ESIC Medical Facilities Scheme for Other Beneficiaries, 2026: A New Step Towards Wider Healthcare Access
The Ministry of Labour and Employment has notified the Other Beneficiaries and Members of their Families Medical Facilities Scheme, 2026 through S.O. 2355(E) dated 8 May 2026. The Scheme has been issued under Section 44 of the Code on Social Security, 2020 and has come into force from the date of its publication in the Official Gazette.
Background
The Employees’ State Insurance Corporation has a wide network of hospitals and medical infrastructure across India. However, in some areas, certain ESIC hospitals remain under-utilised. To ensure better use of these medical facilities, the Central Government has introduced this Scheme for extending medical treatment and attendance to certain other beneficiaries and their family members.
This is an important welfare measure, as it allows healthcare infrastructure created under ESIC to be used more effectively while also expanding access to medical care for beneficiaries covered under other Central Government schemes.
Applicability of the Scheme
The Scheme applies to other beneficiaries and members of their families who are registered under any scheme framed by the Central Government, other than the regular Employees’ State Insurance Scheme.
In simple terms, this Scheme is not meant for regular insured persons already covered under ESIC. It is meant for a separate category of beneficiaries who may be permitted to access ESIC medical facilities under the prescribed conditions.
Registration Requirement
Any person who wishes to avail medical treatment and attendance under this Scheme will be required to complete the registration process.
The beneficiary must fill in a registration form, either electronically or through any other prescribed mode, giving details of himself or herself and family members. The person must also produce the identity card issued by ESIC or under any other Central Government scheme, as applicable.
This registration mechanism ensures that only eligible beneficiaries and their family members are allowed to use the medical facilities under the Scheme.
Medical Benefits Available
The Scheme provides that registered persons will be given medical treatment and attendance from under-utilised Employees’ State Insurance hospitals.
This is a significant provision because it allows ESIC hospitals with available capacity to serve a broader group of beneficiaries. It may also help improve utilisation of ESIC infrastructure and reduce pressure on other public healthcare facilities.
User Charges
Beneficiaries availing treatment under this Scheme will be required to pay user charges. These charges will be at such rates as may be notified by the Employees’ State Insurance Corporation in consultation with the Central Government.
The Scheme further clarifies that the user charges collected will be treated as contribution and will form part of the Employees’ State Insurance Fund.
This means that while the Scheme extends medical access, it also provides a financial mechanism to support the ESIC fund.
Maintenance of Records
The concerned ESIC hospitals are required to maintain separate electronic registers and records for beneficiaries receiving treatment under this Scheme. They must also maintain records of user charges collected from such beneficiaries.
This requirement is important from a compliance and monitoring perspective. It ensures transparency, accountability and proper segregation of records between regular ESIC beneficiaries and other beneficiaries covered under this Scheme.
Key Takeaways for Employers and Compliance Professionals
This Scheme does not replace the regular ESIC coverage applicable to employees under the ESI Act or Social Security Code framework. It is an additional scheme for other beneficiaries registered under Central Government schemes.
Employers should note that regular ESIC compliance obligations for eligible employees will continue separately. The present Scheme mainly deals with medical access through under-utilised ESIC hospitals for a different category of beneficiaries.
The Scheme also indicates the Government’s intention to make better use of ESIC healthcare infrastructure and gradually expand social security-linked medical support beyond traditional insured persons.
Conclusion
The Other Beneficiaries and Members of their Families Medical Facilities Scheme, 2026 is a progressive step towards wider utilisation of ESIC hospitals and broader access to medical care. By permitting registered beneficiaries of other Central Government schemes to avail treatment from under-utilised ESIC hospitals, the Government has created a structured mechanism for improving healthcare access while maintaining registration, user charge and record-keeping controls.
For employers, HR teams and compliance professionals, this notification should be understood as part of the larger implementation framework under the Code on Social Security, 2020, and not as a dilution of regular ESIC compliance requirements.
