Senior Citizens Guide 23-07-09.pmd - Helpage India Programme

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48A pensioner will have the option to pay contribution either based onhis last pay drawn or based on his present pension (excluding DearnessRelief).For entry in the scheme, pensioners shall be required to apply inthe prescribed application form (Annexure-A) along with a photographto the designated card issuing authority. The cost of photograph will beborne by the pensioner. The card issuing authority shall intimate thepensioner about the medical card and the index card for submission tothe Medical Officer Incharge etc. The procedure for obtaining a duplicatemedical card shall also be issued by the card issuing authority.Pensioners residing within eight kilometers of an E.S.I.C./ESISDispensary/Hospital shall avail medical facilities through thatdispensary/hospital in the first instance, in absence of which he willhave the option to avail the facilities through any other approveddispensary/hospital nearest to his residence. In case, any particulartreatment is not available in such dispensaries/hospitals, they m ayrefer the patient to any of the recognized hospitals where such treatmentis available. If a pensioner takes treatment from a hospital which is notrecognized in non-emergent circumstances, no reimbursement shallbe made and the entire expenditure will be borne by the pensioner.Pensioners who are provided medical facilities through ESIinstitutions shall remain entitled to the available ward irrespective oftheir entitlement. Those who are referred to any other recognizedhospitals shall be entitled to the class of accommodation as shownbelow:-Sl. No. Rate of Monthly Corresponding Ward incontribution paid approved Hospitals1. Upto Rs. 15/- General2. Rs. 40/- General3. Rs. 70/- General/Semi-private as available4. Rs. 100/- Private5. Rs. 150/- Private or above as availableAll decisions/instructions issued hitherto shall stand modified uponimplementation of this scheme w.e.f. 1/4/2006.There shall be a designated Nodal Officer for each State/UT whowill be empowered for reference to other approved hospital in case thefacility is not available in ESI hospitals. The communication in this regardshall follow shortly.
49The reimbursement will be restricted to the rates approved byE.S.I.C./State Govt./CGHS/CS(MA) Rules, whichever is lower orapplicable. The cases where contingencies have arisen on or before31.03.2006 shall be regulated in accordance with the instructions inforce prior to 1/4/2006. Reimbursement claims already decided shallnot be reopened.A copy of the scheme is sent herewith the request to bring thecontents of the scheme to the notice of all concerned.Encl:- E.S.I.C. Pensioners’ Medical Scheme(S.K. Sinha)JT. DIRECTORFor Director GeneralToAll Regional Directors/Joint Directors InchargeD(M)D/D(M)Noida/SSMC/Medical Superintendents of E.S.I.C.Hospitals/ODCs/JD(Fin.)/Accounts Branch-III, Hqrs.
Page 5 and 6: iiiCONTENTS1. CONSTITUTIONAL PROVIS
Page 9 and 10: 3• Access to food and adequate nu
Page 11 and 12: 5MINISTRY OF SURFACE TRANSPORTi) St
Page 13 and 14: 7Implementing Agencies:Assistance w
Page 15: 93. LEGAL RIGHTS(a) CODE OF CRIMINA
Page 18 and 19: 124. PRIVILEGES & BENEFITS(a) ECONO
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Page 36 and 37: 30sisters, widowed daughters, minor
Page 38 and 39: 32(iii) Headquarters of CGHS in the
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Senior Citizens Guide 23-07-09.pmd - Helpage India Programme

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