LIST OF 64 KB SMART CARDS

i) Kathmandu

ii) Pokhara

iii) Dharan

iv) List of 64 KB ECHS Smart Cards under observation

EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME (ECHS) NEPAL

INTRODUCTION

1. ECHS is a flagship welfare scheme of Government of India and the scheme was sanctioned and extended to Nepal for the benefit of Nepal Domiciled Gorkha (NDG) Ex-Servicemen (ESM) and their dependants in Feb 2012.

2. The ECHS Branch in the Embassy of India, Kathmandu was established in May 2012, while the three Polyclinics at Kathmandu and Pokhara (Type A) and Dharan (Type B) were established in April 2014. Alongwith the three Polyclinics, the Government of India also sanctioned three Type E Mobile Medical Units (MMUs)

3. ECHS caters to the medical care of all NDG ESM pensioners including disabled, family pensioners and their dependents, which includes wife/husband, legitimate children and wholly dependent parents. To be eligible for membership of ECHS, a person must meet followingconditions:-

(a) Individual should have an Ex-serviceman status.

(b) Individual should be in receipt of Pension / Family Pension / Disability Pension drawn from Controller of Defence Account.

(c) Unemployed / unmarried son below 25 yrs of ageandunemployed/ unmarried daughter for life can also be the dependants and can avail ECHS facilities.

(d) The dependents/ dependent parent’s income should be less than INR 9,000/- excluding DA.

DOCUMENTS REQUIRED FOR FILLING UP ONLINE 64 KB ECHS SMART CARD APPLICATION AT RESPECTIVE POLYCLINIC

1. For fresh applicant (those who does not have any type of ECHS Cards/Temporary Slip).

(a) PPO.

(b) Pension Patta.

(c) Passport size photo with red background – 1 copy.

(d) Discharge Certificate.

(e) Blood group report.

(f) NagariktaPramanPatra (NPP).

(g) CDO certificate if difference in Name, Caste and Age.

(h) Signature or fingerprint on plane white paper with blue ink.

(j) Charge of NPR 333.20/- for smart card per person.

(k) No contribution charges are applicable forretirees prior to 01 Jan 1996.

(l) Contribution charges are applicable to the retirees after 01 Jan 1996 as mentioned below :-

RATES OF ECHS CONTRIBUTION

S.No	Category	One time Contribution	Ward Entitlement
(aa)	Recruit to Havs& equivalent in Navy & AF	INR 30,000/- (NPR 45,045/-)	General
(ab)	Nb Sub/Sub/Sub Maj or equivalent in Navy & AF (including HonyNb Sub/MACP Nb Sub and Hony Lt/Capt)	INR 67,000/- (NPR 1,07,300.50/-)	Semi Private
(ac)	All officers	INR 1,20,000/- (NPR 1,92,180/-)	Private

2. For 16 KB Smart Card, 32 KB Smart Card & ECHS Temporary Slip (manual) holder :-

(a) Original copy of 16 KB, 32 KB & ECHS Temporary slip.

(b) PPO.

(c) Pension Patta.

(d) Passport size photo with red background – 1 copy.

(e) Discharge Certificate.

(f) Blood group report.

(g) NagariktaPramanPatra (NPP).

(h) CDO certificate if difference in Name, Caste and Age.

(j) Signature or fingerprint on plane white paper with blue ink.

(k) Charge of NPR 333.20/- for smart card per person.

(l) No contribution charges are applicable for those who already have any of the ECHS cards/ ECHS Temporary Slip.

LIST OF EMPANELLED HOSPITALS WITH ECHS IN NEPAL AND FACILITIES AVAILABLE

1. Nepalgunj Medical College And Teaching Hospital, Kohalpur,Nepalgunj, Nepal(Contact No : +977-81-521572)

General Services :- General Medicine, General Surgery, Obstetrics and Gynecology, Pediatrics, Orthopedics excluding Joint replacement surgery, ICU and Critical Care Units, ENT, Dermatology, Dental, Psychiatry and Emergency.

Specialized Services :- Cardiology (consultation and Diagnostics) Urology-including Dialysis & Lithotripsy, endoscopic surgery, Neuro Surgery, Pediatric Surgery and Laparoscopic Surgery.

