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.

Procedures of Registration for Central Government Health Scheme (CGHS)

For Pensioners

A pensioner can register under CGHS and get a CGHS card from the office of Additional Director (AD)/Joint Director (JD) of their city.

Pensioners Must Provide the Following Required Documents

  • An application in a prescribed format.
  • Proof of residence of the pensioner.
  • Proof of residence of the dependents of the pensioner.
  • Proof of age of son of the pensioner.
  • Disability Certificate. (If any)
  • Pictures of the beneficiary family members.
  • Surrender Certificate(If a pensioner has an active CGHS card)
  • Attested copies of PPO
  • Attest Copies of Last Pay Certificate
  • A draft for required amount towards CGHS contribution.
  • Provisional Card.(If PPO isn't provided)

For Current Employees

If an existing employee wants to apply for CGHS, they will have to submit an application form with the required photos and documents of their family members to the Ministry/Department/Office where they are currently working.

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.

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.

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