AFVOA Newletters of Year 2003

Page 106 of 170 those pensioners who are referred to them from the Polyclinic, and provide proof of membership/SMART Card. ECHS members are NOT permitted to go directly to any empanelled Hospitals/Diagnostic Centres/Consultant (except in emergency – see provisions in this Brief). 65. The ESM/dependent does not have to clear bills or make payment (except for dietary charges) either on admission or when discharged from the Hospital/Diagnostic Centre/Consultant, provided the cost is as per rate contract concluded with the empanelled facility. These Hospitals/Diagnostic Centres/Consultants will be paid directly by the concerned Station Headquarters under whose jurisdiction the clinic falls. ECHS is responsible for such payments incurred on treatment of the entitled members – but only if the laid down procedure is followed. If a member/dependant goes directly to a Hospital/Diagnostic Centre/Consultant, without first having shown himself to a Polyclinic Doctor and having got referred, then ECHS will not be held responsible for costs incurred and will not make payment to the empanelled facility. 66. There will be no burden of payment (except hospital stoppages in Service Hospitals, and dietary charges in empanelled Civil Hospitals) on the ECHS member, either for medicines or for any treatment - whether out-patient or in-patient - so long as laid down procedures are adhered to, and rate contract concluded with the facility is not exceeded. PART 6 Treatment in Emergency 67. In an emergency, the ECHS pensioner/eligible family members, may report to the nearest hospital (preferably empanelled) and inform the dependant Polyclinic/Station HQ/Regional Centre of the emergency within 48 hrs of admission. In case of admission to an empanelled hospital, the bills will be cleared by ECHS directly. However, in case of emergency admission to a non-empanelled hospital, the member will first clear the bills, and thereafter put up claim for re-imbursement to the dependant ECHS Polyclinic, duly supported with original bills. The bills will be reimbursed if ECHS is satisfied as to the reasons of emergency and the cost of treatment availed is reasonable. The onus of proving the emergency lies with the member and ECHS may, or may not, clear bills in entirety in the event of doubt/misuse of emergency provisions. PART 7 Status of AGIS (MBS) and AFGIS (MIS) 68. AGIS (MBS) will terminate on 31 Mar 2006, and its members will be refunded the full amount of subscription once they have acquired ECHS membership. For further details members should contact MD AGIS. 69. AFGIS (MIS) will terminate on 31 Mar 2004. AFGIS will issue separate instructions regarding refund to its members. Road Map for Development of ECHS Polyclinics 70. Ex Servicemen Contributory Health Scheme (ECHS) is one amongst the many important initiatives take by the Government and the Armed Forces to alleviate the social- economic needs of retired pensioners of the three Services. These essential steps are just a small compensation to the brave soldiers who sacrifice their youth and life in the nations’ service.