Central Government Health Scheme (CGHS)

The Central Government Health Scheme (CGHS) is a health care facility scheme for the existing and former employees of the Central Government of India. The health care facility by CGHS is provided in some particular areas, which are as follows:Allahabad, Ahmedabad, Bangalore, Bhubaneshwar, Bhopal, Chandigarh, Chennai, Delhi & NCR, Dehradun, Guwahati, Hyderabad, Indore, Jaipur, Jabalpur, Kanpur, Kolkata, Lucknow, Meerut, Mumbai, Nagpur, Patna, Pune, Ranchi, Shillong, Thiruvananthapuram and Jammu.

CGHS is a special health scheme for the government employees.

The medical facilities are provided through Wellness Centres (previously referred to as CGHS Dispensaries) / polyclinics under Allopathic, Ayurveda, Yoga, Unani, Sidha and Homeopathic systems of medicines.

Components of the Central Government Health Scheme (CGHS)

  • The dispensary services including domiciliary care.
  • F. W. & M.C.H. Services.
  • Specialists' consultation facilities both at dispensary, polyclinic and hospital.
  • Level including X-Ray, ECG and Laboratory Examinations.
  • Hospitalization.
  • Organization for the purchase, storage, distribution and supply of medicines and other requirements.
  • Health Education to beneficiaries.

Beneficiaries of the Central Government Health Scheme (CGHS)

  • The current working employees of Central Government and their dependent family members living in CGHS covered areas.
  • Existing and Former members of the Indian Parliament.
  • Former governors & Lieutenant governors of India.
  • Freedom Fighters of India.
  • Former Vice Presidents of India.
  • Existing and Former Judges of Supreme Court & High Courts of India.
  • Workers and Pensioners of selected autonomous organizations in the Delhi state.
  • Journalists qualified with PIB (In Delhi Only).
  • Police Personnel (In Delhi Only).
  • Workers of Railway Board.

Eligibility for Central Government Health Scheme

  • All employees of the central government who receive wages from the Central Civil Estimates.
  • All dependent family members of Central Government employees who receive wages from Central Civil Estimates and are residents of areas covered under CGHS.
  • Pensioners and family pensioners of the Central Government.
  • Eligible dependent family members of pensioners and family pensioners of the Central Government.
  • Members of parliament
  • Ex-vice presidents
  • Ex-Governors & Lt. Governors
  • Retired/sitting judges of high courts and Supreme Court.
  • Freedom fighters
  • Journalists accredited with Press Information Bureau
  • Employees of the Railway Board
  • Delhi Police Personnel in Delhi only
  • Pensioners and employees of certain statutory/autonomous bodies that have been extended CGHS facilities in Delhi.
  • Post and Telegraph Department Employees.

Types of Medical Systems Covered Under CGHS

CGHS provides health care through following systems of Medicine:

  • Allopathic
  • Homoeopathic
  • Indian system of medicine
    • Ayurveda
    • Unani
    • Siddha and
    • Yoga

Facilities Offered Under Central Government Health Scheme (CGHS)

  • OPD Treatment including issue of medicines.
  • Specialist Consultation at Polyclinic/Govt. Hospitals.
  • Indoor Treatment at Government and Empanelled Hospitals.
  • Investigations at Government and Empanelled Diagnostic centers.
  • Cashless facility available for treatment in empanelled hospitals and diagnostic centers for Pensioners and other identified beneficiaries.
  • Reimbursement of expenses for treatment availed in Govt. /Private Hospitals under emergency.
  • Reimbursement of expenses incurred for purchase of hearing aids, artificial limbs, appliances etc. as specified.
  • Family Welfare, Maternity and Child Health Services.
  • Medical consultation and dispensing of medicines in Ayurveda, Homeopathy, Unani and Siddha system of medicines (AYUSH).

Cost of Central Government Health Scheme (CGHS) Facilities

The cost of CGHS facilities differs for the serving employees and the pensioners of the central government of India.

For Pensioners

In case a pensioner wants to avail the facilities of CGHS they will also have to make a contribution according to the grade pay they were entitled at the time of their service. The contribution can be done as yearly contribution and one time contribution:

  • Yearly Contribution: Every year a certain amount of money (as per grade pay) is to be contributed towards CGHS.
  • One Time Contribution: A pensioner pays onetime contribution amount towards CGHS for 10 years. It will be considered as a life time contribution.

