Cancer is one of the most difficult and expensive medical conditions a family can face. For defence veterans and their dependents enrolled in ECHS, the good news is that cancer treatment is covered comprehensively under the scheme. But the process for cancer treatment under ECHS is different from routine treatment — and not knowing the correct process can cause serious delays in receiving life-saving medicines and therapy.
This article explains the complete cancer treatment process under ECHS — referrals, drug provisioning, chemotherapy rules, hospital responsibilities, and billing procedures. Every fact in this article is strictly from ECHS SOP April 2026 compiled by RC ECHS Dehradun, including the latest guidelines issued by the Ministry of Defence in December 2025.
Referral for Cancer Treatment
Like all ECHS treatment, cancer treatment also begins at the polyclinic. The polyclinic issues a referral based on the recommendations of the oncologist at the empanelled hospital.
The referral for cancer treatment is valid for 180 days — significantly longer than the standard three-month referral. This is because cancer treatment involves multiple sessions over a long period.
The number of treatment sessions — whether chemotherapy, radiotherapy, or immunotherapy — is decided by the Medical Officer at the polyclinic or military hospital based on the oncologist’s recommendations.
Who Provides Anti-Cancer Drugs — A Critical Change from December 2025
This is the most important update in cancer treatment under ECHS. As per the latest guidelines issued by the Ministry of Defence in December 2025, the responsibility for providing anti-cancer drugs required for chemotherapy and immunotherapy now rests with ECHS authorities.
This means —
ECHS will procure and supply the anti-cancer drugs to the cancer patient. The empanelled hospital will then administer these drugs.
What Happens if ECHS Cannot Provide the Drug?
If ECHS authorities fail to provide the required anti-cancer drug to the patient, the oncology empanelled hospital will provide the drug on production of a valid NA cum Referral from ECHS — where the Medical Officer of the polyclinic clearly mentions whether the drug is available or not available.
The hospital then claims the expenditure from ECHS. There are two ways the hospital can claim reimbursement for the drug —
Option 1 — Claiming at MRP The hospital claims the Maximum Retail Price of the drug. ECHS reimburses 70 percent of the MRP. The hospital must upload a photograph of the drug pouch clearly showing the MRP, expiry date, and manufacturing date along with the claim.
Option 2 — Claiming at GST Invoice Rate The hospital claims the rate from an external vendor’s GST invoice. ECHS reimburses the full GST invoice rate. The hospital must upload the external vendor invoice along with a photograph of the drug pouch.
Chemotherapy Package Rate — What is Included
The package rate for chemotherapy covers procedural charges only. The following are reimbursable separately in addition to the procedural charges —
Room rent, investigations, and anti-cancer medicines are all reimbursable over and above the chemotherapy package rate.
Where Do Cancer Patients Collect Their Medicines?
For all cancer patients, medicines must be collected from the dependent ECHS polyclinic on the prescription of the oncologist of the empanelled hospital. The empanelled hospital does not issue cancer medicines directly to the ECHS beneficiary.
PET CT Scan for Cancer Patients
Empanelled hospitals that are empanelled for oncology services including PET CT scan will undertake the PET CT scan at ECHS/CGHS rates. If PET CT scan services are not available at that hospital, the ECHS patient will be advised to get it done at another facility at CGHS rates.
Follow-Up Treatment for Cancer Patients
Cancer patients are among the critically ill ECHS patients who are permitted for follow-up treatment at empanelled hospitals. There is no time limit on follow-up treatment for cancer patients. Additionally no referral is required for post-operative follow-up after cancer-related surgeries covered under the specified post-operative conditions.
Common Mistakes to Avoid
Not knowing that ECHS now supplies anti-cancer drugs — patients should not buy drugs on their own without first checking with ECHS.
Not obtaining a valid NA cum Referral from the polyclinic when the hospital needs to provide the drug.
Collecting cancer medicines from the hospital instead of the dependent polyclinic.
Not knowing that the chemotherapy package covers only procedural charges — room rent and investigations are billed separately.
Assuming PET CT scan is available at all empanelled hospitals — confirm before visiting.
