New Delhi: 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, the government has said that 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.
“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,” an official release said.
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.
Earlier in December 2020, the labour ministry had said that ESIC subscribers would be able to visit empanelled as well as non-empanelled private hospitals for emergency treatment. However, the only difference is that treatment will be cash-less in the empanelled private hospitals. There would be reimbursement as per Central Government Health Services (CGHS) rates in non-empanelled private hospitals.
Super speciality services in cardiology including nephrology, urology and oncology will be strengthened in select ESIC hospitals in Delhi/NCR and this will be extended to other ESIC hospitals across the country in a phased manner.