ECHS – Medical facilities when residing in districts not covered by ECHS

No. 22D (09)12013/US (WE)/D (Res)

Govornment of India

Deptt of Ex-Servicemen Welfare

Ministry of Defence

New Delhi

Dated the 21st August, 2013

Sir.

1, The undersigned is directed to invite attention to Govt. of India, Ministry of Defence letter No. 24(48)/03/US(WE)D(Res) dated 19th December, 2003 and to state that keeping in view, the difficulties being faced by the ECHS beneficiaries residing in districts not covered by ECHS it has now been decided to liberalise the ECHS Rules as follows to enable them to avail medical facilities for in-patient treatment and post- operative follow-up treatment-

(a) (i)   ECHS beneficiaries who are holding a valid ECHS Card and are residing in districts not covered by ECHS shall be eligible to obtain treatment from Govt. (Central/State/Local Self Government) hospitals and submit the medical re-imbursement claim to the ECHS Polyclinic (i.e. they can avail the treatment without obtaining referral from Polyclinic located outside their district),

(ii) Re-imbursement shall be limited to the CGHS rates applicable to the nearest ECHS Polyclinic and as per the ceiling rates and ward entitlements or as per actuals whichever is lower.

(b) (i)  ECHS beneficiaries who are holding a valid ECHS card and are residing in districts not covered by ECHS shall be eligible to obtain post¬operative follow-up treatment from Govt. (Central/State/Local Self Government) hospitals in follow up cases of Renal Transplant Surgery Knee and Hip Joint Replacement, Cancer Treatment Neuro Surgery and Cardiac Surgery. However, prior permission (referral) is to be obtained from the OIC of nearest ECHS Polyclinic.