Ex-Servicemen Contributory Health Scheme (ECHS)

ECHS

EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME (ECHS)

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EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME (ECHS)
MEMBERSHIP DRIVE

“1. ECHS is a Government financed health Scheme covering all the States of the Country. The Scheme provides quality healthcare to all Ex-Servicemen pensioners and their dependent family members. All veterans who have retired before 2003 and not applied for ECHS membership may do so at the earliest. For becoming member the AFVs can visit our website www.echs.gov.in, or contact the nearest polyclinic & Regional Centres.
2. For any clarification on procedural aspects, please contact Joint Director (Est) at dirrcdelhi2@echs.gov.in &
1800 114 115

Avoid Touts and Agents”

(Source: Echs website-As on 17.01.2015)

TOLL FREE ECHS HELPLINE NO 1800-114-115. HELPLINE SERVICE AVAILABLE FROM 0900Hrs TO 1700 Hrs. MONDAY TO FRIDAY or ANY COMPLAINT ON EMPANELLED HOSPITALS NOT ADMITTING/TREATING ECHS BENEFICIARIES TO BE EMAILED TO – diritechs-mod@nic.in

To see complete details of Ex-Servicemen Contributory Health Scheme (ECHS) – CITIZEN-CHARTER – ESM (Pensioners), please click here.

(As on 02.03.2014)
Ex-Servicemen Contributory Health Scheme (ECHS)

INTRODUCTION

1.         Retired Armed Forces personnel till 2002 could avail medical facilities only for specific high cost surgery/treatment for a limited number of diseases covered under the Army Group Insurance(Medical Branch Scheme) (AGI(MBS)) and Armed Forces Group Insurance Scheme(Management Information System) (AFGIS (MIS)) schemes. These medicare schemes could provide some relief to the ESM, but it was not a comprehensive scheme as compared to and available for other Central Government Employees. Therefore, the requirement was felt of establishing a medicare system which could provide quality medicare to the retirees of the Armed Forces.
2. Based on this noble aim, and after detailed deliberations, a comprehensive scheme has taken shape as ECHS, authorised vide Government of India, Ministry of Defence letter No 22(i) 01/US/D(Res) dated 30 Dec 2002. The ECHS was launched with effect from 01 Apr 2003. With the advent of this scheme. Ex-servicemen pensioners and their dependants who were only entitled for treatment in service hospital are now authorised treatment, not only in service hospitals, but also in those civil/private hospitals which are specifically empanelled with the ECHS.
3. The Scheme is financed by Govt of India.

CONCEPT OF ECHS

4.       Conceptually the ECHS is to be managed through the existing infrastructure of the Armed Forces in order to minimise the administrative expenditure. The existing infrastructure includes command and control structure, spare capacity of Service Medical facilities (Hospitals and MI Rooms), procurement organisations for medical and non medical equipment, defence land and buildings etc.
5. In order to ensure minimal disruption of the Scheme during war/training and availability of ECHS services in non military areas above mentioned resources are to be supplemented as follows:-

(a) Establishing new Armed Forces Polyclinics in Non Military areas.
(b) Augmenting existing medical facilities/clinics in some selected military stations to cater for heavy ESM load (Augmented Armed Forces Clinics).
(c) Empanelling civil hospitals and diagnostic centres.
(d) Finances.

ORGANISATION OF ECHS

6.       The ECHS Central Organisation is located at Delhi and functions under the COSC through AG and DGDC&W in Army HQ. The Central organisation is headed by Managing Director, ECHS, a serving Major General. Detailed Organisation of Central organisation ECHS is at Appendix ‘A’. There are 13 Regional Centres ECHS. Their location and organisation is given at Appendix ‘B’.
7.        Details of military stations where existing medical facilities have been augmented (Augmented Armed Forces Clinics) and details of Stations where new Armed Forces Polyclinics have been established are at Appendix ‘C’. 
8.        There are four types of Augmented/New Polyclinics, i.e. Type ‘A’, ‘B’, ‘C’ & ‘D’.
Authorisation of Personnel in each type is given at Appendix ‘D’. (To see complete details of ECHS, please click here.)

9. Command and Control. The existing Command and Control Structure of the Army, Navy and Air Force have been given the Administrative and Financial Powers to run this Scheme. Station Commanders will exercise direct Control over the ECHS polyclinics. Station Headquarters will be able to clarify any doubts that you may have. ECHS Regional Centres are under Command HQ/ Area HQ. Central Org ECHS functions as part of AG’s Branch, Army HQ.

