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Medical Benefit 
Super speciality treatment 

Procedure to be followed by the ESI beneficiaries to avail Super speciality medical treatment

  • The insured person shall approach the ESI Dispensary to which he/she is attached, and the Medical Officer shall issue a referral letter to the IP to approach the concerned empanelled medical institution.
     

  • If the IP/beneficiary need medical attention during the non working hours of the concerned ESI Dispensary, they may directly approach the nearest ESI Hospital for getting referral letter. If there is no ESI Hospital situation nearer to the IPís place of living, the IP shall approach the nearest Govt. Hospital for getting referral letter.
     

  • In the case of an emergency the IP/beneficiary can get Medical attention just by producing his/her ESI identity card at the designated private medical institution, shall produce necessary referral letter and other relevant documents within 48 hours. (If any case referral letter is a must to avail treatment under package deal
     

  • The IP/beneficiary shall produce the referral letter along with the ESI Identity Card at the designated private medical institution and avail the treatment without paying any amount from out of his/her pocket. However any facility, other than the items included in the package deal shall be borne by the IP/beneficiary.
     

  • While referring the IP/beneficiary to the concerned Empanelled Medical institution, Medical Officer incharge has to verify whether the IP/beneficiary is eligible for treatment.
     

  • The IP shall produce all the relevant documents demanded by the designated hospital and extend his/her co-operation to the hospital authorities.
     

  • The designated hospital after imparting treatment to the IP/beneficiary shall raise the claim bill directly to the Directorate where it will be settled.

 

   
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