Ministry of Labour & Employment

ESIC takes Major Policy Initiatives for better medical services to Workers

Posted On: 08 DEC 2020

Employees’ State Insurance Corporation (ESIC) during its 183rd Meeting held yesterday under the chairmanship of Shri Santosh Kumar Gangwar, Minister of State for Labour & Employment (I/C) has taken several significant decisions to improve its delivery of medical services and other benefits to workers.

Medical services to the insured workers and their dependants under the ESI Scheme are provided primarily through hospitals and dispensaries run by the State Governments.  There are, at present, around 1520 ESI dispensaries and 159 hospitals across the country, out of which 45 dispensaries and 49 hospitals are directly run by ESIC while remaining dispensaries and hospitals are run by the respective State Governments.  Several representatives have been received about deficient services in ESI hospitals run by State Governments due to poor availability of equipment and doctors.

In view of demand from both workers and employees and with the objective to provide better medical services to beneficiaries, ESI Corporation in the meeting held on 7.1.2020 has decided to directly run by itself all newly constructed hospitals and those that are approved in future unless the State Government insists to run the hospital.

Keeping in view the increase in ESI coverage over the recent years and the absence of ESI’s own medical infrastructure in several areas, the ESI Corporation has now decided that in areas where ESI infrastructure is not available within a radius of 10 kms, the beneficiary can avail medical consultation for OPD services directly from a hospital empanelled with ESIC or with Ayushman Bharat without the need for referral from an ESI dispensary or hospital.  In such cases if admission for indoor treatment is required, the empanelled hospital will obtain time bound permission from the ESI approving authority through an online system.

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.

ESIC will engage Hospital Managers with specialisation in hospital management or hospital administration or health care administration for maintenance, housekeeping, patient assistance, patient safety and other ancillary activities in ESIC hospitals across the country.

ESIC will also  engage the services of project management consultant for monitoring and facilitating execution of hospital and dispensary construction projects of ESIC from the stage of concept plan to the commissioning of the project.

The ESI Corporation has also decided to extend the relaxed conditions and the enhanced benefit of 50% of the average per day earning upto a maximum of 90 days under the Atal Beemit Vyakti Kalyan Yojana to the insured workers who became unemployed due to COVID-19 induced lockdown for a further period of six months i.e. upto 30th June, 2021.  The eligible workers can file their claims on the ESIC portal (www.esic.in) with the mobile number, Aadhaar and bank details.

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2 Comments

  1. Sabyasachi Bhattacharya says:

    Sir, I would like to know as per recent decision of ESI authority if there is no ESI hospital in radius of 10 km of my area and I get OPD medical consultant service from any non tie up hospital nearby and buy some prescribed medicines from any pharmacy and submit reimbursement claim form to ESI claiming OPD visit and medicine bills, can I get the reimburse amount.

  2. Sabyasachi Bhattacharya says:

    Sir, I would like to know if there is no ESI hospital in radius of 10 km of my area and I get OPD medical consultant service from any non tie up hospital nearby and buy some prescribed medicines from any pharmacy and submit reimbursement claim form to ESI claiming OPD visit and medicine bills, can I get the reimburse amount ??

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