ADVANTAGES OF BECOMING ECHS MEMBER

1. No age or medical condition bar for becoming a member.
2. Life time contribution ranges from Rs 1800/- to Rs 18000/- (depending upon basic uncommuted pension). The contribution rates of new retirees is under upward revision.
3. No monetary ceiling on treatment.
4. Indoor/outdoor treatment, tests and medicines.
5. Country wide network of ECHS Polyclinics.
6. Familiar environment and sense of belongingness.
7. Covers spouse and all eligible dependents.

SUMMARY OF SUPREME COURT JUDGEMENT DATED 22 AUG 2006
REGARDING MEDICAL BENEFITS FOR RETIRED ARMY MEN

1.         In 1999, a petition under Article 32 of the Constitution was filed as Public Interest Litigation (PIL) by Confederation of Ex-Servicemen Associations praying for recognizing the right of full and free medicare of ex-servicemen, their families and dependants. The petition came up for hearing before a two Judge Bench during May 1999 and the Bench ordered the matter to be placed before a Bench of Five Judges. The matter was subsequently heard by a Bench of five Judges and judgement was finally given on 22 Aug 2006.

2.         Supreme court has opined the following:-
(a) A Contributory Scheme such as ECHS ‘cannot be held illegal, unlawful or unconstitutional’.
(b) One time contribution amount from Rs 1500/- to Rs 60000/- ‘cannot be said to be excessive, disproportionate or unreasonably high. It cannot be held ‘illegal’, unlawful, arbitrary or otherwise unreasonable’.
(c)        ‘Getting free and full medical facilities is not a part of fundamental right of Ex-Servicemen’.
(d)        The Court was concerned with the cases of those ESM who have retired before 01 Jan 1996.
(e)        The Govt should consider granting waiver of contribution by Pre 01 Jan 1996 retiree ESMs or Govt pay contribution on behalf of such veterans.

ELIGIBILITY CONDITIONS

1.         Eligibility For ECHS Membership. The Scheme caters for medical care to all ESM pensioners including disability and family pensioners and their dependents, which includes wife/husband, legitimate children and wholly dependent parents. To be eligible for membership of ECHS a person must meet following two conditions:- (Auth Central Org ECHS letter No B/49701-PR/AG/ECHS dt 01 Jun 2006) :-(a) Should have ESM Status.
(b) Should be drawing normal Service /Disability/ Family Pension.
Ex-Servicemen Status 
2.         The eligibility of the retired defence personnel for status of ex-servicemen is governed by the definition laid down by Department of Personnel and Training, Ministry of HRD, Govt of India. The definition has been undergoing changes from time to time.
3. Those Released Before 01 Jul 1968. Any person who had served in any rank (whether as Combatant or not) in the Armed Forces of the Union and released from there other than by way of dismissal or discharge on account of misconduct or inefficiency.
4. Those Released on or After 01 Jul 1968 But Before 01 Jul 1979. Any person who had served in any rank (whether as a Combatant or not) in the Armed Forces of the Union for a continuous period of not less than six months after attestation and released from there other than by way of dismissal or discharge on account of misconduct or inefficiency.
5. Those Released on or After 01 Jul 1979 But Before 01 Jul 1987. Any person who had served in any rank (whether as a Combatant or not) in the Armed Forces of the Union for a continuous period of not less than six months after attestation if discharged for reasons other than at their own request or by way of dismissal or discharge on account of misconduct or inefficiency and not less than 5 years of service if discharged at own request.
6. Those Released on or After 01 Jul 1987. An ‘Ex-Servicemen’ means a person, who has served in any rank whether as a combatant or non combatant in the Regular Army, Navy and Air Force of the Indian Union and
(a) Who retired from such service after earning his/her pension; or
(b) Who has been released from such service on medical grounds attributable to military service or circumstances beyond his control and awarded medical or other disability pension; or
(c) Who has been released, otherwise than on his own request from such service as a result of reduction in establishment; or  
(d) Who has been released from such service after completing the specific period of engagement, otherwise than at his own request or by way of dismissal or discharge on account of misconduct or inefficiency, and has been given a gratuity and includes personnel of the Territorial Army of the following categories namely:-

(i) Pension holders for continuous embodied service.
(ii) Persons with disability attributable to military service; and
(iii) Gallantry award winners.

