Hi, senior, I am working in a private company for over two years. My ESI deduction amount is either 100, 99, or 95 routinely. Six months ago, my father was admitted to the hospital for a heart problem. I claimed the hospital expense amount in ESI, which was Rs. 29,755. Could you please let me know how they calculate the claim amount and how much they will give me?
Thanks in advance.
"Wishing you all an advance Happy New Year."
From India, Mumbai
Acknowledge(0)
Amend(0)
2Thanks in advance.
"Wishing you all an advance Happy New Year."
From India, Mumbai
Acknowledge(0)Amend(0)
I wish you a Happy New Year in advance and also wish your father a healthy life.
ESI Scheme Hospitalization Benefits
Under the ESI Scheme, hospitalization at ESI hospitals or ESI wards attached to government or public hospitals, or at tie-up hospitals, does not require any out-of-pocket expenses. Treatment is provided free of cost (cashless) with no limit. In cases of hospitalization at private hospitals due to extreme emergency or life-threatening situations, ESIC reimburses medical expenses at actuals with no limit. This reimbursement is not linked to your contributions.
Thank you.
From India, Mumbai
Acknowledge(1)
Amend(0)
ESI Scheme Hospitalization Benefits
Under the ESI Scheme, hospitalization at ESI hospitals or ESI wards attached to government or public hospitals, or at tie-up hospitals, does not require any out-of-pocket expenses. Treatment is provided free of cost (cashless) with no limit. In cases of hospitalization at private hospitals due to extreme emergency or life-threatening situations, ESIC reimburses medical expenses at actuals with no limit. This reimbursement is not linked to your contributions.
Thank you.
From India, Mumbai
Acknowledge(1)Amend(0)
Reimbursement of Medical Expenses under ESIC
The question is whether the treatment for a dependent was obtained from an ESIC Hospital or dispensary. If yes, then there is no question of any reimbursement since the expenses are to be incurred by the ESIC institutions. However, if the treatment is obtained from any private or even government hospital without recommendations and reference through an ESIC dispensary or hospital, then in such a situation, the reimbursement of any amount is doubtful.
For reimbursement, the Insured Person can visit the concerned ESI Dispensary and submit the claim on the prescribed form, completing the formalities as per the procedure laid down.
Regards
From India, Noida
Acknowledge(0)Amend(0)
The question is whether the treatment for a dependent was obtained from an ESIC Hospital or dispensary. If yes, then there is no question of any reimbursement since the expenses are to be incurred by the ESIC institutions. However, if the treatment is obtained from any private or even government hospital without recommendations and reference through an ESIC dispensary or hospital, then in such a situation, the reimbursement of any amount is doubtful.
For reimbursement, the Insured Person can visit the concerned ESI Dispensary and submit the claim on the prescribed form, completing the formalities as per the procedure laid down.
Regards
From India, Noida
Acknowledge(0)Amend(0)
Sir, my father has been diagnosed with diabetes and he also requires insulin for treatment. Could you please confirm if it is possible to receive treatment for this condition through ESIC since our entire family is covered by it? Additionally, please advise on the procedure for obtaining insulin injections from ESIC if it is necessary to administer them on a weekly basis.
From India, New Delhi
Acknowledge(0)Amend(0)
From India, New Delhi
Acknowledge(0)Amend(0)CiteHR is an AI-augmented HR knowledge and collaboration platform, enabling HR professionals to solve real-world challenges, validate decisions, and stay ahead through collective intelligence and machine-enhanced guidance. Join Our Platform.
ESI Medical Facilities Scheme 2010.pdf
Medical Reimbursement Format.doc