Financial Assistance for Treatment of Serious Diseases to Non Pensioner ESM (All Ranks)/Widows

Posted by admin October 29, 2021 0 Comments Circular, Medical

FINANCIAL ASSISTANCE FOR TREATMENT OF SERIOUS DISEASES TO NON PENSIONER ESM (ALL RANKS)/WIDOWS

Background

All pensioners of Indian Armed Forces have been provided medical cover under ECHS with effect from 01 Apr 2008. But, non-pensioners who were sent out of service at a nearly stage due to organizational constraints or discharged at own request, do not have such medical cover. With increased costs of health care, it is extremely difficult for the non-pensioner ESM to meet their expenses on treatment of serious diseases like cancer, renal failure and heart ailments in their old age.

Aim

The aim of this aid gratis is to provide financial assistance to a non-pensioner ESM of all ranks and widows to meet medical expenses related to treatment of approved/listed serious diseases like cancer, renal failure, knee replacement and heart surgery.

Financial Assistance

Financial assistance for treatment of the approved serious diseases mentioned at para 6 in this document is applicable to non-pensioner ESM of all ranks and widows subject to a maximum of Rs 1,25,000/- (One Time) and for treatment of cancer/dialysis subject to a maximum of Rs 75,000/- per annum as follows:-

(a) For Non-Pensioner Officers/Widows. 75% of total expenditure incurred on medical treatment, hospitalization, medicines etc.
(b) For Non-Pensioner other Ranks/Widows. 90% of total expenditure incurred per annum on medical treatment, hospitalization, medicine etc.

Eligibility Conditions

The following criteria must be fulfilled:-

(a) Applicant must be a non-pensioner ESM or his widow.
(b) Should not be member of ECHS or availing AFMS facilities.
(c) Should be recommended by respective Zilla Sainik Board (ZSB).
(e) Expenditure must be incurred at a approved govt hospital at the rates applicable under CGHS / ECHS.

Application

Application should be made on the prescribed application format with recommendation of concerned Zilla Sainik Welfare Officer (ZSWO) on it. A specimen application format is placed Annexure 1. Copies of the following documents duly attested by ZSWO must accompany the application:-

(a) Complete Service Discharge Book/Documents.
(b) Photocopy of ESM / widow I Card.
(c) Original medical bills duly countersigned by attending doctor.
(d) Hospital admission and discharge report duly countersigned by hospital authority.
(e) A certificate from applicant that he/she has not taken any money/grant from the State Govt or present employer in the form of reimbursement or medical allowance.
(f) Details of Bank A/c No (in PNB/SBI only) and IFS Code.

List of Serious Diseases

List of the serious diseases are covered under this scheme:-

(a) Angiography & Angioplasty
(b) CABG
(c) Open heart surgery
(d) Valve replacement
(e) Pacemaker Implant
(f) Cerebral stroke
(g) Prostrate surgery
(h) Joint replacement
(j) Renal failure
(k) Cancer
(l) Dialysis

Treatment of other Diseases

In case the treatment of a serious disease which is not listed in this scheme-document, such application will be referred to DGAFMS for comment/recommendation to consider it for financial assistance for treatment of that disease, to ESM under this scheme.

Channel of Application

The application must be submitted by an eligible ESM/widow at respective ZSB. ZSWO will scrutinize the application and if found correct, will forward it directly to the KSB Sectt for payment.

Processing at KSB Sectt.

On receipt in the Welfare Section of KSB Sectt, applications, Section-in-Charge will assign the application to a particular clerk who will enter desired data from applications onto computer. Another clerk will be designated to check correctness of the entries.The Section-in-Charge will verify the same and put up the application in relevant file to JD(Welfare) who will get approval of Secretary, KSB on a monthly basis.

Payment Procedure

After approval of Secretary KSB, the application will be processed for payment by Welfare Section. After verifying the ESM’s service number, name, banker’s IFS Code and bank account number, the Welfare Section will forward the list of approved cases to Accounts Section for payment. The Accounts Section will process the list for payment directly to beneficiaries via ECS to the beneficiaries as applicable.