1. Eligibility Conditions

2. Payment of ECHS Contribution Amount.

(a) For Pre 01 Apr 2003 Pensioners. Ex-Servicemen eligible to become ECHS members are required to deposit ECHS Contribution amount in Govt Treasury/Nationalised Banks through MRO. Four copies of the MRO to be prepared as per sample attached. The rates of contribution will be based on the Revised Pension slabs (Uncommuted Basic Pension + Dearness Pension) of a pensioner as given below: -

Notes: -
 

(i) War Widows (Veer Naris) have have been exempted from paying ECHS contribution amount.

(ii) Ex-servicemen/widows/parents eligible to become ECHS members have the option to become ECHS members only upto 31 Mar 2008. Thereafter, entry to the Scheme for pre 01 Apr 2003 retirees will be closed.

(iii) Medical Allowance of Rs 100/-pm being drawn by Ex- servicemen will be stopped with effect from the date of joining the ECHS.

(iv) Amount paid by Ex-servicemen towards membership of AGIF(MBS)/AFGIS, will be refunded in full by AGIF/AFGI on joining ECHS. Members to apply for refund to AGI/ AFGI Directorate alongwith copy of ECHS Membership Card, AGIF Card, AGIF(MBS) AFGIS Card and their banker details.

(b) Post 01 Apr 2003 Retirees. Post 01 Apr 2003 pensioners are compulsory members of ECHS. Their ECHS contribution amount is deducted at source by CDA(Pension) Allahabad and reflected in the PPO. In cases where ECHS contribution amount has not been deducted at source by CDA(P), pensioners are required to deposit their contribution amount through an MRO, as per Para 2 (a) above.

3. Payment of ECHS Membership Cards

4. Collection, Filling & Submission of ECHS Application Forms

Notes: - 1. On Receipt of ECHS Application Form, Record Office will check the details reflected in the Application Form with that recorded in the Service documents. Record Office will issue the Receipt of Application Form and will submit the form to dependent ECHS Regional Centre.

2. On receipt of ECHS Application form from Record Office, concerned ECHS Regional Centre will re-verify the documents and would arrange manufacturing of Smart Card (s) and dispatch to Station HQ/ Record Office/ Individual.

ECHS MEMBERS: POINTS TO REMEMBER

1. Please note that whenever you or your authorized dependents require medical assistance, you need to FIRST contact your nearest ECHS Polyclinic for treatment. After working hours you may go to a Service Hospital directly.

2. In case of 'EMERGENCY' (Life Saving situation etc.), you may seek medical assistance from any Service/ empanelled/ non-empanelled civil hospital. You must inform your nearest ECHS Polyclinic within 48 hours about your illness and treatment being undertaken. This is very 'IMPORTANT'.

3. In case you have availed treatment in a 'Non-empanelled' hospital during 'EMERGENCY", you need to pay your bills to the treating hospital and claim reimbursement through your nearest ECHS Polyclinic. The reimbursement will be restricted to CGHS rates and subject to confirmation and verification of 'EMERGENCY'.

4. Also remember, whenever you need any guidance about availing treatment under ECHS, go to your nearest ECHS Polyclinic. Do not make presumptions on rules of the Scheme.

PBOR

Registration No. _____________

(USE BLUE INK ONLY)

1. Received following documents from No_________Rank________Name_____________ towards application for membership of Ex-Servicemen Contributory Health Scheme (ECHS): -

2. Category for Hospitalisation (√) Private □ Semi Private □ General □

All photographs to be stamped by issuing Officer.

Note : - 1. This original receipt is required to be returned at the time of collection of Smart Card(s).

2. No Smart Card will be issued if this receipt in original is not produced.

3. Record Office will send this receipt to the individual in his unit after checking the Application Form. Receipt will be collected at the time of handing over the ECHS Smart Card, before individual proceeds on pension.

