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Know all about Central Government Health Scheme for health insurance on Coverfox.com 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.
The cost of CGHS facilities differs for the serving employees and the pensioners of the central government of India.
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:
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.
CGHS Rate List
|CGHS Treatment Procedure/Investigation List||Rates For Non-NABH||Rates For NABH|
|Consultation- for Inpatients||270||270|
|Dressings of wounds||45||52||Suturing of wounds with local anaesthesia||108||124|
|Aspiration Plural Effusion – Diagnostic||120||138|
|Aspiration Plural Effusion – Therapeutic||174||200|
|Abdominal Aspiration – Diagnostic||330||380|
|Abdominal Aspiration - Therapeutic||414||476||Pericardial Aspiration||342||393|
|Removal of Stitches||36||41|
|Venesection||124||143||Phimosis Under LA||1180||1357|
|Injection for Haemorrhoids||373||428|
|7 Injection for Varicose Veins||315||363|
|Dilatation of Urethra||450||518||Incision & Drainage||378||435|
CGHS - Treatment in Private Hospitals
CGHS beneficiaries can undergo treatment at any empanelled private hospital without having to provide a referral letter. An order issued by the Health Ministry has stated that private empanelled hospitals shall perform the treatment on cashless basis for ex-MPs, pensioners, Freedom Fighters, Regular employees (both CGHS and CS (MA) beneficiaries) of Ministry of Health & Family Welfare and other categories of CGHS beneficiaries, who are presently eligible for credit facility. The order reads that they “shall enclose the prescription issued by Government Specialist or a CGHS Medical Officer, in original (or a self-attested photocopy) along with the hospital bill submitted to the competent authorities.”
Steps to book online appointment:
Follow-up and In-patient Treatments are not addressed in case of the following:
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 health care.
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.