Can Former ESI Members Still Access Hospital Treatment? Seeking Clarity on Eligibility

Dear HR professionals,

I was an IP in ESI and quit the job in November 2017. However, I am not an existing member of ESI. Please tell me if I can still receive treatment from ESI hospitals and if so, for how long.

Thanks,
Rohit

Medical Benefits for Retired Insured Persons and Permanently Disabled Insured Persons:

On payment of Rs. 10/- per month in a lump sum for one year in advance, medical benefits can be provided (under Section 56 of the Act) to:

- An insured person and their spouse who leave insurable employment upon reaching the age of superannuation after being insured for not less than five years, for the period for which contributions are paid.

- An insured person and their spouse who stop being in insurable employment due to permanent disablement from an employment injury shall be entitled to medical benefits.

If you have paid your contributions from Apr-17 to Sep-17, and Oct+Nov 17, then you are supposed to get medical treatment and Sickness Benefit during your benefit period, i.e., from Jan18 to Jun 18 and Jul+Aug 18.

Nowadays, everything is online. You can check your entitlement of benefits from the ESIC IP Portal. Put your IP number as the user id. No password is required.

If you are superannuated, then follow the procedure mentioned by Mr. Manoj.

As per ESI, the benefit period is calculated on a quarterly basis. In your case, your contributions for the period from Apr-17 to Sep-17 are accounted for, making you eligible to receive benefits until Jun 18. If subsequent contributions had been made up to Nov 17, you may be eligible to receive benefits for a further period proportionately.