ESIC • Benefits
Benefits of an ESIC Card: Medical Care, Cash Benefits and More
The Employees' State Insurance (ESI) scheme gives workers and their families medical treatment and cash support during sickness, maternity, disability or death. The contribution is small, and the benefits are large. Here is a clear guide to what the ESIC card gives you and how to use it.
Main Benefits
- Full medical care: treatment for the insured person and the family at ESIC hospitals and dispensaries, with no ceiling on the cost of treatment.
- Sickness benefit: cash compensation of about 70% of average daily wage during certified sickness, for a limited number of days in a year.
- Enhanced sickness benefit: higher benefit (about full wage) for certain long-term diseases, when the treatment is approved.
- Maternity benefit: full wages for 26 weeks for insured women (as per the latest rules), with extra support for medical expenses.
- Disablement benefit: 90% of wage for temporary disability, and a monthly pension for permanent disability caused by work injury or occupational disease.
- Dependants' benefit: monthly pension to the family if the worker dies because of a work injury.
- Funeral expenses: a fixed amount is paid to the family or the person who performs the last rites.
- Unemployment support: a relief scheme gives cash help for a limited period to insured persons who lose their job under the conditions of the scheme.
Contribution and Coverage at a Glance
| Item | Details |
|---|---|
| Who is covered | Employees of covered establishments earning up to ₹21,000 per month (₹25,000 for persons with disability) |
| Employee contribution | 0.75% of wages |
| Employer contribution | 3.25% of wages |
| Exemption | Workers earning up to ₹176 per day do not pay the employee share |
| Who gets treatment | The insured person, spouse, children and dependent parents |
| Card | e-Pehchan card with a 10-digit Insurance Number |
How to Use ESIC Benefits
- For treatment: go to your allotted ESIC dispensary or hospital with the e-Pehchan card and a photo ID. You will be referred to a higher hospital if needed.
- For sickness or maternity cash benefit: get the medical certificate from the ESIC doctor and submit the claim through the employer or the ESIC portal. The money is paid to your bank account.
- For disability or dependants' benefit: report the accident to the employer, who informs ESIC. Claim forms are submitted at the branch office.
- For a funeral claim: submit the death certificate and the claim form at the ESIC branch.
- Keep your bank account and mobile number updated in the ESIC profile.
Important Points
- Cash benefits need a minimum number of contribution days in the contribution period. Check the conditions for each benefit on the ESIC website.
- Treatment at a non-ESIC hospital is allowed mainly in emergencies or on referral. Follow the ESIC rules to get the cost reimbursed.
- Benefit amounts, wage limits and conditions are revised from time to time. Confirm the latest on esic.gov.in.
- Coverage continues if your salary crosses the limit, until the end of the ongoing contribution period.
Need Help?
For ESIC registration, card download, claim forms or guidance on benefits, contact Emitrawala.com. Our team will be happy to help you.
Contact on WhatsApp Call: +91 94606 26065