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Convergence between the National Health Authority (NHA) and Employee’s State Insurance Corporation (ESIC) The National Health Authority (NHA) has entered into a partnership with the Employee’s State Insurance Corporation (ESIC). This synergy between Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)and Employees State Insurance Scheme (ESIS) will create an ecosystem wherein ESIC 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 benefits packages, thereby standardising services across schemes. Further, it will create a 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.

In the initial phase, a pilot is being conducted in Ahmednagar, Maharashtra and Bidar, Karnataka wherein ESIC beneficiaries of these districts will be able to access PM-JAY services in PM-JAY empanelled hospitals. The beneficiaries will be eligible for all 1,393 secondary and tertiary packages under the scheme and the initiative will be scaled up to 102 districts with a plan of eventually extending coverage across the country.

Key Benefits of AB PM-JAY and ESIS convergence:
  • ESIC beneficiaries will get access to healthcare providers under AB PM-JAY
  • AB PM-JAY beneficiaries will be able to avail services in ESIC empanelled hospitals.
  • Beneficiaries of ESIC can use their ESIS card to access free treatment at AB PM-JAY empanelled hospitals.
  • Similarly, beneficiaries of AB PM-JAY can use their PM-JAY card to access free treatment at ESIC empanelled hospitals.
  • For more information beneficiaries can call ESIC tollfree number: 1800 112 526/ 1800 113 839
  • Click here for the list of empanelled hospitals under AB PM-JAY