**Executive Summary**
The Ministry of Labour and Employment has notified the "Other beneficiaries and members of their families medical facilities Scheme, 2026," effective from May 8, 2026. Issued under the Code on Social Security, 2020, the scheme provides medical treatment at under-utilized Employees’ State Insurance (ESI) hospitals to beneficiaries of other Central Government schemes. Key requirements include mandatory electronic registration and the payment of notified user charges.
**Key Points / Main Content**
**Scope and Applicability**
* **Effective Date:** The scheme came into force on May 8, 2026, upon its publication in the Official Gazette.
* **Target Population:** The scheme applies to beneficiaries and their family members registered under any Central Government scheme, excluding the Employees’ State Insurance Scheme.
**Registration and Access**
* **Registration Process:** Individuals must fill out a registration form (electronically or through other specified media) containing family particulars as determined by the Corporation.
* **Identification:** Applicants must produce an identity card issued either by the Corporation or under their respective Central Government scheme.
* **Service Delivery:** The Employees’ State Insurance Corporation will specify the time and manner in which medical facilities can be accessed.
**Medical Benefits and Facilities**
* **Facility Access:** Benefits are restricted to medical treatment and attendance provided specifically at under-utilized ESI Hospitals.
**Financial Provisions**
* **User Charges:** Beneficiaries are required to pay user charges at rates notified by the Corporation in consultation with the Central Government.
* **Fund Allocation:** Collected user charges are categorized as "contributions" and will form part of the Employees’ State Insurance Fund.
**Administrative Requirements**
* **Record Keeping:** Concerned hospitals are mandated to maintain separate electronic registers and records of beneficiaries and the user charges collected from them.
**Impact Analysis**
**Non-ESI Beneficiaries and Families**
**Impact**
They gain legal access to medical treatment and attendance at under-utilized ESI hospitals, expanding their healthcare options.
**Action Required**
Must complete the registration process, provide necessary family details, and pay the prescribed user charges to avail of services.
**Employees’ State Insurance Corporation (ESIC)**
**Impact**
The Corporation is tasked with the administrative oversight of the scheme, including the integration of external beneficiaries into their hospital system and the management of additional funds.
**Action Required**
Must specify registration forms, notify user charge rates in consultation with the Central Government, and define the time and manner for availing facilities.
**ESI Hospitals**
**Impact**
Hospitals with surplus capacity will see increased patient inflow and administrative responsibilities regarding data management for non-ESI members.
**Action Required**
Must maintain distinct electronic registers for these beneficiaries and ensure the accurate collection and recording of user charges in the specified format.
Key Entities Referenced
other beneficiaries and members of their families medical facilities Scheme, 2026: The primary policy introduced to provide medical treatment and attendance at ESIC hospitals for beneficiaries registered under various government schemes.
Code on Social Security, 2020: The governing legislation, specifically Section 44, which empowers the Central Government to frame and notify this medical facilities scheme.
Employees’ State Insurance Corporation (ESIC): The regulatory body responsible for implementing the scheme, managing registrations, and providing medical services through its under-utilised hospitals.
Employees’ State Insurance Scheme: The existing social security program used to define the scope of the new policy, which specifically targets individuals not already covered by this scheme.
रजिस्ट्री स.ं डी.एल.- 33004/99 REGD. No. D. L.-33004/99
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असाधारण
EXTRAORDINARY
भाग II—खण् ड 3—उप-खण्ड (ii)
PART II—Section 3—Sub-section (ii)
प्राजधकार स ेप्रकाजित
PUBLISHED BY AUTHORITY
स.ं 2264] नई दिल्ली, िुक्रवार, मई 8, 2026/विै ाख 18, 1948
No. 2264] NEW DELHI, FRIDAY, MAY 8, 2026/VAISAKHA 18, 1948
श्रम एव ंरोिगार मत्रं ालय
अजधसचू ना
नई दिल्ली, 8 मई, 2026
का.आ. 2355(अ).— केंद्रीय सरकार, सामाजिक सुरक्षा संजिता, 2020 (2020 का 36) की धारा 44 द्वारा प्रित्त
िजियों का प्रयोग करते हुए, जनम्नजलजखत योिना बनाती ि,ै अर्ाात:् -
1. सजं क्षप्त नाम और प्रारंभ.– (1) इस योिना का संजक्षप्त नाम अन्य लाभार्र्ायों और उनके पररवार के सिस्ट्यों के जलए
जचदकत्सा सुजवधा योिना, 2026 ि।ै
(2) यि रािपत्र में इसके प्रकािन की तारीख से प्रवृत्त िोगी।
2. लाग ू िोना.- यि योिना केंद्रीय सरकार द्वारा बनाई गई कमाचारी राज्य बीमा योिना के अलावा दकसी भी िसू री
योिना के अधीन पंिीकृत अन्य लाभार्र्ायों और उनके पररवार के सिस्ट्यों पर लागू िोगी।
