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ESIC beneficiaries can now receive medical care from nearby ESIC empanelled hospitals without a referral when an ESIC hospital, dispensary, or insured medical practitioner is not available within a ten kilometer radius of their residence. The beneficiary visits the empanelled hospital with an ESI e-pehchan Card or Health Passbook and an Aadhaar or government issued identity card. The beneficiary receives cashless medical consultation for outpatient department services directly from the hospital. The beneficiary submits claims for reimbursement of prescribed medicines through the nearest Dispensary cum Branch Office or Regional Office. When investigation or indoor treatment is necessary, the empanelled hospital obtains permission from the ESI approving authority through an online system within twenty-four hours and provides cashless treatment.
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Ministry of Labour & Employment
Posted On: 18 FEB 2021 5:39PM by PIB Delhi
Keeping in view the sizeable increase in the number of ESI beneficiaries subsequent to expansion of ESI Scheme in newer geographical areas, efforts are constantly being made to strengthen the ESI medical care infrastructure to provide better medical services in the vicinity of beneficiaries' residence.
To ease the hardship being faced by ESI Beneficiaries in availing medical services in case of non-availability of ESIC's Health Care infrastructure i.e. Hospital or Dispensary or Insured Medical Practitioner (IMP) within a radius of 10 KM of their residences, such ESI beneficiaries can now avail medical care services from nearby ESIC empanelled hospitals (pan-India) without the need for any referral from an ESI dispensary or hospital.
To avail medical services in such areas, the ESI beneficiaries of such areas may visit the ESI empanelled hospital with ESI e-pehchan Card/Health Passbook alongwith Aadhar/Govt. issued Identity Card and avail cashless medical consultation for OPD services directly from such hospital. Such beneficiaries may seek reimbursement of purchased medicines prescribed during OPD consultation through nearest Dispensary cum Branch Office (DCBO) or Regional Office of ESIC where DCBO is not available.
In cases where investigation or admission for indoor treatment is required, the empanelled hospital will obtain the permission from the ESI approving authority through an online system within 24 hours and provide cashless treatment to the beneficiary. A copy of the guidelines issued by the ESIC Hqrs. are available on the website www.esic.nic.in
MS/jk
(Release ID: 1699094)