7.         The Territorial Army personnel will however be treated as Ex-Servicemen wef 15 Nov 1986.
8. Govt of India, Ministry of Defence (Deptt of Ex-Servicemen Welfare) vide its Office Memorandum No 12/1/2005/D(Res) dated 01 Feb 06 has conveyed with the approval of Hon’able Raksha Mantri that such Recruits who were boarded out/released on Medical Grounds and granted Medical/Disability Pension, will also be covered under the category of Ex-Servicemen for all practical purposes.
9. The eligibility of person for the status of ex-servicemen will be governed by the definition in vogue at the time of discharge and will not be affected by the changes in the definition subsequent to his discharge.
10. The personnel of the Army Postal Service (APS) who are a part of the regular Army and retired from such service, ie directly from the Army Postal Service itself without reversion to P&T Department with a pension or who have been released from such service on medical grounds, attributable to military service, or circumstances beyond their control and awarded medical or other disability pension are also covered within the definition of ex-servicemen with effect from 19 Jul 1989.
11.        The following are eligible for membership of ECHS:-
(a) Members of Military Nursing Service (MNS)
(b)        Whole time officers (WTOs) of National Cadet Corps (NCC) who are Ex-Servicemen/NOK, and are in receipt of pension/disability pension/family pension. (Auth: Central Org ECHS No.B49764/AG/ECHS dt 10 Oct 2003)
(c)        1588 Emergency Commissioner Officers (ECOs)/Short Service Commissioned Officers (SCOs) who are permanently absorbed in National Cadet Corps as Whole Time Officers (WTOs) after their release from the Armed Forces meeting the twin conditions of being an ex-servicemen and in receipt of pension/family pension/disability pension. (Auth: Central Org ECHS No.B49764/AG/ECHS dt 10 Oct 2003)
(d) Indian Coast Guard Pensioners and retired Personnel of Defence Security Corps. (Auth ; Central Org ECHS letter No B/49701-CG/AG/ECHS dt 02 May 08 & letter No B/49701-DSC/AG/ECHS dt 17 Apr 08)
(e)        Service Officers who, prior to completing their pensionable service, joined PSUs like Air India, Indian Airlines, Pawan Hans and Shipping Corporation of India, in organisational interest, and Govt had sanctioned pension to these officers on a pro-rata basis. On secondment or transfer to PSUs these officers received their pension either as lump sum or full commutation, or on monthly basis. They would be deemed to comply with the condition of being in receipt of pension from Defence Sources. However a mandatory certificate will have to be endorsed by these ESM in their Affidavit stating that “I certify that I am NOT a member of any other govt/PSU medical health Scheme”. The following documents will be submitted along with Application Form:-
(i) Certificate from current/last employer clearly stating that his previous pension(from service in Armed Forces) has been merged with current pension.
(ii) Copy of PPO, if available or Pension Book / Discharge Book in respect of PBOR.
(iii) Service Particulars Retired/Released Officer’s (Booklet) in respect of officers.
(Auth ; Central Org ECHS letter No B/49701-PR/AG/ECHS dt 19 Apr 07)            x                                  x                                  x                                  x
15. Specific Conditions for Continuance of Eligibility. In case an ESM pensioner (male/female) has declared his/her parents as dependants, they shall continue to receive ECHS benefits for their life time, subject only to the condition that their joint income from all sources does not exceed Rs 3500/-pm from all sources. In the event of the male pensioner’s death, the widow shall be covered as she will start drawing family pension but, her parents will NOT become eligible as dependants. However, parents of the deceased pensioner, if already enrolled as dependants, would continue to enjoy benefits of the ECHS in the event of death of the ESM pensioner, provided their joint income from all sources does not exceed Rs 3500/- pm.
16. Persons NOT Eligible under ECHS. The following are NOT eligible for becoming members of ECHS:-(a) Whole time NCC officers who do not meet the twin conditions referred to under Para 1 of this chapter.
(b) Ex-ECOs/SSCO’s who do not meet twin conditions referred to at para 1 of this chapter.
(c) Legally divorced spouse.
(d) Married and/ or employed daughters/and any child whose total monthly income from all sources is more than Rs 3500/-.
(e) Son(s) above 25 years of age or who have starting earning whichever is earlier.
(f) Parents of widow/war widow.
(g) Husband of a remarried war widow. Including children born from him.

