Central Government Health Scheme

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08 min read.

The Central Government Health Scheme (CGHS) provides comprehensive medical care to the employees of the Central Government and pensioners enrolled under the CGHS upon payment of a monthly contribution. The CGHS also caters to the healthcare requirements of eligible beneficiaries covering the pillars of the democratic set up in India, namely Legislature, Executive, Judiciary and Press. The CHGS is unique due to its large beneficiary base and generous open-ended approach to healthcare.

The CGHS provides healthcare through the following systems of medicine:

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

Eligibility for Joining CGHS

The following persons are eligible for the CGHS facilities:

  • Every Central Government employee (except Delhi administration and railways), including their dependant family members residing in the CGHS covered areas.
  • Central Government pensioners (except pensioners belonging to armed forces and railways) and their families.
  • Pensioners of the Central Government retiring with the contributory provident fund benefits and their families.
  • Widows of the Central Government pensioners.
  • Delhi Police personnel and their families residing in Delhi.
  • Railway board employees.
  • Civilian employees of the defence paid from the defence service estimates.
  • A child receiving pension on death of a Central Government employee including minor sisters and brothers of such a child.
  • Lt. Governors, Ex-Vice Presidents and Ex-Governors and their families.
  • Central Government servants who are deputed to autonomous bodies and semi-government bodies receiving a substantial grant from the Central Government.
  • Central Government employees on deputation to autonomous or statutory bodies during the period of deputation.
  • Military officers on deputation to the civil departments and getting emoluments from the central civil estimates.
  • Government servants’ families transferred to a non-CGHS area for a maximum of six months on deposit of the CGHS contribution in advance.
  • Families of the IAS officers on North-Eastern cadre, who stay back in Delhi after their repatriation, provided they continue to occupy the government accommodation in Delhi or New Delhi, on the deposit of advance CGHS contribution.
  • Parliamentary Secretaries of the Central Government, Ex-Members of the Parliament and members of the Parliament and their families.
  • Sitting and former judges of the Supreme Court and High Court of Delhi.
  • Industrial staff working in the establishments run by different departments or ministries of the Central Government, immediately from the date of joining the service.
  • Employees of the Kendriya Vidyalaya Sangathan at Delhi, Kolkata, NCR, Mumbai, Hyderabad, Chennai, and Bengaluru.
  • Employees of ordnance factory board headquarters at Kolkata and ordnance equipment factories headquarters at Kanpur.
  • All India Service pensioners who retired while serving under the state government at their option.
  • Freedom fighters and their family members who receive the central pension under the Swatantrata Sainik Samman Pension Scheme.
  • Ordnance factory pensioners.
  • Members of the staff side of the National Council of the Joint Consultative Machinery.
  • Persons employed in autonomous and semi-government bodies permitted to join the CGH Scheme.
  • An accredited journalist who submits a certificate from the Press Council of India stating that he/she is a member of the Press Association, New Delhi.
  • Retired divisional accountants of the Indian audit and accounts department.
  • Absorbees of autonomous or statutory bodies of the Central Government who receive the Central Civil Pension.
  • Serving and retired staff of the railway audit.
  • Serving and retired divisional accountants and divisional accounts officers posted in the office of accountant generals in the state governments.
  • CISF personnel and CAPF personnel posted in CGHS cities.
  • Supreme Court legal services committee employees.
  • India Pharmacopoeia Commission employees and their families.
  • Defence industrial employees of the AFMSD and Naval Dockyard Central Ordnance Depot in Mumbai.

Medical Facilities Available Under CGHS

The following medical benefits are available to the CGHS beneficiaries:

  • OPD treatment, including the issue of medicines.
  • Specialist consultation at government hospitals or polyclinic.
  • Indoor treatment at empanelled and government hospitals.
  • Investigations at empanelled and government diagnostic centres.
  • Cashless facility for the treatment in diagnostic centres and empanelled hospitals. 
  • Reimbursement of expenses for the treatment availed in private or government hospitals under emergency.
  • Reimbursement of expenses incurred for purchasing artificial limbs, hearing aids, appliances, etc., as specified.
  • Maternity, family welfare and child health services.
  • Dispensing of medicines and medical consultation and in Homeopathy, Ayurveda, Siddha and Unani system of medicines (AYUSH).

CGHS Contribution

The monthly subscription to be paid by the CGHS beneficiaries for obtaining the CGHS facility are as follows:

Corresponding levels in the pay matrix as per 7th CPCContribution (Rs. per month)
For levels 1 to 5Rs.250
For level 6Rs.450
For levels 7 to 11Rs.650
For levels 12 and above Rs.1000

The private hospital wards empanelled under the CGHS are available based on each individual’s pay grade. The ward entitlement under the CGHS is as follows:

Corresponding basic pay drawn by the officer in 7th CPC per monthWard entitlement 
Up to Rs.47,600General ward
Above Rs.47,601 to Rs.63,100Semi-private ward
Rs.63,101 and abovePrivate ward

CGHS Registration Process

The serving employees must submit the registration form with the photos of eligible family members to the ministry, office or department, where he/ she is employed. The ministry, office or department will forward the application form to the office of the additional director CGHS of the city for the preparation of the CGHS card.

The CGHS cards are distributed through the wellness centres. The employees can obtain medical facilities provided under the CGHS through the CGHS card. A pensioner can register for the CGHS scheme and get the CGHS card by visiting the office of the Joint Director or Additional Director of their city.

The pensioners must submit the following documents for pensioner registration:

  • Address proof of the pensioner and their dependants.
  • Photographs of the beneficiary family members.
  • Age proof of the pensioner’s dependant.
  • Surrender certificate if the pensioner has an active CGHS card.
  • Disability certificate, if applicable.
  • Attested copies of the last pay certificate.
  • Demand draft for the required amount towards the CGHS contribution.
  • Provisional card if PPO is not provided.

CGHS Card

A CGHS card is a plastic card given to the eligible beneficiaries of the CGHS by the Indian government. It consists of a beneficiary ID number and photo ID. A beneficiary and eligible family members of the beneficiaries of the CGHS can receive medical benefits under the scheme when they present the CGHS card in the hospital/diagnostic centres.

In case the beneficiaries lose the card, they need to report it to the police station and the CGHS authorities. The beneficiaries need to submit a copy of the FIR, application form, and a penalty of Rs.50 to obtain a duplicate card.

Validity of the CGHS Card

The validity of the CGHS card for different beneficiaries are as follows:

  • The CGHS card is valid till the date of retirement in the case of the serving employee.
  • In the case of yearly contribution pensioner cards, the contribution is to be made prior to the completion of the continuing year, to continue the card’s validity.
  • In the case of transfer of serving employee to a non-CGHS covered area, the CGHS service card is valid for the family members up to six months after the transfer provided the CGHS contribution for six months is made in advance.
  • The CGHS card is valid in all the CGHS cities for investigation, treatment and hospitalisation. 
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