If there is no ESIC hospital within 10 km radius of the ESI health insurance scheme’s beneficiary’s house, then the employee can go for treatment in private hospitals empaneled by the State Insurance Corporation.
If there is no ESIC hospital within 10 kilometers of the home of the beneficiary of Employees State Insurance Health Insurance Scheme (ESI health insurance), then he can go for treatment in private hospitals empaneled by the Employees State Insurance Corporation (ESIC). Explain that the benefit of ESIC is available to employees whose monthly income is Rs 21,000 or less. However, in case of PwDs, the income limit is Rs 25,000. Employees and employers both contribute to this central government scheme. At present, 0.75% of the employee’s salary is contributed by ESIC and 3.25% by the employer. Employees whose average salary is Rs 137 per day, they do not have to contribute.
According to the Labor Ministry statement, as a result of expanding the ESI scheme in new areas also, there has been a large increase in the number of ESI beneficiaries. In such a situation, continuous efforts are being made to expand and strengthen the infrastructure with the aim of providing medical facilities to ESI members around their own homes.
No approval required
It said, at present, ESI beneficiaries are facing difficulty in getting medical facility in some areas due to the absence of ESI’s hospital or dispensary or the Insured Medical Practitioner (IMP) within 10 km radius. In such areas, ESI beneficiaries have now been given the option of availing health care facilities in empaneled hospitals of ESIC in the country. For this, the beneficiary will not need to get approval from any ESIC hospital or dispensary.
Take these documents with you
According to the ministry, ESI beneficiaries in such areas will have to go there to receive OPD services in hospitals empaneled by ESI for free and get their ESI e-pehchan card / health passbook ) Along with Aadhaar Card / Government issued ID.
Refund for payment made for medicines
Such beneficiary will have the facility to withdraw the payment made in OPD for medicines prescribed by the doctor. To get this facility, the beneficiary has to go to the dispensary and branch office or ESIC regional office.
Cashless will be admitted in the hospital
According to the statement, if the beneficiary is required to be admitted to the hospital, then the empaneled hospital will have to obtain permission from the authorized officer of the ESI through online mode within 24 hours to provide cashless health facilities to the beneficiary.
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