Plz tell me the way to get the Medical Expenses Reimbursement from the ESIC Department
From India, Calcutta
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20From India, Calcutta
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Hi Amit,
As far as I am concerned, there is no reimbursement of medical bills from the ESIC department. Those who earn wages less than Rs 6500/month are eligible for free treatment from ESIC-recognized hospitals. This is part of the insurance coverage to which employers contribute 4.75% and employees contribute 1.75%.
Regards,
Rajat
From India, Pune
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As far as I am concerned, there is no reimbursement of medical bills from the ESIC department. Those who earn wages less than Rs 6500/month are eligible for free treatment from ESIC-recognized hospitals. This is part of the insurance coverage to which employers contribute 4.75% and employees contribute 1.75%.
Regards,
Rajat
From India, Pune
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Hi there,
I agree with Rajatji's reply to you, but the only amendment made here is that the limit of Rs. 6500/- has been increased to Rs. 7500/- recently. Please cross-check. The mode of claiming is the submission of original bills and the discharge summary of the doctor. Make sure that you maintain a photocopy of whatever you are submitting to the ESI authorities just as a precaution.
Regards,
Sadashiv Rao
From Kuwait, Kuwait
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I agree with Rajatji's reply to you, but the only amendment made here is that the limit of Rs. 6500/- has been increased to Rs. 7500/- recently. Please cross-check. The mode of claiming is the submission of original bills and the discharge summary of the doctor. Make sure that you maintain a photocopy of whatever you are submitting to the ESI authorities just as a precaution.
Regards,
Sadashiv Rao
From Kuwait, Kuwait
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(Fact Checked)-The information provided in the user reply is correct. Thank you for sharing accurate details on claiming Medical Expenses Reimbursement from the ESIC Department. (1 Acknowledge point)
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The insured person/employee can avail the benefits in the ESIC hospitals and would not be charged for the treatment. He/she needs to produce the ESI card. I have attached the ESI document for all those HR professionals in India.
Cheers,
Anuradha
From India, New Delhi
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Cheers,
Anuradha
From India, New Delhi
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Dear Amit,
Reimbursement of medical expenses is permissible. For claiming the same, you are required to follow the undermentioned process:
1. Treatment should be under the supervision of an ESI doctor. In case of an emergency, you can approach a private hospital if an ESI hospital/dispensary is not available in the area or if the same is not functioning during your emergency requirements. In such cases, you have to inform the ESI dispensary/hospital doctor regarding the treatment being taken from another hospital. Generally, doctors allow treatment if it is from a Government hospital and/or a super specialty hospital. In such cases, all treatment papers, medicine purchase bills, along with prescription slips, are required to be signed by the hospital doctor from where an individual has taken the treatment.
2. Bills of treatment are required to be submitted to your concerned ESI dispensary/hospital on the prescribed proforma.
3. An eligibility certificate is to be submitted to the dispensary/hospital, duly signed by the Branch Manager of the Local ESI office.
4. A request for treatment from outside in an emergency is to be made in writing to the concerned ESI dispensary/hospital to which an individual is attached.
5. The ESI dispensary/hospital doctor will recommend your case for reimbursement to State health authorities.
If you complete these formalities, the ESI dispensary/hospital will forward these bills to State Health authorities for sanction and reimbursement.
After sanction, you will receive information from the ESI dispensary/hospital for claiming the reimbursement. It takes time (2 to 3 months minimum) depending upon the availability of funds with the government.
So, there is no need to feel otherwise. If you are contributing towards the ESI fund and are eligible for the same, you will definitely get the reimbursement.
Regards,
Anil Anand
From India, New Delhi
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Reimbursement of medical expenses is permissible. For claiming the same, you are required to follow the undermentioned process:
1. Treatment should be under the supervision of an ESI doctor. In case of an emergency, you can approach a private hospital if an ESI hospital/dispensary is not available in the area or if the same is not functioning during your emergency requirements. In such cases, you have to inform the ESI dispensary/hospital doctor regarding the treatment being taken from another hospital. Generally, doctors allow treatment if it is from a Government hospital and/or a super specialty hospital. In such cases, all treatment papers, medicine purchase bills, along with prescription slips, are required to be signed by the hospital doctor from where an individual has taken the treatment.
2. Bills of treatment are required to be submitted to your concerned ESI dispensary/hospital on the prescribed proforma.
3. An eligibility certificate is to be submitted to the dispensary/hospital, duly signed by the Branch Manager of the Local ESI office.
4. A request for treatment from outside in an emergency is to be made in writing to the concerned ESI dispensary/hospital to which an individual is attached.
5. The ESI dispensary/hospital doctor will recommend your case for reimbursement to State health authorities.
If you complete these formalities, the ESI dispensary/hospital will forward these bills to State Health authorities for sanction and reimbursement.
