ECHS Scheme 2024: Benefits, Eligibility & Latest Updates

Posted on: Sep 20, 2024 | 3 mins | Written by: HDFC ERGO Team

ECHS Scheme 2024: Benefits, Eligibility & Latest Updates

Quality and timely healthcare impact the outcome of treatment and determine the well-being of a patient. However, the ever-increasing healthcare costs may prevent individuals from opting for timely treatment, increasing the risk of poor health outcomes. Keeping the importance of quality healthcare in mind, the Ex-Servicemen Contributory Health Scheme or ECHS scheme was launched in April 2003. This scheme works towards ensuring quality healthcare to ex-servicemen and their dependents without creating any financial burden. Let’s take a look at the benefits and eligibility criteria for ECHS.

Overview of Ex-Serviceman Contributory Health Scheme (ECHS)

ECHS, or Ex-Servicemen Contributory Health Scheme, was approved by the Government of India on 30th December 2002 and implemented on 1st April 2003. Before ECHS, retired armed forces pensioners and their families did not have a dedicated healthcare scheme. Thus, they were treated for minor issues at service hospitals and medical inspection rooms, but these healthcare centres were not sufficient, and they often got overcrowded with patients.

After the introduction of ECHS, ex-servicemen pensioners and their dependents could avail of allopathic and AYUSH treatments at the network or empanelled private/government hospitals, polyclinics, and healthcare centres across the country. The scheme has 427 empanelled polyclinics in India for outpatient care, i.e., consultation, investigation tests, and medication.

• Polyclinics

These offer outpatient services, such as doctor’s consultations, diagnostic tests, and medicines.

• Empanelled hospitals

Beneficiaries can opt for inpatient services, such as surgeries and specialised treatments, at empanelled hospitals.

• Medicine supplies

Members can take the prescribed medicines from the pharmacies at polyclinics and empanelled hospitals free of cost.

Benefits of ECHS 2024

The following are the benefits of the ECHS scheme —

1. Easy on the pocket

Ex-servicemen who want to be a part of this scheme must make a one-time contribution towards the scheme. The amount may range from INR 30,000 to INR 1,20,000, depending on the rank they held when they were in service.

2. Easy membership

Ex-servicemen and their dependents can become a member, irrespective of their age and medical condition.

3. Financial support

ECHS covers the medical bills of ex-servicemen and their families, thereby reducing their financial burden. There is no monetary ceiling on treatment, so members can avail of quality and timely healthcare whenever needed.

4. Comprehensive coverage

Like a comprehensive health insurance policy, the scheme offers comprehensive coverage to members. It covers the beneficiaries against a range of medical services, such as specialist consultation, diagnostic tests, hospital bills, and pharmacy bills. Thus, members can avail of timely treatment and recover sooner.

5. Cashless treatment at empanelled healthcare centres

The scheme has a huge network of empanelled hospitals, polyclinics, diagnostic centres, and pharmacies. Thus, the beneficiaries can opt for cashless diagnostic tests and treatment at any of the empanelled healthcare centres without worrying about settling the bills from their pocket. All they must do is show their ECHS smart card at any empanelled polyclinic or hospital and avail of required healthcare.

6. Accessibility

If a member ex-serviceman relocates to any other part of the country, he and his family can avail of healthcare services at the new location. ECHS has empanelled hospitals throughout the country.

Eligibility criteria for ECHS

The following are eligible to become members under the ECHS:

• Armed forces veterans or ex-servicemen who have served in the Indian Armed Forces in any rank and are receiving pension/family pension/disability pension from the government. The scheme also covers the dependents of the ex-servicemen.

• Widows or family pensioners receiving ordinary or special family pension from the government

• Gallantry Award winners

• Members of the military nursing service

Diseases and treatments covered under ECHS

The Ex-Servicemen Contributory Health Scheme covers members against all known diseases. Hence, the beneficiaries can opt for the treatment of any health condition in any of the empanelled hospitals around the country.

To avail of medical treatment, an ECHS member or beneficiary can go to the nearest ECHS polyclinic, hospital, nursing home, or diagnostic centre with the ECHS membership card. The healthcare practitioners will check the card and provide the required treatment and medication.

ECHS — Recent updates and changes in 2024

On June 29, 2024, the following changes and updates were introduced to ECHS —

1. Updating registered mobile numbers

Members can update their registered mobile numbers without seeking the approval of the Officer in Charge (OIC).

2. Change of parent polyclinic

As per the old rules, members who wished to change the parent polyclinic had to seek approvals from the existing and the new parent Officer in Charge (OIC).

After the recent update, members need not seek these approvals. They must simply submit their request for changing the parent polyclinic and their request will be auto-approved.

3. No Referral required from the parent polyclinic

Previously, members visiting the non-parent polyclinic required referral approval from the parent polyclinic OIC.

After the update in June 2024, non-parent polyclinic OIC can approve referrals directly. This will help members to access specialised healthcare sooner.

4. Monitoring healthcare utilisation patterns

After the recent update, the OIC module will track members who visit different polyclinics across the country. This will help understand healthcare utilisation patterns for better allocation of resources.

5. Removal of patient registration report

The patient registration report was previously available in the Officer in Charge (OIC) module.

The new update has removed this to organise the system in a better way and focus on more relevant and important data.

6. Inclusion of polyclinic dependency report

The recent update has added this report to the OIC module. This will help the administrators get a better picture of the dependency of each polyclinic and allocate resources accordingly.

Conclusion

ECHS scheme helps ex-servicemen and their dependents opt for timely diagnosis and treatment in any empanelled healthcare centre across the country. The recent update has streamlined administrative processes and improved communication, thereby expediting access to specialised care. Hence, members can produce their ECHS insurance smart card and avail of healthcare at any of the empanelled polyclinics or hospitals without dipping into their savings.

FAQs

1. Is there any age limit or last date for joining ECHS?

No, there is no age limit to join the scheme. There is no last date either, so ex-servicemen can join the scheme at any time.

2. Does the scheme cover all family members as dependents of ex-servicemen?

ECHS covers the following family members as dependents —

• Spouse of the ex-servicemen

• Other dependents earning less than INR 2,550 per month, such as:

- Sons who are less than 25 years of age. However, sons who start earning before the age of 25 will not be covered.

- Unmarried or divorced daughters

- Parents of the ex-servicemen

- Dependent or divorced sisters

- Dependent minor brothers

- Special child

3. Should members pay their medical bills at the hospital and then claim a reimbursement?

No, members need not pay their medical bills at the hospital. The ECHS organisation settles members’ healthcare bills directly with the empanelled hospitals. Unlike individual health insurance, family floater, or any other health insurance product, members can’t file reimbursement claims under ECHS.

4. What are the subscription rates for ECHS membership?

The subscription rates for ECHS membership vary between INR 30,000 and INR 1,20,000, as per the rank of the ex-servicemen. This is a one-time contribution that ex-servicemen must make to become an ECHS member.

5. What is an ECHS smart card?

ECHS smart card is an important part of ECHS. It helps ex-servicemen and their dependents avail of healthcare in any empanelled polyclinic or hospital nationwide. Members can store their healthcare information on the card, such as medical history, past hospitalisations, etc. Thus, empanelled hospitals can access the necessary data in no time, thereby expediting the entire process. The card also allows members to access their information digitally, anytime and anywhere.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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