Medical Reimbursement Confusion: What Expenses Are Actually Ineligible?

Hi,

Can you please tell me what expenses the employee cannot claim under medical reimbursement? I understand there is a government order (GO) that specifically lists out ineligible expenses under this category. Where can I access this information?

Also, please clarify if an Accu-Check device purchased by an employee is considered an allowable expense.

Thanks,
Priya

Hi,

As a general principle, any perquisite in the form of a medical allowance is typically taxable. On the other hand, reimbursement by an employer of medical expenses incurred by an employee is generally tax-free.

If an employee receives money for their medical treatment or the treatment of any family member or dependent relative, then a sum up to Rs. 15,000 per annum is not treated as a taxable perquisite as per Clause (b) of the provision to Section 17(2) of the Income Tax Act. This exemption is applicable only if the expenditure is actually incurred on the employee's medical treatment or for the treatment of any family member or dependent relative. It is important to note that there is no condition specifying that the medical treatment should be at an approved hospital. It could be at any place and from any type of doctor, whether belonging to the Allopathic, Ayurvedic, Unani, or Naturopathy system.

The following diseases are covered under medical reimbursement:
- Cancer
- Tuberculosis
- Acquired Immune Deficiency Syndrome
- Diseases or ailments of the heart, blood, lymph glands, bone marrow, respiratory system, central nervous system, urinary system, liver, gall bladder, digestive system, endocrine glands, or the skin requiring surgical operation
- Ailments or diseases of the eye, ear, nose, or throat requiring surgical operation
- Fractures in any part of the skeletal system or dislocation of vertebrae requiring surgical operation or orthopedic treatment
- Gynecological or obstetric ailments or diseases requiring surgical operation, cesarean operation, or laparoscopic intervention
- Ailments or diseases of the organs mentioned in (d) requiring medical treatment
- Gynecological or obstetric ailments or diseases requiring medical treatment in a hospital
- Burn injuries requiring medical treatment
- Mental disorders, neurotic, or psychotic conditions requiring medical treatment
- Drug addiction requiring medical treatment in a hospital
- Anaphylactic shocks including insulin shocks, drug reactions, and other allergic manifestations requiring medical treatment in a hospital

Yes, you can claim medical reimbursement for ACCU-CHECK.

KATYANA

I tried to claim for medical reimbursement on the basis of my dental treatment (filling, scaling, polishing). However, my organization refuses to accept it, stating that dental treatments are not covered at all. Can someone clarify this?

Regards,
Sylur

I want to know about ESIC reimbursement. Our employee has met with a burning accident and is currently receiving treatment in a private hospital for 20 days. We have ESIC coverage for him, but we have not informed ESIC about the incident. Can we still reimburse his claim? Is it possible?

Dear all,

I want to know if I can claim medical reimbursement if we did not inform the ESIC hospital or ESIC officer until discharge from the private hospital.