BRIEF ON EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME

(ECHS)

Preamble

1. This Brief is set out as given below, and is only a preliminary

guideline for information of the environment/members joining the
ECHS. This Brief provides progress on the ECHS as on 01
September 2003, and must be referred to in conjunction with
“Frequently Asked Questions” issued by the Central Organisation
ECHS in August 2003. A detailed booklet on the scheme will be
prepared in due course, once procedures are formally approved by
the GOI/MOD: -

(a) Part 1. Medical Treatment entitlement to ex-servicemen (ESM)

pensioners prior to 01 April 2003.

(b) Part 2. Aim & Salient aspects of the ECHS, including Eligibility for
Membership.

(c) Part 3. Procedure for enrolment for ESM who were already retired
on or before 31 March 2003, and procedure to be followed by post -01
April 2003 retirees.

(d) Part 4. Rates of Contribution and method of remittance.

(e) Part 5. Utilisation of ECHS medicare system.

(f) Part 6. Action in case of Emergency.

(g) Part 7. Status of AGIS (MBS) & AFGIS (MIS) & ECHS Road Map.

(h) Part 8. Some Important Information.

(i) Part 9. SMART Card and its use.

(j) Part 10. Progress on ECHS & interim arrangements.

PART 1
General

2. “Authorised” vis-à-vis “Entitled” Medical Treatment. While in

service, all ranks of the Armed Forces are authorised to full & free
medical treatment for themselves and for their declared
dependants. However, on proceeding on retirement, as per
Regulations for Medical Services of the Armed Forces (RMSAF),
ex-servicemen (ESM) pensioners (including family pensioners) are
only entitled to a medical allowance of Rs 100/- pm for purchase
of medicines - which amount is included in their Pension Payment
Order (PPO) - or in lieu, to avail free outpatient treatment in
Service facilities and limited in-patient facilities by paying stipulated
stoppages. Those in receipt of Medical Allowance are NOT
permitted to utilise any outpatient facility/medicines from Service
 Hospitals/MI Rooms. Therefore, treatment to the extent possible
was provided to them as an entitlement, and as a welfare
measure, at Service Hospitals, Augmented Armed Forces Clinics
(AFC) and Medical Inspection (MI) Rooms, subject to availability
of bedspace, facility and expertise. Such treatment does not
cater for any of the major diseases, or cover support to dependants,
other than spouse. Moreover, in stations where an MH/AFC/MI
Room is not present, the pensioner has to make his own
arrangements. An additional problem has been that with passage of
time, Service Hospitals/AFCs & MI Rooms (particularly in metro
cities) became overloaded with the progressive increase in demand
of treatment by pensioners, and it has not been possible for the
existing medical infrastructure to cope with either their aspirations
or provide quality treatment.

3. Shortcomings of ESM Medicare. Retired Armed Forces pensioners,

therefore, lacked an adequate post-retirement medicare scheme, as
available to other Central Government employees. The other major
shortcoming was that such entitlement did not cover treatment of
major diseases, and Rs 100.00 pm hardly catered for the prohibitive
costs of even common medicines. To provide some relief to
pensioners, a privately funded Medical Benefit Scheme (MBS)
under the Army Group Insurance Scheme was introduced in Apr 91,
and a similar Medical Insurance Scheme) (MIS) under Air Force
Group Insurance Scheme in 1993. These catered to specific high
cost surgery/treatment, but for a limited number of diseases. Due
to inadequacies of these, it was felt necessary to formulate a
comprehensive health scheme to cater to the needs of ever
increasing pensioners of the Armed Forces, and also to decrease
the out patient load on Service Hospitals.

4. Creation of ECHS. As a consequence of above, and after detailed

deliberations, a comprehensive paper on a health scheme for defence
pensioners, was submitted to Government which finally took shape as the Ex-
Servicemen Contributory Health Scheme (ECHS), duly sanctioned by the
Government vide letter No 22 (I)/01/US (WE) /D (Res) dated 30 Dec 2002, to
come into effect from 01 Apr 2003. The GOI/Min of Def letter ibid only laid
down a broad policy framework, and was to be implemented through detailed
administrative & financial procedures, to be approved separately by MOD. Of
the 11 administrative & financial procedures submitted to Government by the
Armed Forces, for running the ECHS, only three stand approved as on date.

PART 2
Aim

5. To provide comprehensive & quality medical care (covering all

possible diseases) to ESM pensioners and their dependents, to widows
and family pensioners through out-patient (OPD) facilities at 227 all-India
Polyclinics, and in-patient treatment through Service Hospitals (subject to
restrictions)/empanelled Civil Hospitals/ Diagnostic Centres & specialist
Consultants in all such stations.

