Worried About ESI Coverage After Salary Increase? Will My Dad's Treatment Be Affected?

For the last two years, a component of ESI has been deducted from my salary. My salary increased in the month of August, and the ESI deductions will continue until October. My father is suffering from hepatitis C and is undergoing a costly 6-month treatment which is covered by ESI. I am concerned about what will happen after October. Will the treatment still be covered, or will there be changes in coverage?

Kindly refer to the link below: :: Welcome to ESIC ::

Contribution Period and Benefit Period

There are two contribution periods, each of six months' duration, and two corresponding benefit periods also of six months' duration as follows:

- Contribution period: 1st April to 30th Sept.
- Corresponding Cash Benefit period: 1st Jan of the following year to 30th June

- Contribution period: 1st Oct to 31st March of the year following
- Cash Benefit Period: 1st July to 31st December

Best Regards

Don't worry, ESI is obligated by the Act and Government to provide your parents with full treatment.

Regards,
Ukmitra

An ongoing treatment can't be curtailed merely because of contributory norms. The ESIC will extend its help until the end of the treatment. Hence, there is no need to worry about this. We all here wish your father "good health and a long, healthy life."

Regards,
S. Sethupathy
Excellent HR Services,
Erode

Are you sure about this?

ESIC Treatment Continuation Concerns

ESIC is a contributory health cover. Once the person being treated is no longer a member of the scheme, how or why will they continue treatment? The doctor may still see and advise the patient (I have doubts since he needs to quote the ESIC number), but the medicines will definitely not be provided for free. Please tell me where in the ESIC rules it is stated that the treatment once begun must be continued.

Dear Saswata Banerjee, I have read about this continued treatment some time ago, and I am confident about it. I researched and found the following information:

"Medical Treatment for Insured Persons Medical treatment for Insured Persons who are no longer covered by the scheme. During the treatment period, they are entitled to receive continued treatment once it has started, until the sickness ends or for long-term ailments as long as the Insured Person requires active treatment."

This information is sourced from the web page of ESIC, Coimbatore. I have attached a PDF copy for reference.

I must correct a mistake I made by stating that this also applies to dependents. I apologize for providing incorrect information.

Please be aware that this type of medical benefit is extended to Insured Persons until the end of their illness.

With Warm Regards,
S. Sethupathy
Erode

To support my earlier response, I am attaching two files. Please refer to the highlighted portions in the files:

File 1 - Standard Note effective from 1st Jan 2013.

File 2 - ESIC Act 1948 - Section 56.

Regards,
S. Sethupathy, Erode

Thank you for the update. I was not aware of this. Logically, it should be extended to dependents as well. Anyway, I just received information that ESIC coverage is being increased to a salary of 25,000 per month. In that case, the original poster will still be covered after October and need not worry. However, thanks to his post, I learned something new.

This benefit is extended to IP and his/her spouse under the following conditions only:

"Eligibility for Medical Benefits

An insured person who leaves the insurable employment upon attaining the age of superannuation, retires under a Voluntary Retirement Scheme, or takes premature retirement, after being an insured person for not less than 5 years, shall be eligible to receive medical benefits for himself and his spouse subject to the production of proof thereof, and payment of a nominal contribution of rupees one hundred and twenty for one year. In case the insured person expires, his spouse is entitled to the medical benefit for the remaining period for which the contribution was made, and she can continue to receive the medical benefit on payment of the contribution @ 120/p.a. for a further period.

This medical benefit is also admissible to an insured person who ceases to be in employment on account of permanent disablement caused due to employment injury for himself and his spouse on payment of a similar contribution until the date on which he would have vacated the employment on attaining the age of superannuation, had he not sustained such permanent disablement."

With Warm Regards,

S. Sethupathy

Excellent HR Services, Erode

Hi Sir,

My father has retired from a firm and is currently availing the benefits of ESI for retired persons. We are planning for his hernia operation under an ESI-listed hospital. Could anyone guide us on the detailed benefits of ESI for retired individuals? Please advise us.

Regards,
Rajesh Verma