Navigating ESI Benefits: How Can a Data Entry Operator Get Coverage for Dad's Heart Stent?

Dear All,

Someone is working as a Data Entry Operator in a State Public Sector Undertaking in Odisha through a manpower service provider. His father has undergone the application of 3 stents in the heart in an emergency in a private hospital. However, how can he avail the ESI benefit for such treatment? Even the employer and principal employer are not aware of the ESI benefits that the insured employee can avail. Please suggest some solutions.

You have to find out whether the private hospital where the treatment is being given is empanelled with ESI. This you can find out either through the dispensary/ESI hospital/ESIC Local Office.
B. Gramesh, Hosur

The hospital where the dependent father of the insured person (IP) has undergone treatment is an empaneled hospital of ESIC. Please suggest how the IP can avail the financial benefit from ESIC.

Ranjan_Bhubaneswar

You need to approach the nearest ESIC office and speak to the concerned officer. If it was an emergency, they will arrange to reimburse the expenses incurred by you.

Sir, ESIC has its own referral policy, based on which the office refers patients for super-specialty treatment. The copy of the referral policy can be found on the website of the Odisha Regional Office of ESIC or on the website of its Headquarters Office. Patients claiming treatment or reimbursement must justify that they have complied with the referral policy. It would be better if the insured person contacts the Incharge of the ESIS Dispensary to which they are attached.