Salient Aspects of ECHS

6. It covers complete spectrum of ESM pensioners settled in far-flung
areas of the country through a network of Polyclinics in military and non-
military stations. This will bring outpatient treatment & medicines closer to the
location of pensioners, and they will no longer have to go only to service
hospitals that are often located far away.

7. The Scheme is wholly financed by Govt of India from Public Funds

through the Army budget, with only marginal contribution from retiring and
retired service pensioners. All expenditures under this scheme are auditable.
Since GOI/MOD has financed the scheme, the modalities for its
implementation are being set out in a series of eleven administrative &
financial procedures, based on the broad policy letter of 30 December 2002.
Contributions from members do NOT run the scheme (as is commonly
believed) and their money goes into a consolidated fund. There is no
connection between Receipts from pensioners and Expenditure done from
public accounts.

8. It will have a network of 227 polyclinics - 104 co-located at military

stations with service hospitals (where existing), and 123 new Polyclinics at
specified non-military stations. Location of these 227 Polyclinics, as well as
their size/type, has been based on the density of ESM pensioners residing in
a district. All India list of Polyclinic location is given at Appendix to this Brief.

9. ECHS will reduce the out patient load on service hospitals, since an
exclusive Polyclinic facility for ESM pensioners will be located alongside the
MH. Experienced and caring Polyclinic staff (medical and non-medical) will be
recruited, on contractual/basis, through properly constituted Boards of Officers
appointed by Station Commanders.

10. In addition to existing Service Hospitals, good & qualified Civil

Hospitals/Diagnostic Centres and Consultants will also be empanelled by local
Station Commanders, through empowered Station Board of Officers. These
Hospitals/Diagnostic Centres will provide back up support for in-patient
hospitalisation/treatment/investigations where Service Hospitals do not have
bed space or facilities. Treatment will be easily accessible in emergencies,
either through empanelled hospitals or non-empanelled facilities – however,
rules apply as mentioned later in this Brief.

11. Dependent parents are included in the scheme subject to the condition
that their income is less than Rs 1500/- per month. Likewise, dependant
unemployed sons upto 25 years of age, and unmarried & unemployed
daughters, are also included. Physically & mentally challenged children are
covered for life, even after the death of parents.

Eligibility for Membership

12. All ESM pensioners of the Armed Forces who are in receipt of any form
of pension/disability pension, and widows/family pensioners in receipt of
pension, are eligible to become members of the scheme. A detailed policy
letter is under issue clarifying eligibility pre-conditions for membership.
Incidentally, there is NO restriction on age or medical condition of the
pensioner at the time of application.

13. Besides the ESM pensioner himself/herself, the following members of

his/her family are also covered by ECHS: -
 (a) Spouse.

(b) Unemployed son, below 25 years.

(c) Unemployed or unmarried daughter and unemployed

divorced/Widow daughter.

(d) Dependent parents whose income is less than Rs 1500/- pm.

(e) Mentally/Physically Challenged children for life. Certificate from

a Specialist in a Service Hospital is mandatory in such cases.

Note: Wherever there is a doubt about eligibility, the case shall be

referred to the Central Organisation through Regional Centres.
Under NO circumstances will non-entitled members be enrolled. In all
such cases, it is made clear to the applicant that his/her application is
accepted provisionally.

14. Enrolling into the ECHS is voluntary/optional for those ESM

pensioners, and for widows/family pensioners of deceased soldiers, who
retired on or before 31 March 2003. Those who opt NOT to join the scheme
will continue to draw Rs 100.00 pm medical allowance, and continue to avail
the limited medical facilities provided under RMSAF, as hitherto fore. They
shall NOT be permitted to use any ECHS facilities, in any case. This option
of joining the ECHS has to be exercised latest by 31 March 2008, on
which date entry to the Scheme will terminate. The ECHS is, however,
compulsory for all Services pensioners retiring w.e.f 01 Apr 2003, and
their contribution shall be deducted at source by PCDA (Pensions), prior to
retirement.

PART 3

Procedure for joining ECHS (pre 01 April 2003 pensioners)

15. STEP 1

(a) Pensioner/widow/family pensioner or his/her representative can

collect computerised Application form from nearest Station HQs of
Army/Navy/Air Force on payment of Rs 5.00. The forms have got
detailed instructions as to how a pensioner or a widow, or family
pensioner are to fill these up, and the list of documents to be attached.
Pensioners who submitted forms in April – May 2003 are NOT required
to submit computerized forms afresh.

