New Delhi:
Beneficiaries of the ESI health insurance scheme can get medical care at nearby private hospitals empanelled with the Employees’ State Insurance Corporation in case of non-availability of ESIC hospitals within 10 kms of their residence, an official statement said.
Keeping in view the sizeable increase in the number of Employees’ State Insurance (ESI) beneficiaries subsequent to expansion of the 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, the labour ministry statement said.
To ease the hardship being faced by ESI beneficiaries in availing medical services in case of non-availability of ESIC’s health care infrastructure — hospital, dispensary or Insurance Medical Practitioner (IMP) — within a radius of 10 kms of their residences, such beneficiaries can now avail services from nearby ESIC empanelled hospitals (pan-India) without the need for any referral from an ESI dispensary or hospital, it said.
To avail medical services in such areas, the ESI beneficiaries may visit the ESI empanelled hospital with ESI e-pehchan card/health passbook alongwith Aadhaar/government-issued identity card and avail cashless medical consultation for OPD (out patient department) services directly from the 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, it added.
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.
