ESIC employees got a big gift, now treatment will be done in Ayushman Bharat panel hospitals too

The central government will soon provide treatment facilities to the ESIC beneficiaries, workers of the organized sector and their dependents. To make the health facilities under ESIC better and accessible, the proposal to open the way for cashless treatment facility to the beneficiaries of ESIC scheme in the hospitals of Ayushman Bharat panel has been finalized. Now 74 districts of Uttar Pradesh have come under ESIC.

Highlights

  1. Cashless treatment in more than 24000 hospitals included in the panel of Ayushman Bharat.
  2. ESIC workers will now be treated in Ayushman Bharat panel hospitals as well
  3. 15 more districts of Uttar Pradesh included in the scope of ESIC.

 Employees State Insurance Corporation (ESIC) beneficiary organised sector workers and their dependents will soon get treatment facilities in more than 24000 hospitals across the country included in the Ayushman Bharat panel.

 

The Ministry of Labour has finalised a proposal to open the way for cashless treatment facility to the beneficiaries of ESIC scheme in Ayushman Bharat panel hospitals to make health facilities under ESIC better and accessible. This decision to link Ayushman Bharat hospitals with ESIC is being taken to find a better solution to the health challenges of organized sector workers and their dependents along with social security.

 

Now workers will get better health facilities

Confirming the proposal to link hospitals included in the Ayushman Bharat panel with ESIC, Union Labor Minister Mansukh Mandaviya said that this step is being taken to provide better health facilities to organized sector workers in remote and small urban areas. To implement this proposal, he will soon take a final decision on it on behalf of the Labor Ministry. Under ESIC, till March 2024, there are 3.72 crore organized sector workers and a total of 14.44 crore beneficiaries including their dependents have been covered.

 

What did the Union Minister say?

 

 

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Mandaviya said that according to the current data, the average number of members in a worker's family is 3.88. According to this, the number of beneficiaries is more than 14 crores. Since the hospitals included in the Ayushman Bharat panel have been empanelled by the Health Ministry as per the standards of the Central Government, there is no problem in linking them with ESIC.

 

After this decision of the Labor Ministry, the way will open for the workers-beneficiaries of the organized sector to get treatment in about 31000 government and private hospitals in the country, which also includes more than 150 ESIC hospitals and 1600 dispensaries.

 

There will be no limit on medical expenses of the beneficiaries

The Labor Minister clarified that there will be no capping for treatment in hospitals included in the Ayushman Bharat panel under ESIC. That is, there will be no limit on medical expenses for the beneficiaries and all expenses will be borne by ESIC. There is a facility of free treatment up to Rs 5 lakh under Ayushman Bharat and currently about 60 crore people are getting the benefit of this scheme of the Central Government.

 

Workers from these 15 districts of UP will also get the facility

  • The Labor Ministry on Tuesday issued a notification to bring organized sector workers of 15 districts of Uttar Pradesh, who were deprived of the benefits of health facilities under ESIC, within its ambit.
  • With this decision of the central government, now 74 out of 75 districts of Uttar Pradesh have come under the purview of ESIC health facilities. Now only one district of the state, Banda, is outside the purview of ESIC facilities.
  • Union Labor Minister Mansukh Mandaviya termed the inclusion of 15 districts of Uttar Pradesh in the ambit of ESIC as important in the direction of increasing the coverage of health facilities. According to him, ESIC scheme is fully or partially notified in 689 districts of the country. Whereas this scheme was not implemented in 104 districts till now.
  • After the inclusion of 15 districts of Uttar Pradesh, now 89 districts in the country are not notified for ESIC facility and the Ministry of Labor will bring these remaining districts under ESIC coverage in the next two years. After full implementation in a total of 74 districts in Uttar Pradesh, the workers of the organized sector in the state and their families will get the benefit of health facility. This number of beneficiaries is about 1.16 crore.
  • Names of 15 districts of UP notified for ESIC coverage: Ambedkar Nagar, Auraiya, Bahraich, Gonda, Hamirpur, Jalaun, Kannauj, Maharajganj, Mahoba, Pilibhit, Siddharthnagar, Shamli, Pratapgarh, Kasganj and Shravasti

What is ESIC?

ESIC is a multi-faceted social security scheme. This scheme provides socio-economic security to employees in the organized sector. Under the scheme, insured employees and their families get health care facilities in case of illness, maternity and disability. ESIC has more than 150 hospitals across the country. Here, treatment is done for common as well as serious diseases.

 

Who is eligible for ESI?

Under ESI, coverage is provided to employees whose monthly salary is Rs 21,000 per month or less. For disabled employees, this limit is Rs 25,000. It is the responsibility of the employer to enroll eligible employees in the ESIC scheme.

 

Employee and employer contribute ESI scheme is a self-funded program. Both employer and employee contribute to it. In this, the employee contributes 1.75 percent of his salary and the employer contributes 4.75 percent of the employee's salary.

 

Insurance number does not change when you change jobs

A feature of this scheme is that as long as the employee remains within the ESI wage limit, his insurance number remains the same. Changing the job will not affect the insurance status of the employee and his insurance number remains the same.

 

Benefits of ESI?

The insured employee and his family get complete medical care facility – There is no limit on the expenditure on treatment of the insured employee or his family.

 

  • Retired employee and spouse also get medical treatment facility on monthly premium of Rs 120.
  • Cash compensation of 70 per cent of the salary is given during the sickness period up to a maximum of 90 days every year.
  • Women get maternity leave for 26 weeks during delivery/pregnancy.
  • Temporary disability benefit is available at the rate of 90 percent of the salary.
  • In case of death of an employee during work, the dependents receive monthly payment at the rate of 90 percent of the salary.
  • The number of employees insured for ESI benefits is 4.81 crore.
  • There are 22.93 lakh institutions registered under ESIC and number of ESI hospitals is 165.