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The Scheme.
1. Government sanctioned the Ex-servicemen Contributory Health Scheme (ECHS) on
30 Dec 2002 and formally launched on 01 Apr 2003, to be established over a time
span of five years(i.e.) by 31 Mar 2008. The scheme would cater for medicare of
all Ex-Servicemen in receipt of pension including disability pension and family
pension, as also dependents to include wife/husband, legitimate children and
wholly dependent parents.
2. The Scheme would cater for medicare to the Ex-Servicemen by establishing new
Polyclinics and Augmented Armed Forces Clinics at 227 stations spread across the
country. 106 Augmented Armed Forces Clinics at Military Stations and 121 New
Armed Forces Polyclinics at Non Military Station to be established.
3. Financial Outlay. Government accorded sanction for Capital Budget 122 Crores
as one time sanction and Revenue Budget 354.50 Crores Per annum.
4. Man Power At Central Organisation, Regional Centres and Station Headquarters.
Man Power at Central Organisation, Regional Centres and Station Headquarters
will be met from within existing resources of Service Headquarters. 61 Officers
and 249 PBORs sanctioned for Central Organisation and Regional Centers. In
addition 122 Station Headquarters have been provided Manpower from the existing
resources of Service Headquarters.
5. Infrastructure and Manpower at Polyclinics. Infrastructure and Manpower at
polyclinics is based on type of polyclinics (type A/B/C/D and Mil/Non Mil).
Recruitment of the manpower for the proposed Polyclinics would be done on
contractual basis. Following Equipments and Manpower has been provided at
Polyclinics:-
(a) Medical Equipments. X-Ray machine, Ultrasound, Lab Auto Analyzer, Dental
Equipments (including Chair), Physio therapy (Standard Set), ECG Maghine,
Monitor Defibrillator and other small Equipments and Laboratory equipments.
(b) Other Equipments. Generator, Air Conditioners, Ambulances and Light
Vehicles.
(c) Medical Facilities and Manpower. Medical Officers, Medical Specialists,
Gynecologist, Dental Officers, Officer-in-Charge, Nursing Assistant/Nurse, Lab
Assistant, Dental Hygienist, Receptionist/Care taker, Driver, Peon, Safaiwala
and Female Attendant.
6. Referral Procedure. Polyclinic Military Hospital Empanelled Private Hospital.
In emergency for life saving grounds any Hospital, Bills to be paid by Member,
Reimbursement approved only by MDECHS, Emergency clause will be examined.
7. After 31 Mar 08. Ex-servicemen pensioners who are not ECHS Members will not
be entitled to any medicare in Polyclinics and Private Empanelled Hospitals, in
addition No reimbursement will be considered by KSB and INBA due to paucity of
funds.
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Present Status.
01. Polyclinics. All 227 Polyclinics established and all are operational. 09
Polyclinics are managed by the Navy out of 227 Polyclinics, (i.e.) Mumbai, Powai,
Karwar, Visakhapatnam, Kochi, Bhubaneswar, Balasore, Berhampur and Port Blair.
60 out of 227 polyclinics are functioning from the newly constructed buildings.
02. Membership. 5. 5 Lacs ESM pensioners have already joined the scheme out of
20 Lakhs ESM Pensioners eligible.
03. Empanelment of Private Hospitals. 1002 Private Hospitals/Nursing
Homes/Diagnostics Centres/Dental Clinics/Laboratories has been empanelled with
ECHS TILL DATE. In Delhi and NCR 67 Private Hospitals have been empanelled.
04. Smart Cards. Imperative for medicare. It normally takes two months to obtain
Smart Cards on submission of application. In interim the receipt issued on
submission of application by Station Headquarters/Director ECHS(Navy) is valid
for two months till receipt of Smart Cards for availing entitled medicare.
