The Central Organisation, Ex-Servicemen Contributory Health Scheme (ECHS), under the Integrated HQ of MoD (Army), has issued an advisory dated 08 April 2025 regarding Annual Medical Examination (AME)/Preventive Health Checkup for ECHS beneficiaries. This advisory provides clarity on the procedures, permitted facilities, and reimbursement rules related to AME.
Reference
The advisory refers to Government of India, Ministry of Defence (MoD) letter No. 24(8)/03/US(WEP)D(Res) dated 19 December 2003, particularly paragraph 9(h), which outlines the framework for conducting AME.
Key Guidelines
1. Restriction on AME at Empanelled Hospitals
- Annual Medical Examination (AME), in any form, can only be conducted at ECHS polyclinics within their available resources.
- Beneficiaries are not permitted to undergo AME at empanelled hospitals.
- Claims for reimbursement of AME conducted at empanelled hospitals will not be entertained.
2. Specialist Opinion for AME
- If a specialist opinion is required for AME (for official purposes), it can be availed at a government hospital.
- However, empanelled/service hospitals are not authorised for AME purposes.
- Referral to empanelled hospitals is allowed only for ailment-based treatment/tests, not for routine AME.
3. Non-Reimbursement Clause
- Any claims raised for AME conducted outside the prescribed guidelines (e.g., empanelled hospitals) will not be reimbursed.
Purpose of the Advisory
The aim of this advisory is to ensure that preventive health checkups and AME for ECHS beneficiaries are streamlined, cost-effective, and restricted to designated facilities (polyclinics and government hospitals). This also prevents misuse of empanelled hospital facilities for non-ailment-related examinations.
Conclusion
This advisory is an important clarification for all ECHS beneficiaries and regional centres. Beneficiaries must ensure that AMEs are conducted only at ECHS polyclinics and, if necessary, at government hospitals for specialist opinion. Empanelled hospitals are strictly limited to treatment-based referrals, and no reimbursement will be provided for AME claims outside these norms.
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