Under the Ex-Servicemen Contributory Health Scheme, the polyclinic is the gateway to all higher care. You cannot normally walk into an empanelled hospital for planned cashless treatment — you need a referral from your parent polyclinic. This guide explains how that referral process works, how long a referral lasts, what happens in an emergency, and what to carry. Specific timelines and consultation limits are set by the Central Organisation ECHS and revised periodically; confirm the current rules at your polyclinic or on echs.gov.in.
The referral journey, step by step
Step 1: Consult your parent polyclinic
Visit your ECHS polyclinic with your Smart Card. The Medical Officer examines you and decides whether the condition needs a specialist or hospital-level treatment.
Step 2: Referral is generated
If needed, the polyclinic issues a referral — increasingly through the online ECHS system linked to your card — to a service hospital or an ECHS-empanelled civil hospital for the required specialty.
Step 3: Report to the referred hospital
Take your Smart Card and the referral to the hospital. Present them at the ECHS/insurance desk so your entitlement is verified and treatment is provided cashless.
Step 4: Receive treatment cashless
Eligible consultation, investigations, procedures or admission are covered as per ECHS rates and entitlement, without you paying the hospital directly for covered items.
Step 5: Follow up at the polyclinic
Bring back your discharge summary, prescriptions and reports. The polyclinic records them, issues follow-up medicines and arranges any further referral.
Referral validity and consultations
An ECHS referral is not open-ended. It carries a defined validity period and a defined number of specialist consultations. When the validity lapses or the consultations are used up, you return to the polyclinic for a fresh referral if continued specialist care is needed. For chronic conditions managed long-term, the polyclinic can issue repeat referrals as required. Always check the validity printed on your referral.
Emergencies: treatment first, paperwork after
In a genuine medical emergency, do not wait for a referral. Go straight to the nearest hospital — preferably ECHS-empanelled — and get treatment. Then inform your polyclinic or Station HQ within the time prescribed by ECHS (commonly within 48 hours) so the emergency can be regularised. Preserve every document — admission papers, bills, investigation reports and the discharge summary — for cashless settlement or reimbursement.
What to carry to the empanelled hospital
- Your valid ECHS 64KB Smart Card.
- The referral (printed and/or the online reference).
- Previous prescriptions, reports and discharge summaries.
- A list of your current medicines, especially for chronic conditions.
After the hospital: medicines and follow-up
Post-treatment medicines are issued by your polyclinic against the hospital's prescription. If an item is out of stock, read our ECHS medicine shortage guide. For convenient home delivery in our service area, Army Medicine Supplier — an independent licensed pharmacy, not part of ECHS — can deliver prescribed medicines; see how it works.
Frequently asked questions
How does the ECHS referral process work?
You first consult the Medical Officer at your parent ECHS polyclinic. If specialist or hospital-level care is needed, the polyclinic issues a referral to a service hospital or an ECHS-empanelled civil hospital. You take the referral to the referred hospital, where eligible treatment is provided cashless. After treatment, reports come back to the polyclinic for follow-up.
Can I go directly to an empanelled hospital without a referral?
For routine and planned treatment, no — a valid referral from your polyclinic is required for cashless care. The main exception is a genuine emergency, where you may report directly to the nearest empanelled (or even non-empanelled) hospital and inform your polyclinic within the prescribed time so the case can be regularised.
How long is an ECHS referral valid?
An ECHS referral is valid for a defined period and a defined number of consultations as per current ECHS policy (commonly a fixed validity window and a set number of specialist consultations per referral). Check the validity printed on your referral and confirm current rules at your polyclinic, since these are periodically revised.
What is an online ECHS referral?
ECHS has moved much of the referral workflow online. The polyclinic generates the referral in the ECHS system and it is linked to your Smart Card, reducing paperwork and making it easier for the empanelled hospital to verify entitlement. You should still carry your card and any printed referral when you go to the hospital.
What happens in a medical emergency under ECHS?
In an emergency, get treatment first — go to the nearest hospital, preferably ECHS-empanelled. Inform your polyclinic/Station HQ within the time prescribed by ECHS (commonly within 48 hours) so the emergency can be regularised. Keep all documents, bills and the discharge summary for cashless processing or reimbursement.
Does a referral cover diagnostic tests too?
Yes. The polyclinic can refer you for laboratory and imaging tests that are not done in-house, to empanelled diagnostic centres. As with hospital referrals, carry your Smart Card and the referral document, and the test is provided cashless where covered.
Can I choose which empanelled hospital I am referred to?
You can usually indicate a preference among the empanelled hospitals for the required specialty, and the polyclinic refers you accordingly subject to the hospital being empanelled for that treatment. For specialised procedures, referral may be directed to a hospital empanelled for that specific specialty.