Ex-Servicemen Contributory Health Scheme (Echs) Application Form For Membership (Rev 2015) Page 11
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MUST KNOW POINTS
1.
Smart Card will be issued on production of original receipt of application Form.
2.
Validity of receipt is for 60 days only. In case of non receipt of Smart Card validity can be further
extended upto 90 days extension by the Stn HQ. Regional Centre can accord or arng further extension till receipt
of card on case to case basis.
3.
The member and bonafide dependants should activate upgraded
Smart card at any Polyclinics
preferably at parent Polyclinic on receipt by giving thumb impression at the earliest.
4.
Any false declaration/misuse of benefits will entail cancellation of membership. Central Organisation,
ECHS will be the final authority for cancellation of membership
5.
Ensure safe custody of Smart Card.
6.
To avail treatment facilities, the ECHS member or his /her dependent is required to go to ECHS
Polyclinics with the membership Card.
7.
In case further treatment or investigations are required ,the polyclinics doctors will refer the patient to
Service Hospital/Lab/Dental Centre or Empanelled civil facility.
8.
In Military Stations patients will be referred to service Hospital only. Referrals to empanelled civil medical
facilities will only be provided if Service Hospital do not have capacity
9.
A list of Empanelled Hospital/Nursing Home(s), Diagnostics Centre and Dental Clinics/Centers will be
available in the polyclinics for the guidance of patients. The patient will be required to report to the empanelled
facility of his choice along with his ECHS membership card and referral form from ECHS Policlinic. On
Completion of treatment/diagnostics procedure, he/she is not required to make any Payment, bill will be cleared
by ECHS.
10.
In an emergency situation, the ECHS member may not be able to follow the normal referral procedure.
He can report to the nearest/most convenient Hospital, preferably a service Hospital or an Empanelled Hospital.
In Such cases ,no payment is required to be made and the bill of empanelled Hospital will be cleared by ECHS.
In case a member goes to a non-empanelled hospital he/she has to pay the bill and submit a claim for
reimbursement to the ECHS Polyclinics subsequently. In all cases of emergency admission, the nearest ECHS
Policlinics must be informed within 48 hrs. of admission. The reimbursement will be limited to approved
CGHS rates as applicable.
11.
In case of any incorrect entry in the Smart Card .It should be brought to the notice of the issuing authority
within 07 days from the receipt of Card. If brought out later Card will not be replaced free of cost.
12.
In case any complaint /difficulty in availing medical facilities at ECHS Policlinics, please liaise/refer your
correspondence (brief and to the point) to the Stn HQ in whose jurisdiction the Polyclinic is functioning.
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On receipt please activate your card as soon as possible preferably at parent policlinic.
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The following additional documents will be attached with the application form for the following
dependents:-
(a)
Abandoned/Divorced/Widowed daughter/sister
(i)
Court order of divorce decree alongwith an affidavit of current address and employment
status.
(ii)
Death Certificate of late husband alongwith birth certificate of dependent children (i.e
grandchildren of primary beneficiary).
(iii)
Financial documents for past three years to incl IT returns, PAN Card and bank
statement of past one year duly certified by the concerned bank.
(iv)
Affidavit for abandonment by spouse alongwith present address and employment status.
(b)
Disabled child:-
Med certificate from a Service Hospital duly signed by the concerned
specialist regarding the eligibility of the disability. Disability will be decided as per persons with Disability
(PWD) Act 1995.
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