Big news for the beneficiaries of Employees’ State Insurance Corporation (ESIC). They have more reasons now to cheer as the Narendra Modi Government has taken decision to converge Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) and ESIC. The ESIC beneficiaries in Chhattisgarh, Karnataka, Madhya Pradesh (MP) and Maharashtra will be benefited. Want to know how? Read this space to know more. 

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The ESIC has entered into a partnership with National Health Authority (NHA). This convergence between AB PMJAY and ESIC will allow the ESI beneficiaries to access services at ABPM-JAY empanelled Hospitals and vice versa. 

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Calling this a convergence between PM-JAY and ESIC a “landmark initiative” for the development of health systems in the country, ESIC said that this would leverage the presence of an established network of quality services providers under PM-JAY alongside fixed health benefit packages. This would in turn standardise services across schemes.  

Further, it will create higher demand for health services at ESIC empanelled hospitals that may be currently underutilised, ESIC says. This will support in improvement of infrastructure and facilities of such facilities, via utilisation of funds reimbursed under PMJAY, it further says. 

This collaboration will ensure better medical care to the ESI beneficiaries besides curtailing expenditure borne by them for getting medical care services in the absence of ESIC health care delivery institution in their vicinity. 

In the initial phase, a pilot was conducted in Ahmednagar, Maharashtra and Bidar, Karnataka wherein ESI beneficiaries of these districts got access to medical care services in PM-JAY empanelled hospitals. 

On successful completion of this pilot project, the convergence of ESI Scheme with PM-JAY has been extended to 113 designated districts of 4 States viz. Chhattisgarh, Karnataka, Madhya Pradesh and Maharashtra.  

ESI beneficiaries of these 113 designated districts will be able to access medical care services in PM-JAY empanelled hospitals. They can avail secondary and tertiary care from the PM-JAY empanelled hospitals without any ceiling. The link to know designated districts and PM-JAY empanelled hospitals is given below. 

Key Benefits of ESIS convergence and AB PM-JAY: 

1. ESI beneficiaries will get access to healthcare providers under AB PM-JAY 
2. AB PM-JAY beneficiaries will be able to avail services in ESIC empanelled hospitals. 
3. Beneficiaries of ESIC can use their ESIS card to access free treatment at AB PM-JAY empanelled hospitals. 
4. Similarly, beneficiaries of AB PM-JAY can use their PM-JAY card to access free treatment at ESIC empanelled hospitals. 
5. For more information beneficiaries can call ESIC toll-free number: 1800 112 526/ 1800 113 839