3. पररभाषाएँ.- इस योिना में, िब तक संिभ ासे अन्यर्ा अपेजक्षत न िो-
(क) “संजिता” से सामाजिक सुरक्षा संजिता, 2020 (2020 का 36) अजभप्रेत ि;ै
(ख) “जनगम” से कमाचारी राज्य बीमा जनगम अजभप्रेत िै;
3292 GI/2026 (1)2 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(ii)]
(ग) “व्यजि” से लाभार्ी अजभप्रेत ि,ै जिसमें उसके पररवार के सिस्ट्य िाजमल िैं, िो केंद्रीय सरकार द्वारा
बनाई गई कमाचारी राज्य बीमा योिना से जभन्न दकसी भी िसू री योिना के अधीन पंिीकृत िैं;
(घ) इस योिना में प्रयुि और अपररभाजषत अन्य सभी िब्िों और अजभव्यजियों के विी अर्ा िोंगे िो क्रमिः
संजिता में उनके ि।ैं
4. पिं ीकरण.- इस योिना के अधीन जचदकत्सा उपचार और िेखभाल का लाभ उठाने के इच्छुक व्यजि को-
(क) एक पंिीकरण फ़ॉमा, इलेक्ट्ऱॉजनक रूप से या दकसी अन्य माध्यम से भरना अपेजक्षत िोगा, जिसमें उसके
और उसके पररवार के सिस्ट्यों के संबंध में ऐसा जववरण िाजमल िो, जिसे जनगम द्वारा जनधााररत दकया गया
िो;
(ख) यर्ाजस्ट्र्जत, जनगम द्वारा उस व्यजि को िारी दकया गया पिचान पत्र, या केंद्रीय सरकार द्वारा बनाई गई
दकसी अन्य योिना के अधीन िारी दकया गया पिचान पत्र, प्रस्ट्तुत करना अपेजक्षत िोगा।
5. जितलाभ.- इस योिना के अधीन पंिीकृत व्यजियों को, कम उपयोग म ेंआने वाले कमाचारी राज्य बीमा अस्ट्पतालों
से जचदकत्सा उपचार और िेखभाल प्रिान की िाएगी।
6. उपयोगकता ा प्रभार.- (1) इस योिना के अधीन जचदकत्सा उपचार और िेखभाल का जितलाभ उठाने वाले व्यजियों
को, जनगम द्वारा केंद्रीय सरकार के परामिा से अजधसूजचत िरों पर उपयोगकताा प्रभार का भुगतान करना िोगा।
(2) उप-परै ा (1) के अधीन एकजत्रत उपयोगकताा प्रभार को अिं िान माना िाएगा और यि कमाचारी राज्य बीमा
कोष का जिस्ट्सा िोगा।
7. जचदकत्सा सजु वधा का लाभ उठान ेका समय और रीजत.- लाभार्ी, जिस समय और रीजत स ेसुजवधाओं का लाभ उठा
सकते ि,ैं वि ऐसी िोगी िैसा दक जनगम द्वारा समय-समय पर जवजनर्िाष्ट दकया िाए।
8. रजिस्ट्टर और अजभलखे ों का रखरखाव.- संबंजधत अस्ट्पताल, इस योिना के अधीन जचदकत्सा उपचार और िेखभाल
का लाभ उठान े वाल े लाभार्र्ायों और उनस े एकत्र दकए गए उपयोगकताा प्रभारों के जलए अलग-अलग इलेक्ट्ऱॉजनक
रजिस्ट्टर और अजभलेख ऐसे स्ट्वरूप और रीजत से रखगें े, िैसा दक जनगम द्वारा जवजनर्िाष्ट दकया िाए।
[फा. सं. आर-19025/19/2026-एस एस-I]
आिुतोष ए. टी. पेडणेकर, संयिु सजचव
MINISTRY OF LABOUR AND EMPLOYMENT
NOTIFICATION
New Delhi, the 8th May, 2026
S.O. 2355(E).— In exercise of the powers conferred by section 44 of the Code on Social Security, 2020 (36 of 2020),
the Central Government hereby makes the following Scheme, namely:-
1. Short title and commencement.- (1) This Scheme may be called the other beneficiaries and members of their
families medical facilities Scheme, 2026.
(2) It shall come into force from the date of its publication in the Official Gazette.
2. Application.- This Scheme shall apply to other beneficiaries and members of their families registered under
any scheme, other than the Employees’ State Insurance Scheme, framed by the Central Government.
3. Definitions.- In this scheme, unless the context otherwise requires-
(a) “Code” means the Code on Social Security, 2020 (36 of 2020);[भाग II—खण् ड 3(i)] भारत का रािपत्र : असाधारण 3
(b) “Corporation” means the Employees’ State Insurance Corporation;
(c) “person” means a beneficiary, including members of his or her family, registered under any scheme,
other than the Employees’ State Insurance Scheme framed by the Central Government;
(d) All other words and expressions used and not defined in this scheme shall have the meaning
respectively assigned to them in the Code.
4. Registration.- A person desirous of availing medical treatment and attendance under the Scheme shall be
required to-
(a) fill a registration form containing such particulars electronically or otherwise in respect of himself and
members of his family as may be specified by the Corporation;
(b) produce the identity card issued to such person by the Corporation or under any other scheme, as the
case may be, framed by the Central Government.
5. Benefits.- Persons registered under this scheme shall be provided medical treatment and attendance from
under-utilised Employees’ State Insurance Hospitals.
6. User Charges.- (1) Persons availing medical treatment and attendance under this Scheme shall be required to
pay user charges at such rates as may be notified by the Corporation in consultation with the Central
Government.
(2) The user charges collected under sub-paragraph (1) shall be deemed to be contribution and shall form part
of the Employees’ State Insurance Fund.
7. Time and manner of availing Medical Facility.- The time and manner in which the facilities may be availed
by the beneficiaries shall be such as may be specified by the Corporation from time to time.
8. Maintenance of register and records.- The concerned hospitals shall maintain separate electronic registers
and records of the beneficiaries availing medical treatment and attendance under this scheme and user charges
collected from them in such form and manner as may be specified by the Corporation.
[F. No. R-19025/19/2026-SS-I]
ASHUTOSH A.T. PEDNEKAR, Jt. Secy.
Uploaded by Dte. of Printing at Government of India Press, Ring Road, Mayapuri, New Delhi-110064
and Published by the Controller of Publications, Delhi-110054.