Laboratory Services :- Clinical Pathology, Histopathology, Cytopathology, Biochemistry and Microbiology.

Imaging Services :- X-Ray, Mammography, USG, USG Doppler, CT Scan & MRI.

2. Manipal Teaching Hospital, Pokhara, Nepal (Contact No : 061-526416)

General Purpose Hospital :- General Medicine, General Surgery, Obstetrics and Gynecology, Pediatrics, Orthopedics excluding Joint replacement surgery, ICU and Critical Care Units, ENT, Ophthalmology, Imaging Facilities, Blood Bank, Dermatology, Psychiatry.

Specialty Hospitals :- Cardiology (Including Interventional Vascular, Cardiothoracic Vascular Surgery), Urology (Including Dialysis and Lithotripsy), Orthopedic Surgery (Including arthroscopic Surgery & joint replacement), Endoscopic Surgery, Neuro Surgery, Neuro Medicine, Gastro-enter ology, Clinical Hematology, Medical Oncology, Respiratory Diseases, Critical Care Medicine, Radiotherapy, Vascular Surgery, Pediatric Surgery, Onco-Surgery, GI Surgery, Traumatology, Neonatology, Pediatric Cardiology, Hematology& Oncology, Onco-Pathology.

Super Specialty Hospital :- Cardiology, Cardiothoracic Surgery, Specialized Orthopedic Treatment facilities that include joint replacement, Nephrology and Urology, Neurosurgery, Gastroenterology and GI Surgery, Oncology

3. College of Medical Sciences, Bharatpur, Chitwan, Nepal (Contact No :056-524203)

General Services :- General Medicine, General Surgery, Obstetrics and Gynecology, Pediatrics, Orthopedics excluding Joint replacement surgery, ICU and Critical Care Units, ENT, Dermatology, Dental, Psychiatry and Emergency.

Specialized Services :- Cardio Thoracic Surgery (except CABG & Heart Surgery only Thoracic Surgery), Cardiology (consultation and diagnostics) interventional Cardiology, nephrology and Urology (excluding Dialysis and Lithotripsy), Neuro Surgery, Neuro Medicine, Gastro Intestinal, Surgery, Gastroenterology, vascular surgery, critical care medicine and laparoscopic surgery.

Laboratory Services :- Clinical Pathology, Hematology and Microbiology.

Imaging Services :- Radio-diagnosis, X-Ray, USG, USG Doppler, CT Scan & MRI

4. Manmohan Memorial Medical College and Teaching Hospital, Swoyambhu, Kathmandu (Contact No : 01-5247317)

General Services :- General Medicine, General Surgery, Obstetrics and Gynecology, Pediatrics, Orthopedics excluding Joint replacement surgery, ICU and Critical Care Units, ENT, Dermatology, Dental, Psychiatry and Blood Bank (Blood Transfusion).

Laboratory Services :- Clinical Pathology, Hematology, Histopathology, Cytopathology, Biochemistry, Microbiology and Serology.

Specialized Services :- Urology including Dialysis and Lithotripsy, Orthopedic Surgery including Joint Replacement and arthroscopic Surgery, endoscopic surgery, Endocrinology, Rheumatology, Clinical Hematology, Critical care medicine, Traumatology and Nephrology.

Radio Diagnosis & Imaging :- X-Ray, Mammogram, USG, USG Doppler & CT Scan.

5. Nepal Medicity (A unit of ashwins medical college and hospitals pvt ltd) Bhaisepati, Kathmandu (Contact No : 01-4217766) :-

Clinical Services :- Anesthesiology including Pain Management, Cardiology, Cardiothoracic Surgery, Critical & Intensive care, Dermatology & Venereology, Emergency Medicine, Endocrinology, Gastroenterology (Medical, Surgical), General Medicine, General Surgery including Laparoscopic Surgery, Nephrology including Dialysis, Neurology, Neurosurgery, Obstetrics &Gynecology, Oncology (Medical, Surgical), Ophthalmology, orthopedic Surgery including Joint Replacement & Arthroscopic Surgery, Otorhinolaryngology, Pediatrics including Neonatology, Plastic and Reconstructive Surgery, Psychiatry, Respiratory Medicine, Urology.

Laboratory Services :- Clinical Biochemistry, Clinical Microbiology & Serology, Clinical Pathology, Cytopathology, Hematology, Histopathology.