(b) Forms are also available on internet websites, which are,

(www.indianarmy.nic.in/arechs.htm) and (www.irfs-nausena.mil.in).

16. STEP 2

(a) Pensioner/widow/family pensioner to report personally to any of

the designated 104 Station Headquarters (and specifically authorised
Navy and Air Force collection centres) with completed Application,
along with original and photocopy of undermentioned documents.
(Family members are NOT required to accompany the pensioners
for registration). The purpose of personal reporting is for safety of
 original documents and for answering any questions that the
scrutinizing Station HQ staff may wish to ask the applicant: -

(i) PPO duly attested by Bank/Treasury/PDPO from which

drawing pension. This is a mandatory requirement.

(ii) Discharge book – mandatory in all cases, except as given

below: -

(aa) NOT required in case of Officers/PBOR with no

dependants.

(ab) In case only spouse is dependant – AGIS/AFGIS

card with joint photograph will suffice. AGIS/AFGIS Card
is acceptable proof of identity for both husband and wife.

(ac) Naval Officers who are not issued discharge book.

(ad) AF officers who are not issued a discharge book.

(iii) Two passport size photographs each of pensioner &

dependants – (Paste one copy each on Pages 8 and 9 of
application form, and one copy each on affidavit). Also read
instructions in affidavit. Photographs are NOT required to be
stamped by the Notary – they should be signed over by the
dependant, or by the applicant himself/herself if dependant is a
minor.

(iv) Attach original copy of Military Receivable Order (MRO)

as proof of deposit of contribution.

(v) Affidavit duly notarized in original only to be submitted

with application form. Notary is required to sign at one place
ONLY on the Affidavit.

(vi) ESM Identity Card, where available, will be produced in

original only for verification by the checking officer. Identity Card
issued by Kendriya/Rajya/Zila Sainik Boards is NOT acceptable.

Note :- The Station HQ staff will compare attested photocopy with the
original document & return the originals immediately to the pensioner.
They may also ask questions in case of any doubts. They will also
assist pensioners in case of problems in filling in the form. Once
finished they will handover a Receipt to the pensioner. Pensioners
must retain original copy of Reciept carefully. Where there is any
dispute regarding identity/inadequacy of documentary proof, the case
will be referred to the Central Organisation. In such cases, Application
will NOT be formally accepted, unless cleared by Central Organisation.

17. STEP 3

(a) Applicants to come in person to Station HQs when informed, for

collection of ECHS membership SMART CARD. The Receipt provided
by the Station Headquarters at the time of accepting the application
form must be brought along for collection of SMART CARD.
 (b) Card must be kept carefully, as no medical treatment will be
possible without the membership card.

Note :- Personal reporting is required in order to prevent SMART

Card(s) being handed over to a wrong person. Also the pensioner/
widow is required to sign in the Master Ledger at Station HQs, as proof
of having received his/her Card(s).

18. STEP 4

(a) It is mandatory for members and dependents to report jointly or

singly to nearest Polyclinic indicated in their Application, along with
SMART CARD, for recording of fingerprint biometric data of the
applicant and each member of his/her family. This should be done
within 120 days of receiving the SMART CARD.

(b) ECHS SMART CARD will not work at any ECHS Polyclinic unless
activated.

(c) Use the polyclinic facilities. When visiting a Polyclinic

subsequently, it is mandatory for the pensioner or his family member to
carry the ECHS SMART CARD as proof of eligibility. Otherwise, the
Polyclinic may not accept the individual for treatment.

Application Procedure for Soldiers Retiring wef 01 April 2003

19. (a) Separate procedure is being issued through Army/Navy/Air

Forces Orders/Instructions. Such personnel are automatic members of
the Scheme from date of retirement.

(b) Application Form (ECHS Med – 2003), currently under printing,

to be submitted (as indicated in the General Instructions in the form)
well in advance of retirement date. Submission of Application form and
Affidavit is mandatory. Contribution will be automatically deducted by
respective Principal Controller of Defence Account (CDA) (Pensioners)
from terminal benefits and endorsed on PPO with remarks “ECHS
Contribution”.

(c) The organisation will attempt to ensure that SMART CARD is

issued 7-15 days prior to retirement through his/her unit, in respect of
Officers, and from Regimental Centre/Records Office/Commodore
Bureau of Sailors (CABS)/Air Force (AF) unit in case of personnel
below officer rank (PBOR) of the three services.

