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How do I get medical treatment once my contribution has started deducted ?
So far, each insured person who is covered under the scheme, is given an Identity card which has all essential particulars of the said IP on it. Recently ‘Pehchan Card’ is being given to insured person, the card has all biometric details of IP. This is a very important document. Insured Person is required to produce this card at ESI dispensary or Panel Doctor clinic in order to get medical care. |
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How do I get Primary Medical care?
Insured Person or his/her dependent attends ESI Dispensary or Panel Doctor clinic and upon production of Identity Card / Pehchan Card, he/she is issued case papers. He/She is examined by the IMO/IMP. After examination and necessary tests if required, the doctor prescribes medicines to the patient and the medicines are dispensed to the patient. |
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How do I get Ayurvedic Treatment ?
E.S.I.Scheme, Gujarat has widest infrastructure to provide treatment under Ayurvedic System of Medicines. Treatment under this system is available at 15 implemented centers. For this the patient has to go to the dispensary where necessary arrangement for ayurvedic treatment is made.
For aurvedic treatment a separate case of ayurved has to be obtained from the case counter. Aurvedic Medical Officer will prescribe the ayurvedic treatment after examining the patient.
In addition an AYUSH unit has been set-up at each of the hospitals of ESIS Hospitals of Gujarat where treatment including Panchkarma & Yoga therapy under Ayurvedic System is also provided to the beneficiaries of the scheme.
If required Ayurved Medical Officer will refer the patient to any of the following hospitals of Ahmedabad for specialist consultation.
| Akhand Anand Ayurved Hospital , Ahmedabad. |
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| Maniben Ayurvedic Hospital , Ahmedabad. |
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| Vivekanand Ayurvedic Hospital , Ahmedabad. |
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What should I do in emergency?
During the working hours of a dispensary, the patient can go to the dispensary in case of an emergency. When the emergency treatment is required out-side the working hours of the dispensary, the patient is required to attend ESIS/ESIC hospital or at centers where ESIS/ESIC hospital is not set-up, patient is required to attend the hospital with which the scheme has made tie-up arrangement. |
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How do I get Secondary Medical Care ?
When an IP/his/her dependent, in the opinion of the IMO examining him, needs specialists consultation or/and indoor treatment, the patient is referred with refer form to nearby ESIS/ESIC Hospital or if such hospitals are not available at that centre, to an institution with which tie-up arrangement is made for secondary care. At such hospital, the patient is examined and investigated by the specialists following which he is prescribed medicines which is provided by the ESIS Dispy./IMP clinic or the patient is admitted to the hospital for indoor treatment for his/her illness.
If Insured Person has bear the expenditure of his own he/she should apply in written for reimbursement with in one year to the Incharge Medical Officer of his/her dispensary furnishing following documents. |
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How do I get Super Speciality Treatment?
To provide cash-less, hassle-free and quick super speciality treatment to beneficiaries nearer to their residences in case of certain identified various diseases under different disciplines, tie-up arrangement has been made with many medical institutes situated in the centers of the state where scheme is implemented.
For this, medical superintend of ESIS/ESIC Hospital after verifying that the patient needing such treatment is eligible as per rules, refers the patient to such an institute for the said treatment The said institute provides necessary treatment and the institute is paid by E.S.I.Corporation as per policy. |
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How do I get Advance Payment or Reimbursement?
Though adequate measures are taken so that patient of the scheme, gets medical care as per norms, without him having to spend from his pocket, there are cases in which patient has to take treatment in emergency for which he has to spend his own money or some times for spending money to purchase drugs / aids / equipments / instruments necessary as per advice of the attending specialists of the hospital recognized for E.S.I.Scheme. In such cases, he has to submit his claim for reimbursement as per rules to the concerned dispensary.
Similarly, facility for granting advance payment to IPs is there where costly equipment/aids/drugs are advised by hospitals recognized for the scheme and the same is not available with the scheme and IP can not afford to purchase it and then submit his claim for reimbursement. In such cases IP can request to grant advance payment by following rules and the state government grants advance payment. |
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How do I get Cash Benefit ?
Cash benefits are distributed by the local offices of the corporation to an eligible IP on production of medical certificates given by the Medical officer of the dispensaries as per section 52 of the ESI Act. |
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