RECEIPT

Receivd Smart Card(s) (√) One □ Two □ Three □

__________________
Signature of Pensioner

Date : _____________

I, Service No_______________ Rank_____________ Name_______________________ of (Unit) ___________________________________, solemnly affirm and declare as follows : -

1. That I am/will be drawing pension vide PCDA Pension Payment Order No______________ dated ______________.

2. That I have the following legal dependant(s) whose photograph(s) is/are affixed below on this Affidavit:-

Name         Relationship     Age         Date of Birth         Part II Order No / CRD/SD / POR No

(Photograph(s) to be pasted and signed across by each dependant. In case of challenged child/minor, to be signed by Applicant)

3. (a) That the combined monthly income of my dependant father and/or dependant mother (from all sources ) is less than Rs 1500/-.

(b) My mother/father are not presently/ex employees of Central/state Government/Public Sector Undertakings. They are not in receipt of any kind of pension.

4. That my son(s) is/are under 25 years age and is/are NOT employed, & that my daughter(s) is/are NOT employed or married.

5. That I am aware that my son(s) is/are NOT eligible for the Ex-servicemen Contributory Health Scheme (ECHS) after he/they attain 25 years of age, or get employed at any time before that age. I shall inform the ECHS immediately of his/their employment.

6. That I am aware of the fact that my daughter(s) is/are NOT eligible for the Ex servicemen Contributory Health Scheme after she/they marry or get employed. I shall immediately inform ECHS authorities of her/their marriage or employment.

7. That in case of any change in the status of my dependants (due to death, marriage, employment), I will inform my Regional Headquarters ECHS at the earliest and will refund, in full, the cost of any treatment that my dependent may have received after he/she became ineligible. I shall be liable for civil/criminal action should I fail to do so.

8. That I am NOT a member of any other medical scheme funded by Central govt, PSU or any other Govt Undertaking.

9. I understand that in case I have submitted any incorrect information, or if my ECHS Membership card is misused or used by any unauthorized person, my membership will be cancelled without any notice or further hearing. In addition, I will forfeit my contribution and I will pay the entire cost of expenditure incurred on such unauthorized person(s). I will also be liable for legal action by the ECHS Organisation. I will also immediately report the loss my ECHS membership card to Station Headquarters and lodge and FIR with the local civil police.

10. I am not in possession of my Service / Discharge Book. (if applicable).

Signature of Deponent

VERIFICATION

I, the deponent above named, do hereby solemnly declare and verify that the contents of the above affidavit are true to the best of my knowledge and belief, and nothing material has been concealed or suppressed there from.

Verified at (Place)……………on this (Date)………....... day of (Month)………….(Year)………

Signature of Deponent

ATTESTATION

Certified that the above statement is declared before me at (Place) ……………… on this ………………… day os (Month)……………… (Year)………………by DEPONENT Service No……………….. Rank………………Name ……………………who is identified by Name………………………………. S/O (Father's name if Identifier)………………………..and witnessed by Name…………………….... S/O (Father's name of first witness) & Name……………………. S/O (Father's name of second witness)

WITNESS

Original/Duplicate/Triplicate/Quadruplicate In lieu of IAFF (A) 507

MILITARY RECEIVABLE ORDER

STATION

To,

 Please receive from No. _________________ Rank _______________ Name ____________________ or order, the sum of Rupees  _______________________________________________________________ on account of "EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME (ECHS)" and credit the amount as Defence Department receipt pertaining to the PCDA/CDA__________________________________________________________________________

(Fill relevant station - see reverse)

Forwarded to PCDA/CDA ______________________________________________________________

(Fill relevant station - see reverse)

Signature of Issuing Officer

_______________Treasury : State Bank of India Receipt No ______________dated _______20
                                              Reserve

Received the sum of Rs. __________(Rupees _____________________________________only)

_____________________________________________

INSTRUCTIONS FOR MRO

Controller General Defence Accounts (CGDA) has nominated the following Army Principal Controllers of Defence Accounts (PCsDA)/Controllers of Defence Accounts (CsDA) for accounting the contribution made in their areas of jurisdiction. : -

You are requested to insert the requisite data against "EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME(ECHS)" and credit the amount as Defence Department receipt pertaining to the __________________________________ and also insert in the line - Forwarded to _______________________

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