PART 4

Contribution

20. Contribution can be made by Ex-Servicemen as a one-time payment or

in three consecutive yearly installments. The contribution amount is
mentioned in the application form and is per basic pension (ie, without
commutation and without DA) of the ESM and is to be remitted through
Military Recievable Order, to SBI/RBI/Government Treasury. This remittance
procedure is NOT applicable to those persons retiring from 01 Apr 2003
onwards, and where PPOs have the endorsement “ECHS Contribution”
thereon. For pensioners/widows/family pensioners, who opt to pay in one
installment, the ECHS facility is available for lifetime. In case the payment is
remitted in three installments, the validity of the ECHS Smart Card/medical
treatment will only be valid for the period of payment. Pensioners paying by
installments are responsible to inform the Station HQs or concerned Regional
Centre by post (enclosing original copy of MRO) that the second & third
installments have been deposited as & when due. In case the next
installment is not paid by due date, such SMART cards will not be accepted
by Polyclinic Card Readers and the card will automatically become inactive.
However, the ECHS Card will be renewed/reactivated when the next payment
is deposited and proof provided. After the third & final installment is paid, the
SMART Card will become active for lifetime of the pensioner and for eligibility
period for dependents.

21. Rates are at par with rates of CGHS. The amount to be deposited by
MRO is as follows:-

BASIC UNCOMMUTED PENSION RATE OF ONE TIME

(excluding DA & Disability) SUBSCRIPTION

Upto Rs 1500/- Rs 1800/-

Between Rs 1501 and 3000/- Rs 4800/-

Between Rs 3001 and 5000/- Rs 8400/-

Between Rs 5001 and 7500/- Rs 12000/-

Above Rs 7500/- Rs 18000/-

Who is an ECHS Member? An ECHS member is one whose application has

been fully scrutinized and verified, for his/her eligibility, his/her dependants,
widow status, and eligibility of his/her parents. Only such persons who fully
meet eligibility criteria will be issued with an electronic ECHS Membership
SMART Card. They are the only ones who can claim to be members of the
Scheme. (In the interim period, till issue of SMART CARD, Reciept may be
used as proof of membership).

PART 5

Medical Facilities

22. Facilities in 104 military stations are being progressively upgraded. In

123 non-military stations, new polyclinics will be established progressively. 36
such augmented clinics Armed Forces Clinics (AFCs) and 10 Dental Clinics
have already been established in military stations by Service Headquarters
from their welfare funds. These will continue to provide support to
pensioners, while new ECHS Polyclinics are being established/constructed.

23. Eligible members of the Scheme can go to the nearest ECHS

Polyclinic/AFC along with their SMART CARDS to avail treatment (till issue of
Smart Cards Reciept may be utilized). In the interim, till ECHS procedures are
formalized, ECHS members may approach any Service Hospital to be
provided medical cover, under the provisions of Army HQ letter No
B/49769/AG/ECHS dated 14 July 2003 (amended on 12 August 2003).
24. Doctors at Polyclinics will provide required outpatient treatment and
medicines free of cost. In case a prescribed medicine is not available in the
Polyclinic Pharmacy, the OIC Polyclinic or Medical Officer will procure this
through Local Purchase (LP) and provide it to the member. ECHS members
will NOT be required to purchase any medicine specified for him/her by an
ECHS doctor/empanelled hospital. ECHS will NOT deal with any case of
reimbursement for medicines purchased by a member/dependant, as this is
not permissible under ECHS rules. In case any medicine is so purchased the
cost will have to be borne by the member.

25. In case further treatment is required, the patient will be referred to the
nearest Service Hospital if the treatment/bed availability exists there. At the
Service Hospital, the ECHS member will be provided free treatment &
medicines and ward facilities as per his entitlement, but will have to pay
nominal hospital stoppages in cash, on being discharged from the hospital.
The procedure for dealing with ECHS members or dependants will be the
same as for serving Soldiers & their dependants.

26. In case treatment facility/bed space does not exist/is not available in a
service hospital, the ECHS patient will be referred to the desired empanelled
Hospital/Diagnostic Center/Consultant in the city/region as per choice of the
pensioner. He/she alone will have the right to make the selection. A list of
empanelled Hospitals/Diagnostic Centers and Consultants will be available in
each Polyclinic for benefit of patients. In due course this information will also
be provided on an ECHS website.

27. All that the patient is required to do is, to go to the selected

Hospital/Diagnostic Centre, show his ECHS SMART CARD and referral form
from the Polyclinic, and get treatment. Suitable Memorandum of Agreement
(MOA) will have been drawn up with empanelled Civil Hospitals/Diagnostic
Centres and Consultants to provide treatment only to those pensioners
who are referred to them from the Polyclinic, and provide proof of
membership/SMART Card. ECHS members are NOT permitted to go
directly to any empanelled Hospitals/Diagnostic Centres/Consultant
(except in emergency – see provisions in this Brief).