PROCEDURE FOR BECOMING MEMBER OF ECHS

1. Procedure for Pre 01 Apr 2003 Retirees. The procedure for becoming ECHS members applicable to the ESM pensioners who have retired on or before 31 Mar 2003 will be as follows:-
(a) Collect application forms from nearest Station HQs of Army/Navy/Air Force.  Forms can also be downloaded from internet website  www.indianarmy.nic.in/arechs.htm. Sample at appx E.
(b) Submission of Completed Application Forms. Designated Station  Headquarters of Army/Navy/Air Force are the only authorized collection points.
Pensioners are required to personally report to their nearest Station HQs  with the completed application form, alongwith original/photocopy of the following  documents:-
(i) Pension Payment Order (PPO), copy duly attested by Bank/Treasury from where pension is being drawn. Pre-1986 pensioners may submit  copy of Pension Book showing rate of pension.
(ii) DPDO/Bankers Certificate.
(iii) Discharge Book or Certificate/Dependent I-Cards (issued for Naval  Offrs)/ Personnel Occurrence Report.
(iv) Two copies (in original) of the Military Receivable Order (MRO) as  proof of deposit of contribution (Not Applicable to those who are exempted from payment of ECHS contribution).
(v) Affidavit duly notarised.
(vi) Demand Draft for Smart Cards.
(c) Membership will commence from the date of receipt of correctly filled Application Form at Station HQ. On receipt of correctly filled Application Form Stn HQ will give receipt to the individual.
2. Procedure For Becoming Member of ECHS (Post 01 Apr 2003 retirees). The ECHS membership for post 01 Apr 2003 retirees is compulsory. The contribution amount in respect of these Veterans is being deducted by the pension paying authorities. All documents (less PPO) as per para 1 (b) above along with Application Form will also be submitted by such retirees to their Record Offices.
3. Commencement of Membership. An applicant is considered a member of ECHS when his application alongwith all requisite documents is accepted at designated Stn HQ or from the date of retirement for new retirees provided his correctly filled Application Form is accepted by the Record Office. 
Notes: – (a). Deduction of contribution by the CDA or deposition of contribution through MRO is no guarantee for grant of membership 
(b) Identity cards issued by Zila Sainik Board will not be accepted as a proof of identification.
(c) Fixed Medical Allowance. ESM joining ECHS would cease to be entitled for FMA of Rs 100/-pm as authorised earlier in their PPO. The individuals should  approach their Pension Disbursing Authority to ensure stoppages of FMA. ECHS will not be responsible for subsequent lump sum deduction of FMA.
(d) ECHS is not responsible for refund of excess deposition of contribution. Same should be claimed from the concerned CDA by individuals. ECHS functionaries at Station HQ/ Regional Centres will assist individuals, if requested. The refund of excess remittance of ECHS subscription, if made, will be afforded by the concerned PCDA/CDA to the beneficiaries on receipt of a pre-receipted contingent bill  countersigned by the ECHS authorities along with a Xerox copy of the MRO.
4. Disposal of Receipt after Receiving Smart Card(s). Once an individual receives the Smart Card(s) his earlier obtained receipt will be returned and preserved alongith his application Form at the respective Station HQs/ECHS Regional Centre.
5. Smart Card
(a) The Card. A card with a 32 KB chip is being issued to all members as  proof of membership of the Scheme. The Card is usable at all the 227 polyclinics  across the country, after its activation by giving thumb impression at Parent  Polyclinic. The Smart Card stores various details, both in the physical as well as digital form, which can be accessed at all polyclinics.
(b) Quantity. One primary card will be issued to pensioner/ Family Pensioner and each member can have an individual card to provide flexibility of  treatment across the country as per their requirement. In addition a war disabled/battle casualty can be issued a white card for life dependency once eligibility isestablished.
(c) Existing members will have the option of continuing with the current card  albeit with limited facilities or to opt for the new card.
(d) Cost. The cost of each card is Rs 135/- and is to be borne by the member.
(e) Amendment to Card. Any subsequent amendment to the Card desired by the  member will require a fresh card to be made on approval of ECHS Organisation,  and cost to be borne by the member.
(f) Loss of Card. In case of loss of a Smart Card (s)/Temporary Receipt  ECHS member will submit application on plain paper with complete details of lost  Card(s) to dependent polyclinics/Stn/HQ for issue of duplicate cards.
6. Contribution. All ESM pensioners are required to make a one time contribution based on their uncommuted basic monthly pension (including Dearness Pension). A concession has been made in respect of old retirees, who can pay their contribution in three consecutive, equal yearly installments. Contribution rates wef 01 Apr 2004 is as under:-

