Ex-Servicemen Contributory Health Scheme (ECHS)

What is ECHS?

The Ex-Servicemen Contributory Health Scheme (ECHS) is the Ministry of Defence's medicare scheme for ex-servicemen who draw pension from Defence Estimates and for their eligible dependents. ECHS was launched on 1 April 2003 and is administered by the Department of Ex-Servicemen Welfare through the Central Organisation ECHS at Delhi Cantt.

According to the official ECHS FAQ published on echs.gov.in, ECHS delivers outpatient treatment through 427 polyclinics across India and six polyclinics in Nepal, and both outpatient and inpatient treatment through military hospitals, empanelled private hospitals and empanelled diagnostic centres.

Main features

• Cashless and capless treatment; there is no monetary ceiling on the amount of medical care a member can draw in a lifetime.
• No age bar and no medical condition bar for becoming a member.
• One-time contribution ranging from Rs 30,000 to Rs 1,20,000 depending on rank, after which membership is for life.
• Covers the spouse and all eligible dependents on the same 64 KB smart card.
• Indoor and outdoor treatment, diagnostic tests and medicines are all covered.
• Priority in OPD and IPD registration for beneficiaries aged 75 years and above.

Who is eligible for ECHS?

You can apply if:

• You are an ex-serviceman drawing pension from Defence Estimates, including those receiving disability pension or family pension.
• You are a recruit in receipt of medical or disability pension: recruits who were invalided out with a pension are eligible, along with their parents, spouse and children.
• You are the widow or family pensioner of a deceased armed forces pensioner.
• You are a war widow, a pre-1996 retiree or a battle casualty, in which case you are enrolled without paying any contribution.

Dependents covered on your card

• Spouse, legally wedded wife, including more than one wife where applicable.
• Sons; unemployed and unmarried, until they start earning, marry, or turn 25, whichever is earlier.
• Daughters: unmarried, divorced, abandoned, separated or widowed, with no age limit, until they start earning or marry.
• Disabled children, for life, under the Persons with Disabilities Act, 2016, without an age limit.
• Parents; excluding step-parents, whose combined income from all sources does not exceed Rs 9,000 per month excluding DA and who normally reside with the pensioner.
• Sisters; unmarried, divorced, abandoned, separated or widowed, irrespective of age, with income below Rs 9,000 a month excluding DA.
• Brothers — minor brothers up to the age of majority, and permanently disabled unmarried brothers without an age limit, subject to the same income test.
• Minor children of widowed or separated daughters who are dependent on and normally reside with the ECHS beneficiary, up to the age of 18.

You cannot apply if:

• You are a serving member of the armed forces, serving personnel are covered by the Armed Forces Medical Services, not ECHS.
• You do not draw a pension from Defence Estimates. Ex-servicemen who took a lump sum in lieu of pension and receive no defence pension are not eligible.
• You are an ex-cadet or a cadet boarded out on medical grounds. The official ECHS FAQ states these applicants are not eligible because they do not qualify for ex-serviceman status.
• You are already drawing Fixed Medical Allowance (FMA). FMA and ECHS membership cannot be held at the same time. You must stop drawing FMA before applying.
• You are a dependent whose income from all sources exceeds Rs 9,000 per month excluding DA, in the dependent categories where that test applies.

How much is the ECHS contribution and what ward do I get?

According to the ECHS FAQ dated 10 April 2023, these subscription rates and ward entitlements have been effective from 29 December 2019. A one-time contribution is the only route for a pensioner to join ECHS, there is no monthly subscription option.

Separately, the 64 KB smart card printing charges listed on echs.gov.in are Rs 172.50 for a fresh card, Rs 129.38 to replace an older 16 KB or 32 KB card, and Rs 51.75 to replace a lost card. Cards of 16 KB and 32 KB are no longer valid.

What documents are required for ECHS?

How to apply for an ECHS 64 KB smart card

1. Go to the ECHS online card application portal linked from echs.gov.in and register using your service number, PPO number and date of birth.
2. Fill in the online application form with your personal, rank and pension details, and add every dependent you want covered on the card.
3. Pay the one-time contribution applicable to your rank: Rs 30,000, Rs 67,000 or Rs 1,20,000, and obtain the MRO as proof of payment. War widows, pre-1996 retirees and battle casualties skip this step.
4. Upload the MRO along with the PPO, discharge documents, Aadhaar of every listed member and dependency or income proofs.
5. Pay the smart card printing charge; Rs 172.50 for a fresh 64 KB card; online.
6. Submit the application and note the application reference number for tracking.
7. Visit the nominated ECHS polyclinic with all dependents for biometric and photograph capture. Enrolment cannot be completed without this in-person step.
8. Collect a Temporary Slip from the polyclinic, which is valid for three months or until the smart card arrives, and which allows treatment in the meantime.
9. Collect the 64 KB smart card from the polyclinic once it is printed and activate it at the polyclinic counter.

How to apply for ECHS as a family pensioner or in a marital discord case

1. Obtain a copy of the PPO through DIAV for the Army, DESA for the Navy or DAV for the Air Force, which facilitate retrieval from the records office.
2. File the online application with the PPO, dependency proofs and, where applicable, the MRO for the contribution.
3. Complete biometric enrolment at the dependent polyclinic and collect the Temporary Slip while the card is processed.

In marital discord cases the ECHS membership granted is for a limited period of one year or until the dispute is resolved or a divorce is granted, whichever is earlier, and is renewed if the status quo continues.

How does ECHS treatment and referral work?

ECHS beneficiaries first report to their parent polyclinic, where a Medical Officer treats them or issues a referral. Polyclinic working hours are 0800 to 1600 hours, Monday to Saturday, excluding gazetted holidays, with specialist OPD from 0830 to 1330 hours.

Referral validity, as laid down in the SOP on Treatment Management, is one month for a routine referral and six months for cardiac, oncology and nephrology cases requiring repeated consultation, investigation or treatment. Maintenance haemodialysis, chemotherapy and radiotherapy also carry the longer validity.

In an emergency, an ECHS member has three options: report to the nearest service hospital, report to the nearest empanelled hospital which will raise an Emergency Report, or, if neither is reachable, go to a non-empanelled hospital. An empanelled hospital must provide cashless treatment and must inform the polyclinic within 48 hours. If a non-empanelled hospital is used, the patient must inform the parent or nearest polyclinic within 48 hours and submit original bills to the parent polyclinic for reimbursement.

What if there is no ECHS polyclinic where I live?

Ex-servicemen who are ECHS members but live in districts not covered by an ECHS polyclinic, an Armed Forces hospital or an MI Room upgraded to accommodate ESM are entitled to claim Fixed Medical Allowance of Rs 1,000 per month with effect from 1 November 2018. FMA and ECHS card benefits cannot be drawn simultaneously.

Members can also transfer their dependency from one polyclinic to another once in three months, done online through the ECHS application.

Help and grievance redressal

• ECHS toll-free helpline: 1800-114-115
• Smart card queries: echs-card@echs.gov.in
• Portal and login problems: echs@sourceinfosys.com
• WhatsApp support: +91-7703818578, 7701976194, 8448086480, 8448086481
• Central Organisation ECHS: Thimayya Marg, near Gopinath Circle, Delhi Cantt 110010
• e-SeHAT tele-consultation portal and the ECHS mobile apps for Android and iOS

Dependent beneficiaries must complete annual validation to keep their names active on the card. No agent is needed to obtain an ECHS card, and the only payments involved are the rank-based contribution and the published smart card printing charges.