THD NewsDesk, New Delhi: In a welcome move, ESI beneficiaries can now avail medical care services at empanelled hospitals in case of non-availability of ESCI’s health care infrastructure in the vicinity. “In absence of ESIC’s own healthcare facility within a 10-km radius of the beneficiary’s residence, ESIC would bear all expenses for consultation, admission and investigation of insured person and their dependents at an empanelled hospital”, said the Employees State Insurance Corporation (ESIC).
ESIC further stated, “Those cases which require an investigation and admission for indoor treatment in an empanelled hospital, ESIC would provide cashless treatment to the beneficiary, if it receives permission from the ESI approving authority through an online system within 24 hours”. For getting this OPD (Cashless Outpatient Department) Services from empanelled hospital in case of non-availability of ESCI’s health care infrastructure in the vicinity, the beneficiary has to carry the ESI e-pehchan card or health passbook along with Aadhar or any government issued identity card.
“Simultaneously, if medicines prescribed during OPD consultation is purchased through any non-DCBO (dispensary-cum-branch office), it can be later claimed for reimbursement through nearest DCBO or regional office of the ESIC”, it said.
As of March 2018, ESIC had around 13 crore beneficiaries eligible to avail ESI benefits. Therefore, efforts are being made constantly to strengthen the ESI medical care infrastructure in the vicinity of the beneficiaries’ residences. But with the expansion of ESI scheme in newer areas, there has been a tremendous increase in the number of beneficiaries, therefore facilities of OPD services are made available into such empanelled hospitals as well, to reach out to all the beneficiaries.
ESIC further said “In case of non-availability of ESIC’s health care infrastructure such as hospitals or dispensary or insured medical practitioner within a radius of 10km of their residences, such ESI beneficiary can avail medical services through nearby ESI empanelled hospitals (pan-India) without any referral from ESI dispensary or hospital”
