Indian Military Veterans

A COMPLETE GUIDE : ECHS CLAIM PROCEDURE 

The Ex-Servicemen Contributory Health Scheme (ECHS) provides essential medical services to veterans and their dependents. However, many struggle with the claim procedure, leading to potential rejection due to documentation errors or lack of awareness. This guide simplifies the ECHS claim process, breaking it down into three key parts:

Medicine Claims – How to claim reimbursement for medicines not available in ECHS dispensaries.

Travel Reimbursement – Claiming travel costs for treatment in another city.

Checking Claim Status – Tracking the status of submitted claims online.

Let’s explore each step in detail to ensure a smooth and hassle-free claim process.

Part 1: Medicine Claim Procedure

If a required medicine is unavailable at the ECHS dispensary, veterans can purchase it from a civil chemist and claim reimbursement. There are two situations where this applies:

1. When Medicine is Not Available in ECHS Dispensary

• Visit the ECHS doctor, who prescribes the required medicines.
• Go to the ECHS dispensary and check availability.
• If unavailable, the dispensary stamps “Not Available (NA)” on the prescription.
• Purchase the medicine from a civil chemist and submit a claim.

2. When Referred to a Civil Hospital

• The ECHS doctor refers the patient to a civil hospital.
• The civil hospital doctor prescribes medicines, but their prescription is not valid for reimbursement.
• The veteran must return to the ECHS doctor with the civil hospital prescription.
• The ECHS doctor issues a new prescription, which, if marked “NA”, allows for reimbursement.

Documents Required for Medicine Claim Submission

To file a claim, the following four essential documents must be attached:

1. ECHS Card Copy – Proof of eligibility.
2. Cancelled Cheque – For direct reimbursement into the bank account.
3. ECHS Doctor’s Prescription with NA Stamp – Mandatory for approval.
4. Bill from Civil Chemist with Stamp – If the bill is over ₹5000, a Revenue Stamp must be affixed.

Once all documents are filled and attached, submit them to the ECHS polyclinic for processing.

Part 2: Travel Reimbursement Claim

In some cases, specialized treatment is not available in the local city, requiring veterans to travel to another city for medical care. In such situations, travel reimbursement can be claimed under ECHS Claims.

Eligibility for Travel Reimbursement

• The ECHS referral form must mention eligibility for travel reimbursement.
• Both the patient and an attendant (if required) are eligible for reimbursement.
• The travel entitlement remains the same as pre-retirement. Example: If the veteran was entitled to AC II Tier travel during service, the same class is allowed for reimbursement.

Documents Required for Travel Reimbursement

1. ECHS Referral Form – Must indicate travel reimbursement eligibility.
2. Travel Tickets (Train/Bus/Air) – Original or printout required.
3. Discharge Summary from the Hospital – Proof of treatment received.

ECHS Circular on Travel Reimbursement

ECHS issued a circular on 30 April 2024 outlining the detailed ECHS Claim procedure. Veterans can download the letter from the ECHS website or the ECHS mobile app for reference. Once all documents are ready, submit the claim at the ECHS polyclinic for approval and reimbursement.

Part 3: Checking ECHS Claim Status Online

After submitting the claim, veterans can track the ECHS claim status through:

1. ECHS Mobile App

• Download and log in to the ECHS Beneficiary mobile app.
• Click on “Claim Status” to check the progress.

2. ECHS Official Website

• Visit the ECHS official website and log in.
• Navigate to “Claim Status” and enter PPO or Claim Number to track updates.

By regularly checking the status, veterans can stay informed about their claim’s progress and take necessary action if required.

Summary: Key Takeaways

1. Medicine Reimbursement: Only ECHS-stamped prescriptions marked “NA” are valid for claims.
2. Travel Reimbursement: Travel expenses for ECHS-referred treatment in another city can be claimed.
3. Claim Tracking: Use the ECHS app or website to monitor claim status.

Final Words

Understanding the ECHS claim procedure is crucial to avoid rejections and delays. Veterans and their families should always:

 Keep copies of essential documents.
 Follow ECHS guidelines strictly.
 Submit claims promptly.

For further updates on ECHS claim policies, stay informed through official channels and ECHS advisories.

Jai Hind!