Another new facility has been given by the government to the ESIC (employee state insurance corporation) account holders. Till now ESIC account holders were allowed to get treatment in some selected hospitals only. But now the Labor Ministry said in a statement that the ESI beneficiaries who do not have an ESIC hospital within a radius of 10 km of their residence, can get treatment in the nearest private hospitals empaneled by ESIC.
According to the Ministry of Labor, the ESI scheme is being expanded continuously. Efforts are being made to bring more and more people under this scheme. Due to which the number of ESIC beneficiaries (ESIC account holders) is also large and infrastructure is being expanded continuously with the aim of providing medical facilities for them near their residence.
Treatment of ESIC account holders in a private hospital
Now, if ESI account holders do not have an ESIC hospital within a radius of 10 km of their residence, they can get treatment in the nearby private hospitals empaneled by ESIC, then for this free OPD (outpatient) to ESI beneficiaries in such areas. Department) will have to submit his/her ESI e-Identity Card/Health Passbook along with Aadhar Card/Govt issued Identity Card for availing the service. Such beneficiary will have the facility to withdraw the payment made for the medicines prescribed by the doctor in the OPD.
To avail this facility, the beneficiary has to visit the branch office or regional office of ESIC. In case the beneficiary needs to be admitted to the hospital, then the empaneled hospital will have to obtain permission from the authorized ESI officer through online mode within 24 hours.
What is ESIC?
ESIC full form, ESIC means employee state insurance corporation ie Employees State Insurance Corporation. This is a type of health insurance, which is available to the employee and his family for treatment. Such employees have to pay a small part of their wages in ESIC, in return for which they get many benefits. This applies to the employees of those factories in which 10 or more than 10 employees work. Here employees have to deposit 0.75% of their salary in ESIC (Employee State Insurance Corporation).
Benefits of ESI –
Medical benefit of ESIC – The State Government is responsible for providing medical benefits (ESIC account holders). The insured person and his dependents become eligible to get the medical benefit facility as soon as he enters the insurable employment. Primary, outdoor, indoor and specialist services are provided through Employees’ State Insurance Hospitals/Dispensaries and Panel Clinics, while super specialty services are being provided on referral basis through reputed medical institutions of the country. These services are provided immediately in hospitals and dispensaries.
Sickness Benefit of ESIC – Sickness Benefit is provided by Employees State Insurance Corporation in cash. Illness Benefit (ESIC account holders) is payable to the insured person in the form of cash payment in case of illness. Provided that he has been absent from work and his absence is certified by the authorized Insurance Medical Officer/Practitioner. This benefit is paid at the standard rate of benefit within 7 days from the date of illness certification and the rate of this benefit is not less than 50 percent of the daily wage.
Maternity Benefit – Maternity Benefit is payable to the insured woman in the form of confinement or abortion or illness related thereto and it is paid by the Employees’ State Insurance Corporation within 14 days from the date of production of claim documents certified by the Employees’ State Insurance Corporation.
Disability Benefit Employees State Insurance Scheme – Disability benefit is payable to the insured who is physically disabled due to employment injury or occupational disease. Provided that the insured should be an employee on the date of the accident. This benefit payment is payable within one month from the date of submission of complete claim documents.
Dependent Public Benefit ESIC – Dependent Public Benefit (Family Pension), payable to the dependents of the deceased insured person in cases where death occurs due to employment injury or occupational disease. This benefit is paid to the dependents of the Life Assured within a maximum of three months of the death and thereafter is paid on a regular monthly basis.
Funeral Benefit – Funeral expenses are payable from the local office up to a maximum of Rs.10,000/- for the funeral of the insured.