28. The ESM/dependent does not have to clear bills or make payment
(except for dietary charges) either on admission or when discharged from the
Hospital/Diagnostic Centre/Consultant, provided the cost is as per rate
contract concluded with the empanelled facility. These Hospitals/Diagnostic
Centres/Consultants will be paid directly by the concerned Station
Headquarters under whose jurisdiction the clinic falls. ECHS is responsible
for such payments incurred on treatment of the entitled members – but only if
the laid down procedure is followed. If a member/dependant goes directly to a
Hospital/Diagnostic Centre/Consultant, without first having shown himself to a
Polyclinic Doctor and having got referred, then ECHS will not be held
responsible for costs incurred and will not make payment to the empanelled
facility.

29. There will be no burden of payment (except hospital stoppages in

Service Hospitals, and dietary charges in empanelled Civil Hospitals) on the
ECHS member, either for medicines or for any treatment - whether out-patient
or in-patient - so long as laid down procedures are adhered to, and rate
contract concluded with the facility is not exceeded.
 PART 6

Treatment in Emergency

30. In an emergency, the ECHS pensioner/eligible family members, may

report to the nearest hospital (preferably empanelled) and inform the
dependant Polyclinic/Station HQ/Regional Centre of the emergency within
48 hrs of admission. In case of admission to an empanelled hospital, the
bills will be cleared by ECHS directly. However, in case of emergency
admission to a non-empanelled hospital, the member will first clear the bills,
and thereafter put up claim for re-imbursement to the dependant ECHS
Polyclinic, duly supported with original bills. The bills will be reimbursed if
ECHS is satisfied as to the reasons of emergency and the cost of treatment
availed is reasonable. The onus of proving the emergency lies with the
member and ECHS may, or may not, clear bills in entirety in the event of
doubt/misuse of emergency provisions.

PART 7

Status of AGIS (MBS) & AFGIS (MIS)

31. AGIS (MBS) will terminate on 31 Mar 2006, and its members will be
refunded the full amount of subscription once they have acquired ECHS
membership. For further details members should contact MD AGIS.

32. AFGIS (MIS) will terminate on 31 Mar 2004. AFGIS will issue
separate instructions regarding refund to its members.

Road Map for Development of ECHS Polyclinics

33. Ex Servicemen Contributory Health Scheme (ECHS) is one amongst

the many important initiatives take by the Government & the Armed Forces to
alleviate the social-economic needs of retired pensioners of the three
Services. These essential steps are just a small compensation to the brave
soldiers who sacrifice their youth & life in the nations’ service.

34. The ECHS scheme is a major venture and this medicare concept is
being attempted for the first time at an all India level. It is but natural that
such a scheme will take time to emerge on ground, through newly constructed
and equipped Polyclinic buildings. In fact construction of buildings, purchase
of medical equipment/medicines, vehicles, generators, employment of
medical/non-medical staff will take time. Therefore, there will be a minimum
period required for stabilisation of ECHS. In the interim, provisions are being
made to ensure to that ESM joining the scheme are able to use its benefits.

35. A road map has been charted out for progressive build up of ECHS
assets within a span of five years as per GOI letter, ie, by 31 Mar 2008, which
is also linked to the progressive release of funds by MOD. The Polyclinics
where construction work is planned to commence in FY 2003 – 04, is at 62
Polyclinics in military stations and at 33 non-military stations.
36. There is no doubt that the ECHS is a very forward looking &
comprehensive medicare scheme, which will go a long way in providing
succour to the numerous ex-servicemen pensioners who retire each year. It
caters for all types of diseases & conditions that can afflict aged persons, as
also covers problems related to the younger age dependants.

37. This scheme is definitely in the interest of ex-service pensioners and,

through the means of this Brief and through media, it is hoped that ESM will
seize the opportunity to enroll well before the cut off date.

PART 8

Important Information

38. Some important information for pensioners/widows is summarised:-

(a) To become an ECHS Member an initial contribution as per laid

down rates in mandatory. Thereafter, no payment is to be made for
any medicines or treatment provided under the scheme.

(b) There is no restriction on the type of disease to be treated, or

medicine to be provided, to an ECHS Member within the ECHS rules.

(c) An ECHS member can opt for a single ECHS Smart Card for
him/herself and all dependants, or one for him/herself and a maximum
of two add-on cards for his/her dependants. As the scheme stabilizes
we may permit a separate card for each dependant.

(d) All cards will mandatorily carry fingerprints of the member and
his/her entitled dependants.

