hand book on ex-servicemen contributory health - Indian Airforce

187 Pages·2008·1.76 MB·English

HAND BOOK
ON
EX-SERVICEMEN CONTRIBUTORY
HEALTH SCHEME

ISSUED
BY
DIRECTORATE OF PERSONAL SERVICES
AIR HQ (VAYU BHAVAN)

CONTENTS

CHAPTER SUBJECT PAGE NO.

1. Eligibility 1

2. Membership-Enrolment procedure 9

3. Contribution 16

4. Organisation 19

5. Treatment 21

6. Parent Polyclinic 44

7. Smart Card 50

APPENDICES

‘A’ List of 227 Polyclinics 57

‘B’ List of Hospitals Empanelled for ECHS 63

‘C’ Application Form 170
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CHAPTER 1

ELIGIBILITY

1. Entitlement for ECHS. ECHS has been launched to provide
comprehensive medicare to all ESM in receipt of pension or disability
pension, as also to his/her dependents, which includes wife/husband,
legitimate children and wholly dependent parents. The Scheme is also
applicable to NOKs of deceased pensioners who are drawing family/special
family /liberalised family pension. Following are the eligible categories to
become member of ECHS:-

(a) Ex-Servicemen Pensioner. Any person who has served in
any rank (whether as combatant or as non-combatant) in the
regular Army, Navy and Air Force of the Indian Union, and fulfills the
following conditions:-

(i) Who has retired from such service after earning his/her
pension.

(ii) Who has been released from such service on medical
grounds attributable to military service, or in circumstances
beyond his/her control and is in receipt of disability pension.

(iii) Who is a personnel of the Territorial Army and falls under
any of the following categories:-

(aa) Pension holders for continuous embodied service.

(ab) Persons with disability attributable to military
service.

(ac) Gallantry award winners.

(iv) Who falls under any of the following categories:-

(aa) Members of Military Nursing Service.

(ab) Whole time officers of National Cadet Corps who
are Ex-Servicemen /NOK and are in receipt of pension
/disability pension/family pension.

(ac) 588 Emergency Commissioned Officers/Short
Service Commissioned Officers who were permanently
absorbed in National Cadet Corps as Whole Time
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Officers (WTOs) after their release from the Armed
Forces.

(ad) Service officers who, prior to completing their
pensionable service, in organisational interest, joined
PSUs like Air India, Indian Airlines, Pawan Hans, and
Shipping Corporation of India, and to whom Govt had
sanctioned pension on a pro-rata-basis. On secondment
or transfer to PSUs these officers received their pension
either as a lump sum on full commutation or on monthly
basis. For those who commuted full amount, the monthly
pension was to be restored at 43% after 15 years from
their date of retirement on pro-rata basis. Hence, they
would be deemed to comply with the condition of being in
receipt of pension from defence authorities. However,
following additional conditions will have to be
complied with by these ESM pensioners:-

(aaa) A mandatory certificate will have to be
endorsed in their affidavit stating that, “I certify
that I am not a member of any other Govt/PSU
Medical Health Scheme”.

(aab) The contribution amount for enrolling as
member of ECHS will be based on the rank held by
the individual at the time of release and NOT on
the restored pension amount. The amount will be
similar to the current basic pension of the rank held
at the time of retirement. (For example, if the
individual retired as a Lt Col/Commander/Wing
Commander, he will be required to deposit
contribution through MRO as per current basic
pension of this rank).

(aac) Each case will be considered on its merits.

(b) Family Pensioner. It implies the legally wedded spouse of
an Armed Forces personnel, whose name figures in the service
records of the personnel and whose husband/ wife (as the case may
be) has died either while in service or after retirement and is granted
family pension. This term also includes a child or children drawing
family pension on the death of his/her pension drawing father/mother,
as also parents of a deceased bachelor soldier, who are in receipt of
family pension.

(c) Ex-servicemen drawing disability pension.
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(d) War Widows (Exempted from Payment of Contribution)-
War widows are those whose spouse had died due to any of actions
appended below:

(i) Enemy action in international war.

(ii) Action during deployment with a peace keeping mission
abroad.

(iii) Border skirmishes.

(iv) During laying or clearance of mines, including enemy
mines as also mine sweeping operations.

