Functioning of Ex-Servicemen Contributory Health Scheme (ECHS)

GOVERNMENT OF INDIA

MINISTRY OF DEFENCE

LOK SABHA

ANSWERED ON 09.12.2013

(a) whether any service of the Ex-Servicemen Contributory Health Scheme (ECHS) Polyclinics is being outsourced;

(b) if so, the details thereof, service-wise;

(c) whether the Government has received any complaint regarding irregularities in the functioning of ECHS;

(d) if so, the details thereof including the action taken against the officials found guilty; and

(e) the corrective steps taken / proposed to be taken by the Government to ensure effective functioning of ECHS?

ANSWER

(a) & (b): Yes, Madam. The On-line medical bill processing of empanelled hospitals has been outsourced to bill processing agency UTI-ITSL. ECHS has also entered into an agreement with M/s SITL for making the Smart Cards of ECHS beneficiaries.

(c) to (e): A few complaints regarding delay in payment of private hospitals bills, inadequate supply of certain medicines, inadequacy of manpower and discourteous behaviour of staff in ECHS Polyclinics have been received and directions were issued to Central Organisation, ECHS for taking corrective measures. Corrective measures taken / initiated include outsourcing of On-line bill processing for speedy payment of empanelled hospital bills, enhancement of remuneration of contractual staff of ECHS, authorizing additional manpower to ECHS, augmenting supply of medicines in ECHS polyclinics and sensitizing staff to bring in attitudinal changes towards ECHS beneficiaries. Complaints received from time to time regarding irregularities in functioning of ECHS are looked into for appropriate action.

EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME

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. Is ECHS only for army servicemen only?

Ans. This medical facility is for Ex-servicemen only, who have served in Army/Navy/Air force/Indian Coast Guard/Special Frontier Force.

Q3.Where are the application forms available?

Ans. Forms are available at all Station Headquarters, CSDs and at Rajya Sainik Board offices. For those having access to the internet form can also be downloaded from website ‘wwww.echs.gov.in/downloads.html’,‘www.indianarmy.nic.in/arechs.htm’ or “www.irfc-nausena.mil.in”..

Q4. What are the benefits of this scheme?

Ans. ECHS provides cashless medical coverage for the Ex-servicemen and their dependants in the established polyclinic/military hospitals/empanelled hospitals across India.

Q5. When does my medical cover start? From the date of application or receipt of Smart Card?

Ans. ECHS facilitates medical cover right from the day of submission of application form by showing the Receipt. Receipt of application form can be used for temporarily period till the Ex-Servicemen received the smart card. For all retirees who have retired before 01 April’2003 and have not yet taken membership their service particulars/record will be scrutinized and verified by their respective record offices. Temporary card receipt in respect of these individual will be given only after the authenticated record is received from record office. This process may take 2-3 months from the date of fulfilling formalities.

Q6. I am serving in the army, I will retire next year. Can I apply for ECHS membership in advance?

Ans. Yes, you can apply at the time of your release from service. Please fill the documentation required for smart card along with your release documentation from service. Please contact your Unit/Record Office for details. In case of officers please contact MP 5 & 6, Ph. 26106329, 26195662.

Q7. I want to enroll my wife for the scheme. How should I proceed?

Ans. Collect and submit the application form nearby polyclinic along with the copy of PPO/MRO, 2 photographs, affidavit and DD of 135/- in favor of dependant Regional Centre. Spouse has no income limit and will be given membership irrespective of income criteria.

Q8. Are my family members covered in the scheme?

Ans. Yes, ECHS cover ex-servicemen along with his/her dependent family member.

Q1. I have lost my card, what should I do?

Ans. Visit Station head quarter/polyclinic. Collect and submit application form along with documents which includes affidavit of loss of card and DD of 135/- in favor of dependent Regional Center.

Note:FIR is NOT required to be lodged .

Q2. My card is damaged, What should I do?

Ans. Visit Station head quarter/polyclinic. Collect and submit application form along with DD of 135/- in favor of dependant Regional Center. Submit your damaged card when you receive the duplicate card.

Q3. What is the cost of the new 32KB ECHS smart card?

Ans. Each ECHS smart card cost 135/-.

Q4. How many ECHS cards will be issued for a family?

Ans. ECHS smart card will be issued one for each dependant, mentioned in the Discharge Book, provided the dependant meets eligibility conditions as per rules.

Q1. 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 CGHS approved rates..

Q2. What will be the provisions for treatment/hospitalisation in emergencies?

Ans. AFV has three options, namely: –

(a) Report to nearest service hospital for treatment.

(b) Report to nearest empanelled hospital. Bill will be paid by ECHS.

(c) Report to any/nearest non-empanelled hospital. AFV/ his rep will have to pay the charges to the non-empanelled hospital initially.

In all cases where emergency treatment is availed, and where the patient does NOT go through the Polyclinic (where he/she is admitted) referral route, it will be the patient’s responsibility to inform local Polyclinic within 48 hours (2 working days).Such bills will be forwarded in original only to the ECHS Central Organisation, Delhi, through Parent Polyclinic.

Note. The onus of informing the Polyclinic or ECHS shall be of the patient. Also the onus of proving the emergency shall be that of the AFV patient.