(e) It is mandatory to produce the ECHS Smart Card for every visit to a
Polyclinic. Without the Card, the computer at the Polyclinic will not
activate the patients’ record/data, and member/dependant will be
denied treatment, except in emergency. In case a card is lost,
immediately inform the issuing Station HQ/Regional Centre.

(f) Referral to empanelled Civil Hospital / Diagnostic Centre/

Consultant, or Service Hospital, can only be made by Polyclinic
Doctor(s). ECHS Members are NOT permitted to go directly to any of
above.

(g) Patients who are referred by the Polyclinic doctor(s) to a Service

Hospital or to an empanelled facility, must carry their membership
Smart Card & the Polyclinics Referral Card. Without these they will
NOT be entertained by the Service Hospital or the empanelled facility.

(h) No payment to be made by members for treatment (within rate

contract concluded with Hospitals/Diagnostic Centres), or for medicines
- that will be done by ECHS. (Hospital Stoppages/Dietary charges will
be paid by the patient). Since members are not required to buy
medicines or pay for treatment, requests for re-imbursement will not be
entertained. Medicines so bought will be at own cost.

(j) In an emergency, an ECHS patient may be rushed directly to the

nearest Service hospital or to an empanelled hospital (if nearby).
 However, if empanelled hospital is not located nearby, or it is
inconvenient due to the nature of emergency, the member may
proceed to a non-empanelled hospital for treatment. He/she must, in
any case, inform the dependant Polyclinic / Station HQs / Regional
Centre, of the admission within 48 hours.

(k) An ECHS member who has a SMART Card can avail of

treatment at an ECHS Polyclinic anywhere in India. He can also go to
any empanelled Civil Hospital/Diagnostic Centre, provided he has an
authorised Referral slip from an ECHS Polyclinic.

(l) Intercity transportation will invariably be at the members’ cost,

except where he/she is moved on medical advice. Detailed policy will
be issued in due course of time. For movement within town/city limits,
ECHS ambulances may be used to convey very sick and immobile
patients from an ECHS Polyclinic to the Civil Hospital/Diagnostic
Centre at the discretion of OIC Polyclinic or the Polyclinic doctors.

(m) Service Hospitals are automatically empanelled under the ECHS.

Therefore, free treatment/medicines will be provided to ECHS
members/entitled dependants, subject to availability of bed space,
treatment facility and qualified doctors. Nominal stoppages will have to
be paid in cash, before discharge.

(f) First priority for treatment in Service Hospitals is reserved for

serving personnel and their authorised dependants. Hence ECHS
members may be denied admission in Service Hospitals, if bed space
is NOT available. Also, certain types of treatment (Cancer, Heart,
hip/knee replacements, Renal etc) are not available in all Service
Hospitals – admission may be denied in those hospitals.

PART 9

ECHS SMART Card & its utilization

40. To efficiently manage the health needs of an ESM population of

approx 20 lakhs, with an average of 5 dependants per member, the
ECHS would have to track and cater for a strength of over 1 crore
members. This can only be done through an electronic system, for
which the SMSRT Card was found to be the best solution. The main
purposes of the SMART Card are:-

(a) Identification and prevention of fraud. The card will carry

personalized details of the pensioner and eligible dependants. The
information shall be in the form of digitized photos and fingerprints.

(b) Medical History Details. Details of medical history will be

carried on the card so that, in the event of emergency, the data is
available. For example, the card will indicate if patient is Diabetic, or
Asthmatic, or allergic to a particular drug. This will prevent contra
medication.

(c) Medical Expenditure. Amount of expenditure incurred on

each member/dependant, details of reference, hospitalisation and such
like details, will be available for use by ECHS management.
 41. It had been planned to commence issue of Cards from September
2003 onwards. However, that shall NOT be possible, since the
project is enormous, and it has not been possible to short list a
suitable vendor as on 31 August. It may take another few months
for cards to commence issue to members. We do not wish to hurry
matters in view of complexity of the task, it being a prestigious
project being undertaken for the first time in the country.

Interim Arrangements in lieu of SMART Card

42. In the interim, till such time issue of cards commences, a pensioner
who has paid his/her contribution shall be permitted to use the
Reciept provided to him by the Station Headquarters or by
Regional Centre, as authority for availing treatment under the
ECHS, for himself/herself and for his/her authorised dependants.
Orders to this effect have been passed to all Service Hospitals, and
similar instructions will be passed to empanelled hospitals, if
necessary. However, with the Reciept the member shall
mandatorily have to carry/produce some other authentic
document/ identification of his/her or dependants identity.

