As per the new rules, Employees that are registered for their Employee Provident Fund (EPF), are eligible for up to Rs 1 lakh in funds as a medical advance. The process to obtain the PF medical advance is given below
- The patient must be admitted for treatment in a Government/PSU/CGHS empanelled hospital as per the rules. In the event that 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 so that the medical bills can be reimbursed. In such a case the advance can be given to private hospitals as well.
- The employee or a family member has to submit a letter on behalf of the patient for claiming the advance. It need not have an estimate of the cost, but it does need to have the details of the hospital and the patient.
- The medical advance of up to Rs 1 lakh can then be granted by the concerned authority to the patient or family member or can be directly deposited to the hospital’s accounts for beginning the treatment process. This advance should be granted immediately, preferably on the same working day. If not, it should be given on the following working day after the receipt of the application. It should also be given without insistence for the estimate of expenditure from the hospital or any other documentation. This responsibility falls to the concerned office (ACC-ASD for the Head Office).
- In the event that 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. 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. The additional advance will be given, minus the amount that was initially given.
- The employee or family member needs to submit the hospital bill within 45 days after being discharged. The medical advance will be adjusted to fit the final bill of the hospital as per the EPF rules. Any further reimbursement or recovery of advance needs to happen while the medical bill is being processed.