employees who are registered for their Employees Provident Fund (EPF), are eligible for an amount of Rs 1 lakh as medical advance. It can be withdrawn against their accumulated corpus for emergency medical treatment or hospitalization. Employees are also not required to provide an estimate about the cost of the said hospitalization or procedure before withdrawing funds. This information has come in the light of a circular called. was operated by Employees Provident Fund Organization (EPFO). The circular was a revision in the matter of the organization granting medical advances to employees in case of medical emergencies. PF Scheme.
The revised and streamlined circular outlines the scope within which the medical advance falls and even the terms of treatment under which it will be given. One of the parameters was to include additional COVID-19 related treatments.
As per the circular, this advance is applicable to employees covered under the Central Service Medical Attendant (CS(MA)) Rules as well as employees covered under the Central Government Health Scheme (CGHS).
“In life-threatening diseases, at times it becomes imperative to hospitalize the patient in an emergency situation to save his life and in such situations it is not possible to get an estimate from the hospital. The need is felt to streamline the facility in advance for the treatment of such critical patient in the hospital when the family members of the staff are not able to manage the estimate from the hospital concerned in which such patient has been admitted in an emergency. Sometimes the patient staff may be in the ICU where the estimate is not known in advance. Therefore the following procedure may be adopted for grant of medical advance for emergency hospitalization due to serious life-threatening illness including Covid,” the circular stated.
Step-by-step process to get medical advance
1) The patient should be admitted for treatment in a Government/Public Sector Undertaking/CGHS empaneled hospital as per rules. In case the patient is admitted to a private hospital due to an emergency, they may appeal to the concerned authority to consider their case appropriate for relaxation of the rules so as to reimburse the medical bills. In such a situation, advance can also be given to private hospitals.
2) The employee or any family member has to submit a letter on behalf of the patient to claim the advance. This does not require cost estimation, but does require hospital and patient details.
3) Medical advance up to Rs 1 lakh can then be given by the concerned authority to the patient or family member or can be deposited directly into the accounts of the hospital to initiate the treatment process. This advance should be given immediately, preferably on the same working day. If not, it will have to be given on the next working day after receipt of the application. This should also be given without insisting on the cost estimate or any other document from the hospital. This responsibility falls on the concerned office (ACC-ASD for Head Office).
4) In the event that the cost of treatment exceeds Rs 1 lakh upfront, an additional advance is possible as long as it is covered under EPFO withdrawal rules. This advance will be given only after receipt of the estimate for the upcoming treatment and before the patient is discharged from the hospital. Additional advance will be given against the amount given initially.
5) The employee or family member has to deposit the hospital bill within 45 days of being discharged. The medical advance will be adjusted to fit the final bill of the hospital as per EPF rules. No further reimbursement or recovery of advance is required during the processing of medical bills.
What are the withdrawal conditions of EPFO?
The money that can be withdrawn is the basic salary of at least 6 months and the member’s share of the member’s contribution along with dearness allowance or interest.
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