The employees with Employee Provident Fund (EPF), are now eligible for Rs 1 lakh in funds as a medical advance according to a circular by Employees’ Provident Fund Organisation (EPFO).
EPFO Circular For Medical Advance
Basically, the fund can be taken out against their accumulated corpus for emergency medical treatment or hospitalization.
In addition to that, the employees need not give any estimate of the cost of said hospitalization or procedure prior to withdrawing the funds.
Basically, the circular was a revisit by the EPFO, in order to of granting medical advances in the event of medical emergencies for employees under the PF scheme.
The organization has also revisited and streamlined circular outlines the ambit within which the medical advance falls and even the treatment conditions under which it will be given.
Now the organization has added Covid-19 related treatments too.
So, this advance is applicable to the employees covered under the Central Services Medical Attendant (CS(MA)) rules as well as those who fall under the coverage of the Central Government Health Scheme (CGHS).
According to this circular, “In life-threatening diseases, many times it becomes imperative to get the patient immediately admitted in the hospital on emergency to save his/her life and it is not possible to get the estimate from the hospital in such situations. A need is felt for streamlining the advanced facility for such serious in-patient treatment in the hospital whenever family members of employees are not able to manage estimates from the hospital concerned in which such patient has been admitted in an emergency. Sometimes patient employees may be in ICU where an estimate is not known in advance. Hence the following procedure may be adopted to grant medical advance for emergency hospitalization on account of serious life-threatening illness including Covid,”.
How To Get The EPF Medical Advance?
1. First of all the said patient must be admitted for treatment in a Government/PSU/CGHS impaneled hospital.
If the patient is admitted to a private hospital due to an emergency then they can appeal to the relevant authority to consider their case as fit to grant relaxation in rules.
This will help in medical bills reimbursement as the advance can be given to private hospitals as well.
2. For claiming the advance, the employee or a family member has to submit a letter on behalf of the patient.
It is ok if the letter doesn’t have an estimate of the cost, but it does need to have the details of the hospital and the patient.
3. The concerned authority can grant a medical advance of up to Rs 1 lakh to the patient or family member. Or it can be directly deposited to the hospital’s accounts for beginning the treatment process.
It is noteworthy here that this advance should be granted immediately, preferably on the same working day.
If that doesn’t happen, then it should be given on the following working day after the receipt of the application.
Further, it should also be provided without insistence for the estimate of expenditure from the hospital or any other documentation.
Basically, this responsibility falls to the concerned office (ACC-ASD for the Head Office).
4. In case if the treatment costs exceed the Rs 1 lakh advance, then an additional advance is possible as long as it falls under the rules of withdrawal of the EPFO.
But, this advance will only be granted after the receipt of the estimate for treatment that is to come and before the patient is discharged from the hospital.
Not here that the additional advance will be given, minus the amount that was initially given and can be given to private hospitals as well.
5. Post-discharge, the employee or family member needs to submit the hospital bill within 45 days after being discharged.
According to the EPF rules, the medical advance will be adjusted to fit the final bill of the hospital.
The reimbursement or recovery of advance needs to happen while the medical bill is being processed.
EPFO Withdrawal Conditions
According to EPFO, the withdrawal money amount should be the least a 6 months’ basic wages and dearness allowance of the member or to the member’s share of contribution with interest.
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