ESIC Tie-Up with AIIMS & Other Hospitals for Cashless Medical Treatment to Pensioners
Date of Circular: 11 June 2025
Issued By: Employees’ State Insurance Corporation (ESIC)
File No.: D-12/17/3/PMS/-2023-E_VI
📌 Introduction
In a major step toward improving healthcare access for ESIC pensioners, the Employees’ State Insurance Corporation (ESIC) has directed its Regional Directors to ensure tie-up arrangements with AIIMS, CGHS, CSMA, and other State Government approved private hospitals. The goal is to ensure that all medical facilities, including tertiary care, are available to ESIC-PMS beneficiaries without hassle and on a cashless basis.
🔍 Background
Under the Revised ESIC-PMS Guidelines of 2006 (updated on 25 May 2021), there is a clear provision in Para B(4) which states:
“Regional Directors including that of Delhi shall ensure necessary tie-up arrangements with CGHS/CSMA/State Govt. approved Private Hospitals for availability of medical facilities including tertiary care to pensioners as per their entitlement…”
These arrangements are crucial for ensuring smooth access to healthcare for pensioners, particularly in areas where ESIC facilities may be lacking or specialized services are unavailable.
🎯 Key Highlights of the Circular
✅ Tie-Up Responsibility
- Regional Directors are fully responsible for initiating and finalizing tie-ups with hospitals—both government and private.
- These tie-ups must be made in consultation with the Medical Superintendent (M.S.) of the nearest ESIC hospital.
✅ Eligibility of Hospitals
- AIIMS, CGHS-approved, CSMA, and State Government approved private hospitals are to be prioritized.
- If required, other reputed private hospitals (not currently under CGHS/CSMA) can also be tied up as per local needs.
✅ Uniformity in Terms
- The terms and conditions for these arrangements should mirror those already in place under CGHS tie-ups.
✅ Objective
- The initiative is focused on providing hassle-free, cashless treatment to all eligible ESIC-PMS pensioners.
🏥 Why This Matters
This circular is a significant relief for retired insured persons under ESIC, who often face challenges in accessing specialized or tertiary healthcare. By enabling cashless treatment through reputed hospitals and government institutions, ESIC is:
- Enhancing accessibility to quality healthcare
- Reducing out-of-pocket expenses for pensioners
- Ensuring dignity and care for retired workers
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📎 Who Needs to Take Action?
All Regional Directors of ESIC across India must immediately start or expedite the tie-up processes.
Local ESIC offices are expected to assess local requirements and act accordingly.
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📢 Official Communication
This direction comes into force with the approval of the competent authority and is officially circulated to:
All ESIC Regional Offices
All India ESIC Pensioners’ Federation
The Website Content Manager for uploading the notice on the official ESIC website
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📌 Conclusion
This proactive step by ESIC shows its commitment to ensuring that pensioners—who have dedicated their lives to service—receive the medical dignity and support they rightfully deserve. Timely tie-ups and implementation at the regional level will be key to the success of this policy.
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