(v) On account of accidental explosions of mines while laying
operationally oriented mine-field or lifting or negotiating mine-
field laid by the enemy or own forces in operational areas near
international borders or the Line of Control.

(vi) War like situations.

(vii) An act of violence, attack by extremists, anti-social
elements, etc., while on operational duty.

(viii) Action against extremists, antisocial elements, etc., while
employed in the aid of civil power in quelling agitation riots by
demonstrators.

(ix) Operations specially notified by the Govt from time to
time.

(e) The Army Postal Service personnel are permitted to enroll into
the ECHS subject to fulfilling the following conditions:-

(i) The retiring APS personnel must fulfill the primary
condition of being an ex-servicemen, i.e. he/she should have
served in the Armed Forces of India, in any rank as a
combatant or non-combatant.

(ii) Must retire finally from the Armed Forces, without
reversion to the P&T Department.

(iii) Must be in receipt of pension consequent to retirement
or be in receipt of disability pension, if prematurely
retired/released on medical grounds which are attributable to
military service.
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(iv) Must NOT be a member of CGHS or any other Govt
Medical Scheme.

(h) Reservists who are drawing pension including family pension
are permitted to join the Scheme. However Reservists who opted for
ex-gratia payment are not eligible.

(j) A Recruit who is in receipt of medical/disability pension is alone
eligible to join the ECHS. The following dependents of the recruit are
NOT permitted to be included for ECHS benefits :-

(i) Parents.
(ii) Wife.
(iii) Children.

The recruit who was already married prior to joining the training
at the Regimental Centre would be permitted to have his wife and
children, if any, included as his dependents. This fact would be
checked from the Part II Order published. However, the parents of
such a recruit would not be entitled to be shown as dependents.

2. Eligibility Status for Dependants. The following categories qualify
to be called dependants:-

(a) Parents. Father and Mother of the Veteran pensioner shall be
deemed to be dependent if they normally reside with the Veteran
pensioner and their combined income from all sources does NOT
exceed Rs 2550/-pm. Parent of the spouse of the Veteran are NOT
permitted to become members. In case a widow, who is in receipt of
Family Pension, joins the ECHS, then the parents of her late husband
can be made dependants, subject to fulfilling the conditions.
However, her own parents CANNOT be made dependants. In a case
where both the husband and wife are ESM pensioners, then both can
opt to cover their parents as dependents. In this case both pensioners
will have to make ECHS contribution, as applicable. “Parents, ie,
mother and father” of unmarried deceased soldier and in case of
deceased parents, then ‘NOK’ of unmarried deceased soldier are also
eligible, provided they are in receipt of liberalised family pension.

(b) Spouse. Legally wedded husband/wife including more than
one wife. Name should be included in the records of service. Spouse
living separately is included as dependent, as long as the Veteran
pensioner is responsible for her maintenance. When the spouse is
legally separated, he/she cannot be termed as a dependent and
hence cannot be made member of ECHS. In the event of plural
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marriage, where it is permitted by the rules, the following conditions
should be fulfilled for claiming ECHS membership:-

(i) Necessary casualty for entering into plural marriage
should have been published through Unit Part II Orders/POR
and names of both the wives should be found recorded in the
Service Discharge Book/Service Particulars Retired Officers
Booklet issued by respective Service Headquarters.

(ii) The names of both the wives should be found recorded
in the PPO for grant of ‘Family Pension’ award.

(iii) In the case of widows, both wives should be in receipt of
a share of ‘Family Pension’ and PPO produced in support of
evidence.

(iv) If the spouse is employed in Govt service then he/she
can only be a member of any one Govt/Public sector medical
benefit scheme and not the second one.

(v) If a war widow remarries, she would still remain
eligible. Her husband, however, will NOT be eligible.

(vi) In case the ESM pensioner marries after retirement,
following documents will be required as proof for dependency of
wife :-

(aa) Marriage certificate from authorized Registrar of
Marriages/Municipal Committee.

(ab) Application form will have to be submitted for
enrolling the spouse as a dependant.

(c) Daughter(s).

(i) Details must exist in the service record of the pensioner.

(ii) Unmarried and unemployed daughters are permitted
to be included as dependents.

(iii) Widowed/Divorced daughters dependant on
the Pensioner and residing with the latter are also permitted to
be included. However, the children of such a daughter are
not eligible.