The Ex-Servicemen Contributory Health Scheme (ECHS) has issued a Standard Operating Procedure (SOP) for processing Domiciliary Medical Equipment cases, dated 11 September 2026.
The SOP lays down a common process for the scrutiny, approval, procurement, issue and reimbursement of medical equipment required by eligible ECHS beneficiaries for use at home. It applies to ECHS beneficiaries, polyclinics, Regional Centres, Central Organisation ECHS, Service/Government Hospitals and other authorities involved in processing these cases. The official ECHS Medical Section lists the SOP dated 11 September 2026.
Who can get domiciliary medical equipment under ECHS?
According to the SOP, an eligible ECHS beneficiary can be considered for domiciliary medical equipment when the equipment is:
medically essential, recommended by the concerned Specialist or Super Specialist of a Service Hospital or Government Hospital, required for home-based management, not intended for hospital use, and covered under the applicable Government policy.
This means the requirement has to be medically supported; the SOP is not a general purchase facility for home medical devices.
Which types of medical equipment are covered?
For processing purposes, the SOP places domiciliary medical equipment into three categories:
- Category I: Equipment included in an approved Government list with a prescribed CGHS/ECHS ceiling rate. Examples given in the SOP include CPAP, BiPAP, Bilevel Ventilatory System, Oxygen Concentrator, Wheelchair and Hearing Aids.
- Category II: Specialised equipment such as Continuous Subcutaneous Insulin Infusion (CSII) Pump Therapy, Cochlear Implant and other high-end appliances.
- Category III: Unlisted equipment for which no CGHS/ECHS ceiling rate exists. Examples mentioned include Multipara Monitor, Motorised ICU Bed, Air Mattress, Suction Apparatus and DVT Pump with sleeves.
The classification is important because the approval authority and documentation can differ depending on the category.
How can an ECHS beneficiary obtain the equipment?
The SOP provides two routes.
In the first route, the ECHS Polyclinic forwards the requirement, along with the prescription, clinical summary, investigation reports and Specialist/Super Specialist recommendation, to the Senior Executive Medical Officer (SEMO). Once procured by SEMO, the equipment is issued to the beneficiary through an issue voucher.
The second route allows an individual ECHS beneficiary to procure the equipment after obtaining prior approval from the competent authority and subsequently claim reimbursement as prescribed.
For Category I equipment, the competent authority for prior approval is the Director, Regional Centre ECHS.
For Category II and Category III equipment, the case is processed for approval through the High Power Committee/Department of Ex-Servicemen Welfare.
When are three quotations required?
The SOP has a specific provision for Category II and Category III cases.
If the cost of the medical equipment is above ₹50,000, three quotations from authorised distributors are required.
For equipment costing up to ₹50,000, purchase may be made without inviting quotations, provided the item is not available on the Government e-Marketplace (GeM), as stated in the SOP with reference to Rule 154 of GFR 2017.
Other required documents include the clinical records, Specialist/Super Specialist recommendation, ECHS Card, beneficiary’s application, Statement of Case and the recommendations prescribed for the particular category.
What if life-saving equipment has to be purchased in an emergency?
The SOP provides a separate ex-post-facto approval procedure for emergency situations.
It applies where an ECHS beneficiary urgently requires life-saving domiciliary medical equipment because of an immediate medical necessity and prior approval could not be obtained.
The SOP specifically mentions:
Oxygen Concentrator, CPAP, BiPAP and Bilevel Ventilatory System, along with any other listed domiciliary medical equipment urgently required under the applicable policy.
In such cases, reimbursement is admissible up to the applicable CGHS/ECHS ceiling limit, subject to the Government policy and approval process.
The beneficiary must submit documents including an application for ex-post-facto approval, emergency certificate or justification from the treating doctor, clinical summary, investigation reports, recommendation from the concerned Specialist/Super Specialist, original purchase invoice, payment receipt, warranty documents and copy of the ECHS Card.
The Polyclinic verifies the case and forwards it to the concerned Regional Centre. Where no ceiling rate exists or the equipment is unlisted, the case is referred through Central Organisation ECHS to the High Power Committee/DoESW.
What is required for reimbursement?
For reimbursement of domiciliary medical equipment, the SOP requires the beneficiary to submit the applicable prior sanction, original equipment bill, contingent bill, bank details/cancelled cheque, ECHS Card copy and certification from the Polyclinic that the same type of equipment for the same purpose was not issued during the previous five years.
The Regional Centre processes payment for individual reimbursement under the prescribed procedure.
What about consumables used with the equipment?
The SOP also deals with consumables required for domiciliary medical equipment.
These are to be procured through SEMO/Commandant/CO Hospital and issued under the arrangements of the Officer-in-Charge ECHS Polyclinic.
Where the required item is not available in medical stores, the SOP provides for supply through the Authorised Local Chemist (ALC). If it is also unavailable through the ALC or ECHS Polyclinic dispensary, an NA endorsement on the prescription can be provided, after which the beneficiary may purchase the item locally and claim reimbursement as per the applicable ECHS policy.
Who pays for repair and maintenance?
This is an important provision for beneficiaries.
The SOP states that domiciliary medical equipment is issued for a period of five years.
During this period, repair and maintenance are the responsibility of the ECHS beneficiary, and the cost is not reimbursable.
Where the equipment is still under warranty, the beneficiary may approach the Original Equipment Manufacturer (OEM) or SEMO, depending on how the equipment was procured.
When can the equipment be replaced?
After completion of five years, replacement can be processed depending on the condition of the equipment.
If the equipment has become non-functional, an Unserviceability Certificate from an authorised service engineer of the Original Equipment Manufacturer is required.
After obtaining this certificate, the replacement case can be processed in the same manner as the first issue.
If equipment becomes unserviceable before five years, warranty conditions will apply where the warranty is still valid. If the warranty has expired, the procedure specified in the SOP for unserviceable equipment is to be followed.
What should ECHS beneficiaries remember?
The 11 September 2026 SOP is essentially a single processing framework for domiciliary medical equipment cases under ECHS.
For beneficiaries, four points are particularly important:
Medical recommendation is essential.
Prior approval is required in the normal procurement route.
Emergency ex-post-facto approval is limited to eligible cases under the prescribed policy.
Repair and maintenance costs during the five-year period are normally borne by the beneficiary.
The SOP therefore should not be interpreted to mean that any medical equipment bought independently from the market will automatically qualify for ECHS reimbursement. Beneficiaries should follow the prescribed approval and documentation process applicable to their category of equipment.
Source
Central Organisation ECHS — Medical Section
Standard Operating Procedure (SOP) on Processing of Domiciliary Medical Equipment (DME) Cases under ECHS — 11 September 2026 ECHS
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