If there are no ESIC / ESIS Health Care Delivery Facility (Hospital, Dispensary, IMP etc.) available, within the radius of 10 Kms of IPs residence; Then such Insured Person (or enrolled Family Members) may directly avail the facility of such Private or Government Hospitals, whichever are all ready empanelled with ESIC, without referral of ESI Doctor. The approval is issued to reduce the difficulties faced by ESI Beneficiaries in availing the medical benefits and to lessen the delay otherwise caused.
Keeping in view the sizeable increase in the number of ESI beneficiaries subsequent to an 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.
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, 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.
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 along with 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 permission from the ESI approving authority through an online system within 24 hours and provide cashless treatment to the beneficiary. A copy of the guidelines issued by the ESIC Hqrs. are available on the website www.esic.nic.in.