneficiary.
• All expenses covered under the scheme, including surgery, hospital stay, medicines, and diagnostics, are handled directly by the hospital with the scheme authorities.

Hospital Claim Submission Process

• After completion of treatment, the empanelled hospital submits a claim package to the Aarogyasri trust or the state health authority.
• The claim package typically includes:
• Treatment summary and discharge report
• Medical bills and diagnostic reports
• Details of medicines administered during hospitalisation. The authorities review the documents to ensure the treatment is eligible and within the approved package limits.

Claim Settlement Timeline

• Once verified, the scheme directly reimburses the hospital for all approved expenses.
• Cashless settlements typically occur within a few days to a couple of weeks, depending on the complexity of the treatment and the hospital’s documentation.
• Beneficiaries are informed once the claim is processed, and no further payment is required unless additional non-covered services are availed.

Key Points to Remember

• Only treatments performed at empanelled hospitals are eligible for cashless claims.
• Beneficiaries must carry their Aarogyasri card and identity proof to the hospital.
• Pre-authorisation from the scheme is mandatory for major surgeries and critical care treatments.
• Post-hospitalisation expenses covered under the scheme should be claimed through the hospital; beneficiaries do not submit separate claims.

Aarogyasri Hospital List

Government Hospitals Covered

Most major government hospitals in Telangana and Andhra Pradesh are covered under the scheme.

Empanelled Private Hospitals

Several private hospitals are empanelled under Dr YSR Aarogyasri to ensure wider access to quality healthcare.

How to Check the Updated Hospital List

The latest hospital list can be checked on the official Aarogyasri portals or through local health offices.

Why You Should Opt for ManipalCigna Health Insurance Along with the Aarogyasri Scheme

While the Aarogyasri scheme provides excellent coverage for major treatments, it does not cover everything, such as OPD care, minor illnesses, or treatment outside the state. A comprehensive private health insurance plan like ManipalCigna can complement Aarogyasri by covering gaps such as outpatient care, wider hospital choice, and higher flexibility.

FAQs on Aarogyasri Scheme

Who is eligible for the Aarogyasri health scheme?

BPL and other eligible low-income families identified by state government databases are eligible.

How can I apply for the Aarogyasri card?

You can apply online through state portals or offline through designated enrollment centres.

What treatments are covered under Dr YSR Aarogyasri? 

Major surgeries, critical care treatments, and specialised medical procedures as approved by the government.

Is Aarogyasri available in Telangana and Andhra Pradesh? 

Yes, it operates as Aarogyasri Telangana and Dr YSR Aarogyasri in Andhra Pradesh.

How do I claim benefits under the Aarogyasri scheme?

 Benefits are available cashlessly at empanelled hospitals using the Aarogyasri card.