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Anonymous
Anonymous
Asked: 2 years ago2023-10-19T09:51:52+05:30 2023-10-19T09:51:52+05:30In: Work-Life Balance, Workplace Talks

Are family members also entitled to medical benefits under ESI?

Are family members also entitled to medical benefits under ESI?
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  1. Arsh Thakur
    Arsh Thakur Experienced MBA- Finance
    2023-10-19T10:22:23+05:30Added an answer about 2 years ago

    Yes, family members of an insured person under the Employees’ State Insurance (ESI) scheme in India are entitled to medical benefits. The ESI scheme extends coverage to the insured person’s family, providing them access to medical facilities and healthcare services. Family members covered under the ESI scheme typically include:

    1. Spouse:
      • The legal spouse of the insured person is generally covered under the ESI scheme and is entitled to medical benefits.
    2. Children:
      • Dependent children of the insured person, including legitimate, adopted, or stepchildren, are covered. The coverage usually extends until the children reach a specified age (commonly 25 years) or get married, whichever is earlier.
    3. Dependent Parents:
      • In some cases, dependent parents of the insured person may also be covered under the ESI scheme, provided they meet the eligibility criteria.

    Family members are entitled to the same medical benefits as the insured person, including outpatient and inpatient medical treatment, specialist consultations, maternity benefits, and other healthcare services. The ESI scheme aims to provide comprehensive healthcare coverage to both the insured person and their family members.

    It’s important to note that the coverage of family members is contingent on the insured person being currently covered under the ESI scheme. Additionally, the specific details of coverage, eligibility criteria, and benefits may be subject to updates or changes, and individuals are encouraged to refer to the latest guidelines provided by the Employees’ State Insurance Corporation (ESIC).

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