Convergence between Employees’ State Insurance Corporation (ESIC) and National Health Authority (NHA)

The Employees’ State Insurance Corporation (ESIC) has entered into a partnership with National Health Authority (NHA). This convergence between Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) and Employees’ State Insurance Scheme (ESIS) will create an ecosystem wherein ESI beneficiaries will be able to access services at ABPM-JAY empanelled Hospitals and vice versa.The convergence between PM-JAY and ESIC is a landmark initiative for the development of health systems in the country. This will leverage the presence of an established network of quality services providers under PM-JAY alongside fixed health benefit packages, thereby standardising services across schemes. Further, it will create higher demand for health services at ESIC empanelled hospitals that may be currently underutilised. This will support in improvement of infrastructure and facilities of such facilities, via utilisation of funds reimbursed under PMJAY.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 04 States i.e. Chhattisgarh, Karnataka, Madhya Pradesh and Maharashtra. ESI beneficiaries of these 113 designated districts will be able to access medical care services in PM-JAY empaneled 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 empaneled 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 E♍SIC toll-free number: 1800 112 526/ 1800 113 839

For More Information

• 1. Click here for designated districts- flamengo x fluminense:Chhattisgarh / flamengo x fluminense:Karnataka / flamengo x fluminense:Maharashtra / flamengo x fluminense:Madhya Pradesh
• 2.  for the list of empanelled hospitals under AB PM-JAY
• 3.  to know about Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)
• 4.  to get latest updates on AB PM-JAY
• 5.  to access guidelines under AB PM-JAY
• 6.  to know about NHA