Notes. (a) War Widows and Next of Kin’s of deceased Soldier who are in receipt  of ‘Liberalized Family Pension’ are exempted from payment of ECHS  contribution.
(b) War disabled soldiers are exempted from payment of ECHS contribution.
(c) Pre-1996 retirees are exempted from contribution.
7. Parent Polyclinic. Every member will be allotted a parent polyclinic, one nearest to his permanent/ temporary residence. Irrespective of parent polyclinic a member can take treatment at any polyclinic in India. If required a member can be given referral to hospital by any polyclinic as per referral policy. However, member can be issued with only seven days medicines at a time from non parent polyclinic unless he carries a Temporary Attachment Certificate (TAC). The validity of TAC is for six months at a time.
8. Change of Parent Polyclinic (Old Card holder). The member is to submit the following to nearest Stn HQs for change of Parent Polyclinic:-
(a) An application on plain paper clearly giving following details:-
(i) Old ECHS Regn Number.
(ii) Old Address.
(iii) Old Parent Polyclinic.
(iv) New Address.
(v) New Parent Polyclinic.
(b) An undertaking on a separate plain paper stating that:-
(i) No information has been concealed or suppressed.
(ii) Any false information submitted will make him liable for termination of his ECHS membership.
(c) Proof of new address like electricity/telephone/water bills/RWA certificate etc.
(d) A fresh ECHS application form with relevant columns filled and superscribed“CHANGE OF ADDRESS “ and “CHANGE OF PARENT POLYCLINIC”.
(e) Return the old cards duly defaced.
(f) Deposit DD on the name of concerned Regional Centre @ Rs 135/-per card requested.
9. Station HQs will receive the application form and provide “Receipt of Documents duly affixed photographs” which will be valid for 60 days and thereafter to be revalidated if ECHS Smart Cards are not received. ECHS member should personally collect the cards from Stn HQ within 60 days of submission of application.
10. Station HQ will place the demand to SITL through concerned Regional Centre ECHS for re-manufacturing of Smart Cards as per request of the member. SITL will issue fresh cards duly indicating new address and new parent polyclinic. SITL will also maintain details of old address and old parent polyclinic in their data base.
11. Change of Parent Polyclinic (New Card holder). The ECHS beneficiaries those who want to change his parent (original) polyclinic will be able to do so for any polyclinic of his choice and need. Once the parent polyclinic has been changed, reversion/second change of the parent polyclinics will be admissible only upon the expiry of a period of six months. The change of the parent polyclinic can be done at the reception centre of any polyclinic with approval of OIC polyclinic.

PROCEDURES FOR TREATMENT, ISSUE OF
MEDICINES AND REFERRAL PROCEDURE
x                                  x                                  x                                  x

4. Conditions of Emergency. It is emphasised that ECHS is designed to be a cashless scheme as far as possible. Treatment is to be availed at authorised hospitals ON REFERRAL ONLY. Reimbursement is permitted only in circumstances which are unavoidable due to absolute Emergency. The conditions of Emergency are as under:-
(a) Acute Cardiac conditions/syndromes.
(b) Vascular catastrophies.
(c) Cerebro-Vascular accidents.
(d) Acute respiratory emergencies.
(e) Acute abdominal pain.
(f) Life threatening injuries.
(g) Acute poisonings and snake bite.
(h) Acute endocrine emergencies.
(j) Heat stroke and cold injuries of life threatening nature.
(k) Acute renal failure.
(l) Severe infections leading to life threatening situations.
(m) Any other condition in which delay could result in loss of life or limb.
Auth : Central Org ECHS letter No B/49774/AG/ECHS/Referral dt 01 Dec 09.
5. In cases where date of emergency hospital admission is PRIOR to membership, reimbursement for ongoing emergency that spell of hospitalization is NOT reimbursable.
            x                                  x                                  x                                  x

ECHS website address:  www.indianarmy.nic.in/arechs.htm

E mails
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REGIONAL CENTRES OF ECHS  
RC Jammu                –           0191-2433139
RC Chandimandir      –           0172-2589400
RC Delhi Cantt         –            011-25682657
RC Jaipur                 –            0141-2249159
RC Lucknow             –           0522-2482745
RC Jabalpur             –           0761-2608177
RC Pune                   –           020-26334257
RC Patna                  –           06115-225955
RC Hyderabad          –           040-27797932
RC Chennai              –           044-25673092
RC Kochi                 –           0484-2373394
RC Kolkata               –           033-22318988
RC Guwahati            –           0361-2642727
(Source:  ECHS website)

To see complete details of ECHS, please click here.
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