Can ESI Cover My Employee's Hypertension Medicine Costs and His Mother's Expenses Too?

An employee who joined us recently was given the facility of ESI. He was not covered by ESI so far. He currently incurs monthly expenses of Rs 3000.00 on medicines for Hypertension (High Blood Pressure), which are prescribed by a Cardiologist from a private hospital (not connected to ESI).

Will he be reimbursed the amount of his monthly medicine expenses under the ESI scheme? Also, can his dependent Mother claim reimbursement for her monthly medical expenses?

Thanks,

Dear Nordy,

ESIC provides medical benefits that can normally only be utilized from ESIC hospitals or dispensaries. Thus, he can go to an ESIC dispensary to receive benefits. Additionally, his mother can also benefit from ESIC if she is listed as a dependent under him. However, she must utilize the benefits from ESIC authorized dispensaries only.

Thank you for your reply. Does the person have to be checked by a doctor at the ESI facility, or will his existing prescription from the private doctor be sufficient?

Dear Nordy,

ESI Hospital's doctor will not give you medicine based on an existing prescription. First, they will conduct a check-up and then prescribe medicine. If the disease is not under control at ESI Hospital, they may refer you to another private hospital, and ESIC will cover the expenses.

Regards,
CP Singh