Step-by-Step Guide to Submit Reimbursement Claim for Non-Available Medicine in ECHS

Why Reimbursement ?

Ex-Servicemen Contributory Health Scheme (ECHS) beneficiaries may sometimes be prescribed medicines that are not available at ECHS Polyclinics. In such cases, veterans and dependents are entitled to purchase from the market and claim reimbursement. This guide outlines the complete procedure to claim such reimbursements.

✅ Step 1: Ensure the Prescription is from an Authorized Source

  • Prescription must be issued by:
    • ECHS Polyclinic Medical Officer (for basic ailments)
    • Service Specialist / ECHS Empanelled Specialist
  • Mention of “Not Available (NA)” must be endorsed by OIC or Polyclinic staff on the prescription.

📝 Tip: Always collect the original signed prescription and ensure “NA” is clearly marked on it.

✅ Step 2: Purchase the Medicines

  • Purchase only the prescribed quantity.
  • Keep the original bill/cash memo from a registered medical store with:
    • GST Number
    • Pharmacy Stamp
    • Proper break-up of medicines
    • Date of purchase

📌 Reminder: Medicines must be purchased within 10 days of the prescription date.

✅ Step 3: Prepare the Reimbursement Claim Documents

Your reimbursement claim must include:

Sl.Document DescriptionRemarks
1.Original PrescriptionWith “NA” marking
2.Cash Memo/BillWith full medicine details
3.Reimbursement Claim FormDownload from ECHS website or collect from Polyclinic
4.Photocopy of Smart CardECHS card of patient
5.Self DeclarationMentioning non-availability and not claiming from other sources
6.Bank Passbook copyFirst page or cancelled cheque for account verification

✅ Step 4: Submit the Claim

  • Submit the complete set of documents to the OIC of your Parent Polyclinic.
  • Take an acknowledgment receipt for your submission.
  • Claims are forwarded to the Regional Centre (RC) for approval and processing.

📤 Submission Timeline: Preferably within 30 days of purchase.

✅ Step 5: Track Your Claim

  • Use the SPARSH portal or contact the ECHS Polyclinic to check claim status.
  • Claims are normally processed within 45 to 60 days.

🔎 Info Box: How to Track

Common Reasons for Rejection

ReasonAction to Avoid
Prescription not signed or NA not endorsedGet endorsement before purchasing
Pharmacy not registered / Bill not validAlways buy from recognized medical stores
Incomplete documentsUse checklist before submission
Claim submitted after 30 daysSubmit on time

🎯 Pro Tips for Smooth Reimbursement

  • Maintain a medicine diary with prescription and purchase details.
  • Prefer Government authorized / empanelled pharmacies where possible.
  • Always make single-bill purchases per prescription to avoid confusion.
  • Do not buy extra or substitute medicines without re-prescription.

🖼️ Suggested Infographic (Structure for Designing)

You can use a simple Canva or PowerPoint template to create the infographic using this structure.

📬 Conclusion

ECHS provides critical support to veterans and dependents by allowing reimbursement of medicines when not available at polyclinics. Timely submission with proper documentation ensures smooth processing and settlement of claims.

🛡️ Your health is your right – be informed, be prepared!

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