For Serving Government Employees

A central government employee, who is currently serving in CGHS covered area, is bound to take the CGHS card. A deduction is made from the salary by their department every month, which depends upon the grade pay of the serving employee.

Required time to get CGHS Card

A printed index card of CGHS is issued on the day of application for CGHS. Later, the plastic cards are issued and sent to the concerned card holders within 3 weeks. The cards are sent to the residence of the government employees.

Treatments Not Covered Under Central Government Health Scheme (CGHS)

Follow-up and In-patient Treatments are not addressed in case of the following:

  • In case of a declared emergency, the treatment can be done at any hospital, but the reimbursement claim can only be submitted to the Additional General where the CGHS card is registered.
  • In case of reimbursement of medical bills, the beneficiary can be treated at any hospital and the claim amount will be limited to the rates as per mentioned under CGHS. The reimbursement claim can only be submitted to the Additional General where the CGHS card is registered.

Central Government Health Scheme (CGHS) & Mediclaim Policy

An individual may have a Mediclaim Insurance Policy also along with the CGHS. If due to the medical emergencies, the individual is treated in a private hospital, and some of the bills are paid by the insurance company, the individual will still be able to get the rest of the cover from CGHS.

All the medical bills submitted to the insurance company and the duplicate bills with certificate from Insurance Company will be claimed from CGHS by the pensioner. The serving employees will have to contact their concerned departments for getting the balance from CGHS.

CGHS in Private Hospitals

CGHS is only provided in the Government hospitals and the empaneled private hospitals under CGHS. But if an individual faces an emergency and is treated from a non empaneled private hospital, the expenses are reimbursed as per normal CGHS rates.

Surgeries at Private Empaneled Hospitals under CGHS

Before proceeding for doing a surgery, an individual will have to obtain advice from a government specialist/ CMO i/c of Wellness Center.

However, to obtain advice, pensioners will have to apply to CMO i/c of Wellness Center for getting the permission before doing the surgery. However, CGHS will provide reimbursement at CGHS rates to contact their respective department/office.

Central Government Health Scheme is an important and unique scheme that is introduced in India to help the Government employees in providing medical care.

Applicable Cities Under Central Government Health Scheme (CGHS)
AhmedabadAllahabadBengaluru
BhopalBhubaneshwarChandigarh
ChennaiDehradunDelhi NCR
GuwahatiHyderabadIndore
JabalpurJaipurJammu
KanpurKolkataLucknow
MeerutMumbaiNagpur
PatnaPuneRanchi
ShimlaShillongThiruvananthapuram

Frequently Asked Questions

How do I apply for Central Government Health Scheme (CGHS) online?

You can apply for CGHS online by submitting a duly-filled application form available form the official website of cghs.nic.in and cghs.gov.in. This application form can also be availed from any of the listed wellness centres.

How do I print my CGHS card online?

An individual may have a Mediclaim Insurance Policy along with the CGHS. If due to the medical emergency, the individual is treated in a private hospital and some of the bills are paid by the insurance company, the individual will still be able to get the rest of the cover from CGHS. All the medical bills submitted to the insurance company and the duplicate bills with certificate from Insurance Company will be claimed from CGHS by the pensioner. The serving employees will have to contact their concerned departments for getting the balance from CGHS.

What is CGHS card?

All government employees are provided with a CGHS plastic card which contains the photo ID and beneficiary ID number. This card is mandatory to furnish at the wellness centre if the beneficiary seeks to avail any of the facilities under CGHS.

Is CGHS cashless?

CGHS pensioner beneficiaries are entitled to cashless medical treatment only in the respective CGHS empanelled private hospitals. The empanelled private hospitals under CGHS provide treatment to the pensioners on credit /cashless basis for the procedures for which they are empanelled.

Is AIIMS under CGHS?

Yes, cashless/reimbursement facilities are provided to CGHS beneficiaries at All India Institute of Medical Sciences.

Leave a rating!
3.6 (30 votes)