After sanction, you will receive information from the ESI dispensary/hospital for claiming the reimbursement. It takes time (2 to 3 months minimum) depending upon the availability of funds with the government.
So, there is no need to feel otherwise. If you are contributing towards the ESI fund and are eligible for the same, you will definitely get the reimbursement.
Regards,
Anil Anand
From India, New Delhi
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(Fact Checked)-The user's reply is correct in detailing the process for reimbursement of medical expenses from the ESIC Department. Well explained and accurate. (1 Acknowledge point)
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Hi,
You can't claim Medical Reimbursement from ESIC. You can only avail Medical benefits (Medical Treatment, Medicines, etc.) free of cost, if your salary is less than 7500 per month and you have contributed to ESI for 6 months, i.e., 1 contribution period from April to September. The only thing you can claim from ESI is for Leave Payment, i.e., you can claim for the salary for the number of days on Medical leave, which has to be certified by an ESI medical officer.
If you want to get Medical leave, you have to obtain an ESI leave form from the ESI medical officer and submit it to your ESI local office, where you will get reimbursement for up to 75% of your leave days' salary.
Manu
From India, Bangalore
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You can't claim Medical Reimbursement from ESIC. You can only avail Medical benefits (Medical Treatment, Medicines, etc.) free of cost, if your salary is less than 7500 per month and you have contributed to ESI for 6 months, i.e., 1 contribution period from April to September. The only thing you can claim from ESI is for Leave Payment, i.e., you can claim for the salary for the number of days on Medical leave, which has to be certified by an ESI medical officer.
If you want to get Medical leave, you have to obtain an ESI leave form from the ESI medical officer and submit it to your ESI local office, where you will get reimbursement for up to 75% of your leave days' salary.
Manu
From India, Bangalore
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Hi Amit Mr. Rao is right the wages limit is 7500/- & the contribution is 4.45% (employer) & 1.75% (employee). Pardeep Sangwan
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Dear Pardeep Correct contribution rates towards ESI are Employee 1.75% of salary / wages Employer 4.75% of salary / wages Regards Anil Anand
From India, New Delhi
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From India, New Delhi
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Hi,
There is a possibility of reimbursement of medical expenses through ESIC, provided that such medical facility may not be available in the ESIC Hospital and the Chief doctor should recommend the insured person to go for external treatment. Once you have made the expenses, you can approach the relevant ESIC Hospital, fill out the required forms, and submit the original bills. You should also provide an undertaking that the expenses were incurred by the company and not by the employee, and will not be recovered from their salary.
I have already received such reimbursement from Hosur ESI Hospital in the year 2004.
All the best,
M. Suriyanarayanan
Chennai
From India, Madras
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There is a possibility of reimbursement of medical expenses through ESIC, provided that such medical facility may not be available in the ESIC Hospital and the Chief doctor should recommend the insured person to go for external treatment. Once you have made the expenses, you can approach the relevant ESIC Hospital, fill out the required forms, and submit the original bills. You should also provide an undertaking that the expenses were incurred by the company and not by the employee, and will not be recovered from their salary.
I have already received such reimbursement from Hosur ESI Hospital in the year 2004.
All the best,
M. Suriyanarayanan
Chennai
From India, Madras
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(Fact Checked)-The information provided in the user reply is mostly accurate. However, it's important to note that the process for medical expenses reimbursement from ESIC may vary based on specific guidelines and procedures. It's advisable to always refer to the latest rules and regulations from ESIC for the most updated information. (1 Acknowledge point)
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Hi Amit & Sadashiv Limit of ESIC applicable has been increased to Rs.10000/- recently. please check it , isn’t it???? Regards Sweta
From India, Ahmadabad
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From India, Ahmadabad
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Hi, The limit of ESIC is Rs.10,000/- . But can you tell that who are covering under ESIC....I want to clear basic funda....mim. no. of employees etc. Regards, Devesh V. Gavand
From India, Mumbai
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From India, Mumbai
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Hi, I'm Sarah Jafri, working as an Assistant Manager - Operations. My ESIC has been deducted since October 2009. Recently, my mother was hospitalized, incurring Rs. 25,000 in expenses because I haven't received my ESIC card or number. Please guide me on what can be done in this case. Can I get reimbursement from ESIC? Also, please send me the list of hospitals registered with ESIC.
From India, Delhi
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From India, Delhi
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(Fact Checked)-The ESIC provides medical reimbursement for registered employees. You can apply for reimbursement with the necessary documents. Check the ESIC portal for registered hospitals. (1 Acknowledge point)
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ESIC Form-Medical Expense Reimbursement.p df
Medical Reimbursement Format.doc
CiteHR.AI
(Fact Checked)-The information provided is accurate. Thank you for explaining the eligibility criteria and contribution percentages for ESIC medical benefits. (1 Acknowledge point)