Diagnostic Services :- 2D ECHO, Audiometry, Bone Densitometry, CT Scan, EEG, EMG/EP Mammography, MRI Scan, Spirometry, Tread Mill Testing, Ultrasound, Urodynamic Studies, X-Ray.

Transfusion Services :- Blood Bank, Blood Transfusion Services.

Professions Allied to Medicine :- Dietetics, Occupational Therapy, Physiotherapy, Psychology, Speech and Language Therapy.

6. Universal College of Medical Science – Teaching Hospital, Bhairahawa, Rupandehi, Nepal (Contact No:071-522896) :-

General Services :- General Medicine, General Surgery, Obstetrics and Gynecology, Pediatrics, Orthopedics excluding Joint replacement surgery, ICU and Critical Care Units, ENT, Dermatology, Psychiatry and Blood Bank (Blood Transfusion), Emergency.

Specialty Hospitals :- Endoscopic Surgery, Laparoscopic Surgery.

Laboratory Services :- Hematology, Biochemistry, Microbiology& Immunology.

Imaging Services :- X-Ray, Mammogram, USG, USG Doppler, CT Scan & MRI.

7. Lumbini Medical College & Teaching Hospital Ltd, Pravas, Palpa, Nepal (Contact No: 075-411201) :-

General Services :- General Medicine, General Surgery, Obstetrics and Gynecology, Pediatrics, Orthopedics, ICU and Critical Care Units, ENT, Ophthalmology, Dermatology & Psychiatry.

Laboratory Services :- Clinical Pathology, Hematology, Histopathology, Biochemistry, Microbiology & Transfusion Medicine.

Imaging Services :- X-ray, USG, MRI & CT Scan.

Specialty Hospitals :- Cardiology (Consultation & Diagnostics), Urology (including Dialysis & Lithotripsy), Endoscopic Surgery, Neuro Medicine, Gastroenterology, Gastro Intestinal Surgery, Plastic & Reconstructive Surgery, Vascular Surgery, Endocrinology, Respiratory Diseases, Rheumatology, Neonatology, Pediatric, Cardiology, Interventional & Vascular Radiology, Prosthetic Surgery, Traumatology.

8. Gandaki Medical College Teaching Hospital & Research Centre Pvt Ltd, Pokhara, Nepal (Contact No: 061-538595) :-

General Services :- General Medicine, General Surgery, Obstetrics and Gynecology, ICU and Critical Care Units, ENT, Ophthalmology, Dental, Orthopedics excluding Joint Replacement.

Laboratory Services :- Clinical Pathology, Hematology, Histopathology, Biochemistry, Microbiology.

Imaging Services :- X-ray, USG & CT Scan.

Specialty Hospitals :- Cardiology (Consultation & Diagnostics), Urology (including Lithotripsy), Gastroenterology, Nephrology.

DOCUMENTS REQUIRED FOR ONLINE MEDICAL BILLCLAIM

1. ECHS Card.Legible copy of ECHS Card duly authenticated by OIC Polyclinic/ Dir RC for individual reimbursement & hospital claims to be attached along with the claim file.

2. Online Referral.Copy of online referral generated by respective ECHS Polyclinic to be attached along with the claim file.

3. MRP Certificate. MRP Certificate from empaneled hospital /treating doctor countersigned by Polyclinic/ Dir RC to be attached along with the claim file.

4. Emergency Certificate.Copy of emergency certificate by treating hospital to be attached along with the claim file (As the case may be).

5. Discharge / Death Summary. Discharge / Death Summary. duly authenticated by Dir RC to be attached along with the claim file. If the ECHS beneficiary has passed away, then death certificate is mandatorily required to be attached.

6. Final Bill Summary. Final bill summary duly authenticated by Dir RC to be attached along with the claim file.

7. Original Bill.Original copy of bills should be placed in claim file duly countersigned by Dir RC.

8. Pre and post PTCA real time images and reports.Original copy of pre and post PTCA real time images and reports to be attached along with the claim file as required by respective authority.

