EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME

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.

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.

6. The ECHS Central Organisation is located at Delhi and functions under the Chief of Staff Committee (COSC) through AG and DGDC&W in Army HQ. The Central organisation is headed by Managing Director, ECHS, a serving Major General. There are 28 Regional Centres ECHS and 426 ECHS Polyclinics. ECHS is also an attached office of Dept of Ex-Servivemen Welfare (DoESW), Ministry of Defence (MoD) as are Directorate General Resettlement(DGR) and Kendriya Sainik Board (KSB)

7. There are five types of ECHS Polyclinics i.e. Type ‘A’, ‘B’, ‘C’ D, & E . Authorisation of Contractual Staff in each type of ECHS Polyclinic is based on the load capacity of echs ECHS Polyclinic.

8. 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. Regional Centre ECHS and ECHS Cell, Station Headquarters will be able to clarify any doubts that you may have on ECHS. Regional Centres ECHS are under Command HQ/ Area HQ. Central Org ECHS functions as part of AG’s Branch, Army HQ.

CONCEPT OF ECHS

ADVANTAGES OF BECOMING ECHS MEMBER

1.No age or medical condition bar for becoming a member.
2.Life time contribution ranges from Rs 30,000/- to Rs 12,0000/- (depending upon Grade Pay)
3.Provision for re-imbursement at CGHS rates, in case of treatment under Emergency in a non-empanelled facility.
4.No monetary ceiling on treatment.
5.Indoor/outdoor treatment, tests and medicines.
6.Familiar environment and sense of belongingness.
7.Covers spouse and all eligible dependents.

Q1. What is the Ex Service Men Contributory Health Scheme?
Ans. ECHS was authorised by Government of India on 30 Dec 2002, and has been introduced from 01 April 2003. It is a publicly funded medicare scheme for those who are ex-servicemen and pensioners & their eligible dependants, and will provide medical care through out-patient treatment at 227 Polyclinics all over India, and in-patient hospitalization & treatment through Military Hospitals and out-sourced Civil Hospitals & Diagnostic Centers at all these 227 locations, which will be empanelled for the purpose. Treatment/hospitalization in Service Hospitals will be available to ECHS members, subject to availability of speciality, medical staff and bed space.
Q2. Who are eligible to become ECHS members?
Ans. Following are eligible to become ECHS members:- Armed Forces Veterans (AFV) drawing Pension / disability pension and their dependents, as indicated at Answer 4. Widows/Family Pensioners drawing Ordinary/Special family pension. Armed Forces Veterans (AFV) drawing disability pension
Q3. Is there any age limit, medical condition and last date for joining the ECHS?
Ans. Joining the ECHS is voluntary for those AFV/eligible persons who retired on or before 31 March 2003. There is no restriction on age or medical condition at the time of seeking membership or joining the scheme. It is also clarified that there is no last date for joining ECHS. However, this is to inform you that ESM who do not join ECHS will not be provided medical facilities at Service Hospitals after 31 Mar 08
Q4. Who are the family members covered?
Ans. Following family members are covered as dependents:- Spouse Other Dependents earning less than Rs. 2550/- PM to include Sons (Till he starts earning or attaining the age of 25 yrs whichever earlier) Unmarried/Divorced Daughters Parents (normally residing with the Pensioner) Special child (mentally/physically challenged) for life
Q5. Will the members continue to get Fixed Monthly Allowance (FMA) of Rs. 100/-?
Ans. No, they have to forfeit it
Q6. What are the arrangements for those entitled ECHS members who need specialized treatment, which is not available in the Polyclinics?
Ans. In the first instance the Polyclinic doctor (s) will refer them to the local Service Hospitals. If facilities are not available at Service Hospitals, they will be referred to an empanelled hospital of the patient's choice
Q7. Will the members have to initially make payment to the empanelled hospital and then seek reimbursement?
Ans. No, The ECHS organisation will make direct payment to the empanelled hospital. There is no burden of any payment on the ECHS member either for treatment or medicines. The ECHS will NOT reimburse the member for any payments made by him knowingly or inadvertently. However ECHS will make payment only at approved rates
Q8. What is the address of Central Organisation of ECHS?