PART 10

Progress on ECHS

43. Based on the broad policy letter issued by the GOI/MOD on 30 Dec
2002, Central Organisation ECHS had forwarded to the MOD
(between April 2003 – August 2003) a total of 11 administrative and
financial procedures to implement the scheme. Of these, the
following procedures have been approved by GOI/MOD so far:-

(a) Engineering Design of Polyclinics.

(b) Procurement of Medical Equipment for Polyclinics.

(c) Empanelment of 431 CGHS approved Hospitals, in 27

cities, as an immediate measure for referral/treatment of ECHS
patients.

44. Eight more procedures are yet to be approved as on 01 September

2003. Of these, the two most important ones are – Empanelment/employment
of Polyclinic Doctors, Technical and non-medical staff; and Payment
Procedures to empanelled Hospitals, staff and for other ECHS functions. In
the event that these two procedures are approved, it will permit the ECHS
Central Organisation to refer patients through Polyclinic staff to empanelled
hospitals and pay for the treatment.

45. In the interim period, when ECHS Polyclinic buildings are under
construction (as per phased plan) in military stations, a separate building(s)
will be earmarked for the Polyclinic from where ECHS doctors will function. In
non-military stations, buildings will be hired. Authorised Medical equipment
shall be provided to Polyclinics in phases – in the interim period, existing
resources of the Armed Forces shall be utilized.

Arrangements for Medical Treatment till Approval of MOD Procedures

46. Since GOI/MOD procedures may take time in being approved,

owing to detailed vetting and financial clearance, ECHS members
and their authorised dependants (less parents) requiring critical
medical care, should report to the Service Hospital nearest to them,
with their RECIEPT and some identification. Routine treatment shall
be provided as hitherto fore. For specialized treatment/referral,
each Service Hospital has been provided with a sample form in
which the clinical management of the patient and likely cost of
treatment is to be indicated by the Hospital, and forwarded through
medical channels to DGAFMS. On receipt of medical
recommendations, financial concurrence shall be accorded by
ECHS. Payment will be made to the concerned hospital for the
approved treatment.

47. The above procedure has been invoked for the interim period vide
Army Headquarters AG’s Branch letter No B/49769/AG/ECHS dated 14 July
2003, as amended vide letter of same number dated 04 September 2003, and
is applicable to all three Services.

Tele: 2736 Pashchim

Kaman Mukhyalaya
Headquarters
Western
Command
Chandimandir –
134107

46153/5/ECHS 16 Aug 04

List ‘A’

PH & HP
81 Sub Area
91 Sub Area

___________________
(Station Headquarters)

CHANGE OF ADDRESS

A photo copy of Central Organisation letter No

B/49726/AG/ECHS/ii DT 27 Jul 2004 regarding their change of address encl
for your and necessary action.
 (S Dhillon)
Maj
Offg SO (ECHS)
For COS
Enclose : (One only)

Tele: 25684946 Central

Organisation
ASCON: 6832 Ex-
servicemen Contributory
Health
Scheme (ECHS)
Maude
Lines
Delhi
Cantt – 110010

B/49726/AG/ECHS/II 27 Jul 2004

HQ WESTERN COMMAND (A)

(All Concerned)

CHANGE OF ADDRESS

1. The office of Central Organisation, Ex-servicemen Contributory

Health Scheme (ECHS) has shifted from Room No 278 A , South Block,
Army HQs to its temporary premises at Maude Lines, Delhi Cantt – 110010
wef 12 May 2004. The HQs is expected to be located at this address upto 31
march 2007. You are kindly requested to correspond with this office on the
following address:-

Central Organisation, ECHS

Maude Lines
Delhi Cantt – 110010

2. The tele Nos of various apps are as under:-

Ser No Appts Office Tele Nos

(a) MD (Maj Gen) 6830 (ASCON), 25684846 (CIV)

(b) Dy MD (Brig) 6831 (ASCON), 25684847 (CIV)

(c) Dir (Ops & Coord)-(Col) 6832 (ASCON), 25684946 (CIV)

(d) Dir (Med) - (Col) 6833 (ASCON), 25684945 (CIV)

(e) Dir (P & FC) -Gp Capt 6834 (ASCON)

3. This is for your info please.

 Sd –x-x-x-x-x-x
(O S Yadav)
Col
Dir (Ops &
Coord)
For Managing
Director
 Appendix