Conclusion
Cancer treatment under ECHS is comprehensive and well-structured. From the 180-day referral validity to ECHS-supplied anti-cancer drugs, from clearly defined reimbursement options to follow-up treatment with no time limit — every aspect is designed to protect the cancer patient from financial and procedural burden.
Know the process, collect medicines from the correct source, and ensure your polyclinic is kept informed at every step. No cancer patient enrolled in ECHS should face the additional burden of paying for treatment that is rightfully covered.
READ ALSO: ECHS AYUSH TREATMENT POLICY 2026: COMPLETE GUIDE FOR EX-SERVICEMEN
Frequently Asked Questions
Q1. How long is the ECHS referral valid for cancer treatment?
The ECHS referral for cancer treatment is valid for 180 days. This is significantly longer than the standard three-month referral validity because cancer treatment involves multiple sessions of chemotherapy, radiotherapy, or immunotherapy over an extended period. The number of sessions is decided by the Medical Officer at the polyclinic or military hospital.
Q2. Who is responsible for providing anti-cancer drugs under ECHS from December 2025?
As per guidelines issued by the Ministry of Defence in December 2025 ECHS authorities are now responsible for providing anti-cancer drugs required for chemotherapy and immunotherapy. The drug is supplied by ECHS and administered by the empanelled hospital. If ECHS cannot supply the drug the hospital provides it and claims reimbursement.
Q3. What is an NA cum Referral and when is it required?
An NA cum Referral is a referral issued by the ECHS polyclinic in which the Medical Officer clearly mentions whether the anti-cancer drug is available or not available with ECHS. This document is required when the empanelled hospital needs to provide the anti-cancer drug on behalf of ECHS because ECHS could not supply it directly.
Q4. How does a hospital claim reimbursement for anti-cancer drugs provided to ECHS patients?
The hospital can claim reimbursement in two ways. First at MRP where ECHS reimburses 70 percent of the MRP and the hospital uploads the drug pouch photograph showing MRP, expiry date, and manufacturing date. Second at GST invoice rate where the full GST invoice rate is reimbursed and the hospital uploads the external vendor invoice along with the drug pouch photograph.
Q5. Where should cancer patients collect their medicines from under ECHS?
All cancer patients must collect their medicines from their dependent ECHS polyclinic on the prescription of the oncologist of the empanelled hospital. The empanelled hospital does not issue cancer medicines directly to the ECHS beneficiary. Collecting medicines from the hospital instead of the polyclinic is incorrect.
Q6. What does the ECHS chemotherapy package rate include?
The chemotherapy package rate under ECHS covers procedural charges only. Room rent, investigations, and anti-cancer medicines are reimbursable separately in addition to the procedural package rate. This means the package does not cover medicines or room charges — these are claimed separately over and above the chemotherapy package.
Q7. Is PET CT scan covered under ECHS for cancer patients?
Yes. Empanelled hospitals that are empanelled for oncology services including PET CT scan will conduct the scan at ECHS/CGHS rates. If PET CT scan is not available at that hospital the ECHS patient will be directed to another facility where it can be done at CGHS rates.
Q8. Is there a time limit on follow-up treatment for cancer patients under ECHS?
No. Cancer patients are among the critically ill ECHS patients who are permitted for follow-up treatment at empanelled hospitals with no time limit. They do not require a fresh referral for follow-up treatment once the initial treatment has been established under the covered post-operative conditions.
Q9. Can a cancer patient go directly to the empanelled hospital without a polyclinic referral?
No. Cancer treatment under ECHS also begins with a referral from the polyclinic. The polyclinic issues the referral based on the oncologist’s recommendations. The referral is valid for 180 days. Without a valid referral the empanelled hospital cannot provide cashless cancer treatment in a routine situation.
Q10. What should a cancer patient do if the hospital asks them to buy drugs themselves?
If a hospital asks a cancer patient to purchase anti-cancer drugs on their own the patient should immediately contact the Officer in Charge of their ECHS polyclinic. As per Ministry of Defence guidelines from December 2025 ECHS is responsible for providing anti-cancer drugs. The patient should not bear this cost without first exhausting the ECHS supply process.
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