AFVOA Newletters of Year 2003

Page 118 of 170 has been concealed (no matter what the reasons) the provisions of Para 9 of the Affidavit will be applied and membership of the ESM and all his dependants will be terminated, without any relief. There is NO appeal in such cases. Question No 34. Can the members have the option to continue with more than one Govt/PSU Scheme? Answer. Individual cannot become a member of two Govt/PSU Schemes – he has to cancel membership of the other scheme in case opting for the ECHS. For example, one cannot be a member of CGHS & ECHS at the same time. Nor can one be a member of the ECHS and a PSU scheme at the same time. In case any concealment of facts is discerned, recourse will be taken as per provisions of Para 9 of the Affidavit. Question No 35. What is the medical coverage for those Ex-Servicemen who do not join the ECHS Scheme? Answer. Existing facilities through MI Room and Service Hospitals will continue. This will be reviewed after five years. Question No 36. Why is re-imbursement not allowed under ECHS yet, even though members have submitted forms and made payment of contribution? Answer. The procedures for empanelment of hospitals/diagnostic centres/consultants and payment to them are under consideration of the Govt. There is NO payment to be made by an ECHS member under the scheme, hence, NO provision for re-imbursement. Question No 37. Will all dependents of ESM be allowed add-on SMART cards independently? Answer. Only two add-on cards are being provided in the initial phase. However, the question of having more add-on cards will be reviewed later, depending on demand. Question No 38. Whether dentures will be authorised under ECHS? Answer. Yes. Details will be issued through an ECHS Brochure by 31 Mar 2004. Question No 39. What will be the provisions for treatment/hospitalisation in emergencies? Answer. ESM has three options, namely:- (a) Report to nearest service hospital for treatment. (b) Report to nearest empanelled hospital. Bill will be paid by ECHS. (c) Report to any/nearest non-empanelled hospital. ESM/his rep will have to pay the charges to the non-empanelled hospital initially. (d) In all cases where emergency treatment is availed, and where the patient does NOT go through the Polyclinic referral route, it will be the patient’s responsibility to inform his Polyclinic/ECHS Central Org or Regional Centre within 48 hours of where he/she is admitted. (e) Such bills will be forwarded in original only to the ECHS Central Organisation, Delhi. Note. The onus of informing the Polyclinic or ECHS shall be of the patient. Also the onus of proving the emergency shall be that of the ESM patient. Question No 40. Can an ESM regularly go to a particular consultant/specialist? Answer. Yes, but only to empanelled consultants, after he/she is referred by the Polyclinic. ECHS members cannot go to non-empanelled Consultants, or go to empanelled consultants without reference by the Polyclinic authorities.