Ans. Central Organisation ECHS
                Adjutant General's Branch
                Maude Line, Delhi Cantt
                New Delhi -110 010

Q9. How to apply for ECHS membership?
Ans. Collect the forms. Thereafter, read the instructions carefully, fill up the application form, get the affidavit notarized and subscription/contribution deposited in Government Treasury/Reserve Bank of India or State Bank of India. Pensioners are then to personally report to Station Headquarters with the completed application form and following original and photo copy of documents (Dependants are NOT required to accompany): - Pension Payment Order (PPO), duly attested by Bank/Treasury from where the pension is being drawn. Original is to be shown at the time of submission of application form. In case of pre-86 retirees, application form may be accepted without PPO. However, following documents would be insisted upon along with the application form:-Discharge book (Not required in case of Naval officers) Discharge Book showing name of spouse Pension Book showing details of pension sanctioned
DPDO/Banker's Certificate
Non Effective Strength Records Part II order in case of marriage after retirement and the fact is not shown in the DPDO/Banker's Certificate Three passport size photographs each of the pensioner & dependants, who propose to use the ECHS facilities - paste one copy of each photo on Pages 1, 2 & 3 of the application form, one copy on 'Receipt' of application and one copy each on the Affidavit Attach original copy of Military Receivable Order (MRO) to the Application Form as proof of deposit of contribution (note that the duplicate copy is for the bank, triplicate copy for pensioner & fourth copy is a spare one) Affidavit duly notarized, in original Armed Forces Veterans Identity Card photocopies to be attached. Original will be shown for comparison at the time of submission of form Station Headquarters (In case of future retirees, copy of PPO is not required. However the application form will be processed through concerned Record Office which is in a better position to certify the impending pensioners status)
Q10. What are the diseases, which can be treated under the ECHS?
Ans. All known diseases are covered for treatment under ECHS
Q11. What is the contribution of the Govt to sustain the expenditure of the Scheme?
Ans. The ECHS scheme is totally Govt funded. The contribution by the pensioners has no bearing on the expenditure to be incurred
Q12. What is the procedure for obtaining medicines, which are not available either with the Polyclinic or with the empanelled hospital?
Ans. Local purchase will be done through concerned SEMO, in military stations, and by the OIC Polyclinic/Medical Officer in non-military stations. They have been authorized certain LP powers. ECHS members are NOT required to purchase any medicines and, hence, will not be re-imbursed, except under following specified conditions:-

 Post operative Neurosurgical & Neurology cases
                Post operative major Cardiac Surgery/Cardiology
                Oncology cases
                Post operative Organ transplantation cases
                Post operative joint replacement cases

Q13. What are the methods of empanelment of hospitals and doctors with respect to each Polyclinic?
Ans. Hospitals desirous of empanelment are required to apply through application forms available at all Stn HQs. Inspection will be done by a Station Board of officers, comprising of the Station Cdr/his rep, SEMO, concerned specialists medical officers. The proceedings of the Board of Officers will be forwarded to Central Organisation ECHS through the chain of Command, for approval of Min of Defence. List of empanelled Hospitals/Diagnostic Centres & Specialist Consultants will be available at each Polyclinic. The updated list is also posted on ECHS website
Q14. How do the members intimate the change of residence, or change of status of dependants?
Ans. Change may be intimated to Station HQs. However, each time the pensioner or his dependants visit a Polyclinic, the status of dependants will automatically be checked. ECHS members must provide accurate facts of status. In case it is discovered that change of status has been concealed (no matter what the reasons) the provisions of Para 9 of the Affidavit will be applied and membership of the AFV and all his dependants may be terminated, without any relief. There is NO appeal in such cases
Q15. Can the members have the option to continue with more than one Govt/PSU Scheme?
Ans. An individual cannot become a member of two Govt/PSU Schemes – he/she has to cancel membership of the other scheme in case opting for the ECHS. For example, one cannot be a member of CGHS & ECHS at the same time. Nor can one be a member of the ECHS and a PSU scheme at the same time. In case any concealment of facts is discerned, recourse will be taken as per provisions of Para 9 of the Affidavit
Q16. What is the medical coverage for those Armed Forces Veterans (AFV) who do not join the ECHS Scheme?
Ans. Existing facilities through MI Room and Service Hospitals will cease to non-members of ECHS after 31 Mar 2008
Q17. What will be the provisions for treatment/hospitalisation in emergencies?
Ans. AFV has three options