Labour Ministry Plans to Increase Medical Reimbursement Limits Under Welfare Scheme

The Ministry of Labour and Employment is considering changes to medical reimbursement under the Labour Welfare Scheme, according to a Business Standard news report.  

The proposal includes higher limits for several treatments and a digital system for beneficiaries. The reimbursement limit for heart disease could be raised to ₹2 lakh from ₹1.3 lakh.  

For kidney treatment, the proposed ceiling is ₹3 lakh, up from ₹2 lakh, with dialysis also included under the revised limit. 

Other Treatments 

The reimbursement ceiling for a number of other illnesses may increase to ₹40,000 from ₹30,000 per disease. The list includes tuberculosis, hernia, appendectomy, ulcer, gynaecological and prostate diseases, and cataract. 

The proposed rules would also include diagnostic tests and investigations for these illnesses. Claims would be reimbursed according to actual expenditure, subject to the prescribed limits. 

Digital Records 

The ministry is planning a digital beneficiary database linked to Aadhaar or another unique identification number. Existing worker records, including those available through e-Shram, would be used for the database. 

The proposed system would have QR-code-enabled health cards and a portal for registration, medical claims, and health records. OPD and IPD registration, e-claims, and digital medical records would be handled through the Next Gen e-Hospital platform. 

Scheme Coverage 

The Labour Welfare Scheme covers beedi workers, cine workers and workers in specified non-coal mines, along with their families. The health services currently operate through 10 hospitals and 279 dispensaries across 18 Labour Welfare Organisation regions. 

Workers must have income of up to ₹21,000 a month or ₹2.52 lakh a year, be aged up to 60 and have completed at least six months of continuous service. Dependants require one year of continuous service. 

Budget and Health Data 

The scheme was allocated ₹52 crore in the 2026-27 Budget, compared with ₹50.68 crore for 2025-26. The revised estimate for 2025-26 stood at ₹78.09 crore. 

A 2023 review of 95 studies on beedi workers reported diseases including tuberculosis, asthma, and chronic bronchitis. In specified non-coal mines, fatalities rose to 40 in 2024 from 33 in 2023. 

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Conclusion 

The proposed changes cover higher reimbursement for selected treatments, including dialysis for kidney cases. The ministry is also planning digital registration, claims, and health records for beneficiaries. 

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