What this scheme offers
A health insurance premium is one more deduction most low-wage workers genuinely can't absorb, which is exactly why ESI isn't a premium-based product at all — it's a social insurance fund, built from small, mandatory contributions (0.75% of wages from the employee, 3.25% from the employer) that together buy something far larger than either side is putting in: free medical care for the worker and their entire family at ESIC hospitals and dispensaries, plus cash benefits during sickness, maternity, and temporary or permanent disability, and a dependant benefit if a worker dies from an employment injury. It's capped to workers earning up to ₹21,000 a month (₹25,000 for persons with disabilities), which is a deliberate design choice — it targets exactly the income band where a medical bill or lost wages from illness can do the most damage. As of the 2025 reforms, ESIC beneficiaries can also access treatment at Ayushman Bharat PM-JAY hospitals nationwide, genuinely widening where the card actually works.
Who is eligible
- Employee earning up to ₹21,000/month gross wages (₹25,000 for persons with disabilities), at an establishment covered under the ESI Act.
- Covers factories and a widening range of establishments (shops, hotels, restaurants, cinemas, newspaper establishments, and more) employing 10 or more persons, per state notification.
- Family members (spouse, dependent children, dependent parents) are covered for medical benefit under the same ESI number.
Documents required
- Aadhaar card
- ESI card/Insurance Number (issued by employer on enrollment)
- Bank account details
- Family details for dependant coverage
How to apply
- ESI registration is done by your employer at the time of joining an eligible establishment — you don't register yourself.
- Confirm your Insurance Number and e-Pehchan card are issued; these are what you present at ESIC hospitals/dispensaries for cashless treatment.
- For cash benefits (sickness, maternity, disability), submit a claim with medical certification through your employer or directly at your ESIC branch office, depending on the benefit type.
- Access treatment at any ESIC hospital/dispensary, empanelled private hospital, or now also any Ayushman Bharat PM-JAY empanelled hospital nationwide, using your ESI card.
- If you lose your job involuntarily, check your eligibility for the Atal Beemit Vyakti Kalyan Yojana unemployment allowance, which is specifically linked to ESI contribution history.