Dear Seniors,
Is the employee eligible for medical benefits under ESI even after his contributions are stopped as his salary is more than Rs.15000. Benefits like sickness,maternity are dependent on contributions paid. What about medical benefits like OPD treatment-Is the employee eligible even in his later years when he is not contributing to ESI?
Regards,
Suresh
10th February 2013 From India, Bangalore
Dear Seniors, Eager to have your point of view on the above subject matter. Please provide your opinion on this. Regards, Suresh
11th February 2013 From India, Bangalore
Dear Suresh ji,

Answer is yes, to your question - is the employee eligible for medical benefits under ESI even after his contributions are stopped?

IP is eligible for medical benefit till such time the corresponding benefit period is not over. This corresponding benefit period start after the contribution period i.e. after contributions are stopped.

Apart from this, IP is eligible for following benefits even after his contributions are stopped.

1. Old Age Medical Care: This benefit is available to IP retiring on attending the age of superannuation or under VRS / ERS and person having to leave service due to permanent disability. IP and spouse are eligible for this medical care on payment of Rs. 120/- per year.

2. Rajiv Gandhi Shramik Kalyan Yojana: Under this scheme, unemployment allowance is introduced by corporation w.e.f. 01.04.2005. IP who became unemployed after being insured for 3 or more years, due to closure of Factory / Establishment, retrenchment or permanent disability, are entitled to:

(i) Unemployment allowance equal to 50% of wage for max. period up to 1 year;

(ii) Medical care for self and family from ESI Hosp. / Dispenseries during the period IP receives unemployment allowance.
15th February 2013 From India, Mumbai
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