Navigating ESIC Insurance for My Mother's Cancer Treatment: What Costs Are Covered?

I am Shabeer. I am an ESIC insured person. My mother is affected by breast cancer. Initially, we did surgery in a private hospital under the Tamil Nadu state government insurance. After the surgery, the tumor biopsy report came back. The result showed that Her-2 is positive. After receiving the biopsy report, the doctor said she needs 6 chemotherapy sessions and a special injection of 18 or 12 doses of Herceptin (costing 40 to 50k per injection), which is very expensive.

Cancer Treatment Under ESIC Insurance

1. Can we get cancer treatment for my mother (Chemotherapy + Herceptin injection) under ESIC insurance?

2. Is the cost of the injection covered by ESIC insurance?

3. If my mother receives treatment in an ESIC empaneled hospital, when will the reimbursable amount be credited to my account?

Hi Shabeer,

According to my knowledge, cancer treatment will not be given at ESI hospitals, but they will refer you to the nearby corporate hospitals. You can get an exemption from medical expenses, like Herceptin injection, which you are in need of. Contact your dispensary for further details.

Swathi Krishnamani, Chennai