Central Government Health Scheme (CGHS)

Central Government Health Scheme or CGHS is a model health care facility provider introduced by the Government, wherein all the central government employees and pensioners are offered healthcare facilities at government owned hospitals or polyclinics. The scheme is a one of its kind facility offered by the central government due to the large volume of beneficiaries and the open-ended generous approach of providing health care services.

Features

• The Central Government provides comprehensive medical care to all the Government employees and pensioners in the country
• The services are offered to previous and current employees of the government through wellness centres, previously referred to as CGHS dispensaries or polyclinics
• The scheme intends to cater to all the healthcare needs of of beneficiaries from all the four pillar of democratic set up in the country, namely-
  • Legislature
  • Judiciary
  • Executive
  • Press
• The scheme covers approximately 35 lakh beneficiaries in a total of 71 cities across the country
• The central government endeavours to include more and more cities to the scheme in order to improve the accessibility of the services offered

Facilities Offered

The Central Government Health Scheme covers the following medical areas-

• Allopathy
• Homeopathy
• Ayurveda
• Unani
• Siddha
• yoga

The Central Government Health Scheme offers the following medical services to the eligible candidates:

 

• OPD treatment including the issue of medicines
• Specialist consultation at Polyclinic or Government hospitals
• Indoor treatment at Government and empanelled hospitals
• Investigations at Government and empanelled diagnostic centers
• Cashless facility has been made available for treatment in empanelled hospitals and diagnostic centers
• Reimbursement of expenses incurred for purchase of products such as hearing aids, artificial limbs, appliances, etc. along with expenses for treatment availed in Govt or Private hospitals under emergency
• Family welfare, maternity and child health services
• Medical consultation and dispensing of medicines in Ayurveda, Homeopathy, Unani and AYUSH (Siddha system of medicines)

Points to be considered– It must be noted that in case of a declared emergency, the treatment expense will be reimbursed only if it is submitted to the Additional General where the CGHS card is registered. Additionally, in case of reimbursement of medical bills, the beneficiary can be treated at any hospital but the claim amount will be limited to the rates as mentioned under the scheme.

Eligibility Conditions

In order to avail the benefits of the Central Government Health Scheme, you must fulfill the following conditions:

• All employees of the Central Government who draw their salary from central civil estimates
• The dependent family members of all the above-mentioned employees residing the CGHS covered areas
• Pensioners and family pensioners of the Central Government, who receive pension from central civil estimates
• The eligible dependent family members of pensioners and family pensioners of the central government who receive pension from central civil estimates
• Widows of Central Government Pensioners, in receipt of family pension
• Delhi Police personnel and their family members residing in Delhi only
• Civilian employees of Defence paid from Defence Service Estimates
• Child drawing pension on the death of a Central Government including minor siblings of the child
• Members of the parliament, both ex and sitting
• Ex-vice presidents and their families
• Retired judges of high courts
• Freedom fighters
• Ex-Governors and their families
• Retired and sitting judges of Supreme Court
• Journalists accredited with Press Information Bureau
• Employees of the Railway Board
• Pensioners and employees of certain statutory/autonomous bodies that have been extended CGHS facilities in Delhi
• Families of Government servants transferred to a non-CGHS area for a maximum period of 6 months on deposit of CGHS contribution
• Work charged and industrial staff working in establishments run by various Ministries or Departments of the Central Government
• Employees of Kendriya Vidyalaya Sangathan stationed at Delhi, NCR, Kolkata, Chennai, Hyderabad, Mumbai and Bengaluru
• Employees of Ordnance Equipment Factories Headquarters, Kanpur

Expenses to be Incurred under the Scheme

The cost of availing the facilities under the scheme is different for serving employees and pensioners. 

 

The pensioners must bear the following expenses-

• Pensioners willing to avail the facilities will have to make a contribution according to the grade pay that they were entitled to at the time of their service
• The contribution can be made either on a yearly basis or one time
• The one-time contribution will be a lifetime contribution and will be paid for a total of 10 years

On the other hand, The serving government employees must bear the following expenses-

• Any central government employee serving in the CGHS area is bound to take the CGHS card
• The deduction will be made from the employee’s salary by their department on a monthly basis, depending on his/her grade pay

It must be noted that it takes around 3 weeks’ time for the plastic CGHS card to be issued to the concerned employee/card holder on his/her residence. Before the issue of this plastic card, the employee is given a printed index card on the day of application for CGHS.

Applicable Cities for Central Government Health Scheme

The eligible candidates from the following Indian cities have been provided the services of Central Government Health Scheme :

• Agartala
• Agra
• Ahmedabad
• Aizawl
• Ajmer
• Aligarh
• Allahabad (Prayagraj)
• Ambala
• Amritsar
• Baghpat
• Bengaluru
• Bareilly
• Berhampur
• Bhopal
• Bhubaneshwar
• Chandigarh
• Chennai
• Chhapra
• Cuttack
• Darbhanga
• Dhanbad
• Dehradun
• Delhi & NCR
• Delhi, Faridabad, Ghaziabad, Greater Noida, Gurgaon, Indirapuram, Sahibabad
• Dibrugarh
• Gandhinagar
• Gangtok
• Gaya
• Gorakhpur
• Guwahati
• Guntur
• Gwalior
• Hyderabad
• Imphal
• Indore
• Jabalpur,
• Jaipur
• Jalandhar
• Jalpaiguri
• Jammu
• Jodhpur
• Kanpur
• Kohima
• Kolkata
• Kota
• Lucknow
• Meerut
• Moradabad
• Mumbai
• Muzaffarpur
• Nagpur
• Nellore
• Panaji
• Patna
• Puducherry
• Pune
• Raipur
• Ranchi
• Rajahmundry
• Saharanpur
• Shillong
• Shimla
• Silchar
• Sonepat
• Srinagar
• Varanasi
• Vijayawada
• Tiruchirapalli
• Tirunelveli
• Tirupati
• Thiruvananthapuram
• Visakhapatnam

The scheme will soon be launched in Kochi, Kannur, and Kozhikode.