05. Supreme Court Judgment. Supreme Court has given judgment regarding exemption
of ECHS Contribution for Pre-1996 Retirees. Armed Forces Veterans who are
drawing pension form Controller of Defence Accounts and who have retired before
01 Jan 1996 are exempted from payment of contribution under Ex-Servicemen
Contributory Health Scheme. However, they have to apply for membership on the
prescribed application form attaching all relevant documents except the MRO. The
issue of refund of contribution to those Pre- 01 Jan 96 Retirees, who have
become ECHS members, is sub-judice and action will be taken as per the ruling
given by the Govt.
06. Medical Treatment to ex-servicemen who have not joined ECHS. The ECHS has
been operational wef. 01 Apr 2003. The Ex-servicemen who have retired prior to
01 Apr 2003 have the option of joining the scheme and thereby avail the medical
benefits. Despite having issued clear instructions on the subject in the past,
there seems to be doubt regarding the status of ESM who have not joined the ECHS.
It is intimated that the AFV who have not joined the ECHS will continue to be
treated in service hospitals subject to availability of beds and facilities. AFV
are not entitled to transfer/referral from one service hospital to another.
07. No Reimbursement. No reimbursement applicable directly to ECHS members
except for non empanelled private hospital bills on lifesaving grounds.
Reimbursement approved only by MDECHS. KSB/INBA is not considering reimbursement
to ex-servicemen pensioners for serious diseases as hitherto due to paucity of
funds. Es-servicemen pensioners advised to join ECHS earliest. AFV to forward
medical reimbursement cases to Kendriya Sainik Board directly through ZSB/RSB
and not to NHQ/DGMS(N)/PDNPF/PDESA as KSB will not reimburse claims submitted
directly from NHQ. Non pensioners ex-servicemen and families, will continue to
be provided with financial support for medical treatment by KSB through Armed
Forces Flag Day Funds for serious ailments. Financial assistance up to 90% for
sailors and 75% for Officers provided by KSB and balance reimbursement
considered by Secy INBA/PDNPF.
08. Ex-Servicemen Non Pensioners. Not entitled for any medicare in ECHS/Military
Hospitals.
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ECHS EXPANSION NETWORK
1. ECHS Expansion Network duly approved by the COSC on 10 Sep 07, has been
submitted to Government for according approval. The number of personnel who are
availing of medical facilities under ECHS is expanding exponentially. Almost 90%
of the beneficiaries are treated in polyclinics.
2. Subsequent to the directions of Hon'ble PM during the Kendriya Sainik Board (KSB)
meeting held on 19 May 07, wherein it had been directed to set up more
polyclinics and provide improved access to ECHS for veterans and their families.
3. Financial Implications.
| S.No. |
On Account of |
InfrastructureCost. (in Rs. Crores) |
Annul RunningCost (in Rs. Crores) |
| (i) |
New Polyclinics |
119.76 |
32.83 |
|
(ii) |
Up Gradation of
Polyclinics |
3.18 |
1.14 |
| (iii) |
Conversion of
Polyclinics |
2.87 |
0.82 |
| (iv) |
New Regional
Centres |
4.20 |
6.97 |
| (v) |
Addl Central Org |
- |
0.56 |
| (vi) |
Addl AFMSD /Service Hosp |
- |
2.07 |
| |
Total |
130.01 |
44.39 |
4. COSC approved the following:-
(a) Establishment of 181 new polyclinics
(b) Authorisation of 15 military med facilities in remote area.
(c) Conversion of 10 mil type polyclinics to non mil type.
(d) Upgradation of 12 Polyclinics.
(e) Establishment of 14 addl Regional Centres.
(f) Employment of addl 77 Offrs and 336 PBOR (on accretion) and 2372 Contractual
employees.
(g) Expenditure of additional Rs. 130.01 Crores for infrastructure and Rs. 44.39
Crore for Annual Running Cost.
5. Activities / Issues being currently progressed:-
(a) Aggressive approach to ECHS membership
(b) Increase Private Empanelled Hospitals to cover all Stations/Districts.
(c) Augmentation study of Military Hospitals under consideration especially for
super specialty medicare (viz.) Cardiology/Oncology/Nephrology including
Dialysis/Orthopedics/Rheumatology to reduce Private Hospitals empanelled bills.
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