LIST OF 227 ECHS POLYCLINICS PLANNED UPTIL 31 MARCH 2008

State Polyclinic/Station
Andaman & Nicobar Port Blair
Chittoor, East Godavari, Guntur, Hyderabad, Krishna, Ongole, Rangareddy,
Andhra Pradesh Vishakhapatnam, West Godavari
Arunachal Pradesh
Assam Jorhat, Gauhati, Masimpur
Bihar Bhojpur, Chappra, Danapur, Darbangha, Gaya, Muzaffarpur, Singhbum
Chandigarh (UT) Chandigarh
Chattisgarh
Delhi NCR Delhi, Faridabad, Gurgaon, Hindon, NOIDA
Goa Panjim
Gujarat Ahmedabad, Jamnagar, Vadodra
Ambala, Bhiwani, Chandimandir, Fatehabad, Hissar, Jhajjar, Jind, Kaithal, Karnal,
Haryana Kurukshetra, Narnaul, Panipat, Rewari, Rohtak, Sirsa, Sonipat, Yamunanagar
Himachal Pradesh Bilaspur, Chamba, Dharamsala, Hamirpur, Mandi, Una, Shimla, Solan
Jammu & Kashmir Baramulla, Doda, Jammu, Janglot, Leh, Poonch, Rajauri, Samba, Srinagar, Udhampur
Jharkhand Ranchi
Bangalore (U) Urban, Bangalore (R) Rural, Belgaum, Bijapur, Dharwad, Karwar, Madikeri,
Karnataka Mangalore, Mysore
Kerala Allepy, Kannanur. Kochi, Kottayam, Kozhikode, Malappuram, Palakkad, Pathanmitha,
Quilon, Trissur, Trivandrum
Akola, Alibagh, Amravati, Aurangabad, Buldana, Jalgaon, Kohlapur, Latur, Mumbai,
Mumbai (U) Upnagar, Nagpur, Deolali, Osmanabad, Pune, Ratnagiri, Sangli, Satara,
Maharashtra Sholapur, Sindhudurg, Thane
Manipur Imphal
Meghalya Shillong
Mizoram Aizwal
Madhya Pradesh Bhind, Bhopal, Gwalior, Mhow, Jabalpur, Morena, Rewa, Sagar
Nagaland Mokokchung, Kohima
Orissa Balasore, Behrampur, Cuttack
Amritsar, Bhatinda, Faridkot, Fatehgarh, Firozpur, Gurdaspur, Hoshiarpur, Jalandhar,
Punjab Kapurthala, Ludhiana, Mansa, Moga, Muktsar, Pathankot, Ropar, Sangrur
Ajmer, Alwar, Barmer, Bharatpur, Bikaner, Churu, Jaipur, Jaisalmer, Jhunjhunu, Jodhpur,
Rajasthan Kota, Nagaur, Pali, Sikar, Sawai Madhopur, Sriganganagar, Udaipur
Sikkim Gangtok
Chennai, Coimbatore, Dharampuri, Dindigul, Guddalore, Kanyakumari, Kanchipuram,
Madurai, Nagapattinam, Salem, Thanjavur, Theni, Thiruvannamalai, Thiruvalur, Tiruchi,
Tamilnadu Tirunaveli, Tuticorin, Vellore, Villupuram, Virudhnagar, Wellington
Tripura Agartala
Agra, Allahabad, Aligarh, Azamgarh, Badaun, Ballia, Bareilly, Bulandshahr, Deoria, Etah,
Etawah, Faizabad, Fatehgarh, Fatehpur, Firozabad, Ghazipur, Gorakhpur, Jalaun, Jhansi,
Kanpur, Kanpur (D) Dehat, Lucknow, Mainpuri, Mathura, Meerut, Muzaffarnagar,
Uttar Pradesh Pratapgarh, Rai Bareilly, Saharanpur, Shahajanpur, Sultanpur, Varanasi
Uttaranchal Almora, Chamoli, Dehradun, Lansdowne, Nainital, Pauri Garhwal, Pithoragarh, Raiwala
West Bengal 24 Parganas, Bengdubi, Burdwan, Darjeeling, Howrah, Kolkatta, Krishnanagar, Midnapore

NOTE : This list may be updated in future & number of Polyclinics increased. New Clinic
locations may be added, based on fresh Ex-servicemen pensioner census inputs.

ECHS Contribution (.) copy of Indarmy (ECHS Central Org) Sig A-

333342/AG/ECHS of Nov 05 (05) is reproduced below (.) Quote (.) with

immediate effect the ECHS contribution will correspondingly go up on merger

of 50% dearness allowance / dearness relief with Basic Pension of ESM(.)

example if basic pension of ESM is Rs 5200/- comma the ECHS contribution

will be Rs. 12,000/- (.) Now basic pension plus 50% of merged DA with

pension works out to 7,800/- thus ECHS contribution by ESM will be Rs.

18,000/- (.) the new rates of ECHS contribution are to be implemented

forthwith (.) confirm action (.) Unquote (.) for info and necessary action