 

GRANT OF FMA (FIXED MEDICAL ALLOWANCE)

1. Fixed medical allowance of INR 1000 is being stopped after being a membership at ECHS.

2. ESM / Family pensioner will now be eligible for grant of FMA [at] INR 1000/- per month despite being an ECHS member or an as amended by Govt from time to time wef 01 Dec 2019

3. Conditions for grant of FMA.

(a) If there is no any ECHS Polyclinics, Service Hospitals & MI Rooms in their district.

(b) Ex-servicemen pensioners from all districts except Kathmandu, Kaski&Sunsari can opt for FMA.

(c) The address at the time of grant of pension / family pension, Permanent address as recorded in PPO, Pension Book and Discharge book will be the basis to ascertain whether an ESM belongs to an applicable district or not. Wrong data when detected will make such an ESM ineligible for ECHS membership alongwith his/her dependants.

4. Option for FMA Beneficiaries.

(a) It is optional for an individual ESM to opt for FMA even if he/she is eligible.

(b) Unless an ESM applies, FMA will not commence automatically even if eligibility conditions are fulfilled.

(c) Once opted for FMA, individual ESM will not have any choice to apply for stoppage of FMA. Stoppage will be only based when any of the ECHS Polyclinics, Service Hospitals & MI Rooms gets established.

5. Restrictions for opting for FMA.

(a) No OPD treatment and reimbursement form any ECHS Polyclinics, Service Hospitals & MI Rooms.

(b) No medicines except those given during inpatient treatment or at the time of discharge from Service Hospital/ Govt Hospital/ Empanelled Hospitals as applicable as per ECHS norms.

6. Provision for IPD Treatment.ESM alongwith his / her dependents will continue to eligible for IPD treatment as applicable to all other ECHS members. Procedures for IPD treatment will be same for emergency treatment. As regards planned IPD treatment, the ECHS beneficiary will be required to initially obtain lab tests/ diagnostics/ prelim examination by a Medical Officer clearly endorsing the requirement of IPD based treatment. The authority for the referral, however, will be the decision of Medical Officer at the ECHS Polyclinic. ECHS polyclinic will be utilized only for decision for IPD referral and if required , for issue of IPD referral as applicable in that Polyclinic.

7. Commencement / Restoration of FMA.The ECHS member residing in a district where ECHS Polyclinic/ Service Hospital /Upgraded MI Room is not available can seek commencement of FMA payment by submitting an application to the nearest Military Station (ECHS Cell) in triplicate.

8. Format of application for grant of FMA.
RATES FOR TREATMENT AT HOSPITALS EMPANELLED UNDER ECHS IN VIEW OF THE COVID-19 PANDEMIC.

Hospital rates for per day of admission (In INR)
Category of hospitals	Moderate Sickness	Severe Sickness	Very Severe Sickness
	ISOLATION BEDS Including supportive care and oxygen	ICU without the need for ventilator care	ICU with ventilator care (invasive / non-invasive)
NABH accredited Hospitals (including entry level)	INR 10,000/- (NPR 16000) (Including the cost of PPE INR 1200/-) (NPR 1,920/-)	INR 15,000/- (NPR 24,000) (Including the cost of PPE INR 2000/-) (NPR 3,200/-)	INR 18,000/- (NPR 28,800/-) (Including the cost of PPE INR 2000/-) (NPR 3,200/-)
	Non-NABH accredited Hospitals	INR 8,000/- (NPR 12,800) (Including the cost of PPE INR 1,200/- (NPR 1,920/-)	INR 13,000/- (NPR 20,800/-) (Including the cost of PPE INR 2000/-) (NPR 3,200/-)	INR 15,000/- (NPR 24,000/-) (Including the cost of PPE INR 2000/-) (NPR 3,200/-)
Covid-19 Testing	(State Rate or ICMR Rates)

PROCEDURE TO CHANGE PARENT POLYCLINIC ONLINE.

A software solution has been implemented to enable all ECHS beneficiaries with New 64 Kb Smart Card to enable them to change their parent polyclinic online. This facility can be exercised once in six months by beneficiaries who have already collected the new 64 Kb ECHS card. The procedure to be adopted is given below :-

Action by the ESM. The ESM/Primary beneficiary will adopt the following procedure :-

1. He/ she will login to ECHS website, echs.sourceinfosys.com, using his login credentials.

2. He/she will select the beneficiary whose polyclinic is required to be changed.

3. Select the new polyclinic out of the dropdown.

4. Submits the request.