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What is CGHS?

In 1954, the Central Govt Health Scheme was launched for the current as well as former employees of the Central Government of India. The Government of India has specially crafted the scheme for the betterment of the beneficiaries. Therefore, medical services are facilitated through CGHS dispensary or clinic under allopathy, Ayurveda, homoeopathy, and so on.

 

In a country like India, which has the highest population living below the poverty line, healthcare is a major concern. The inadequacy of funds limits access to quality medical facilities. The Central Government Healthcare Scheme (CGHS) has been introduced to combat the health issues of all the employees of the Central Government.

 

The CGHS scheme is a broader concept of health insurance. Hence, an individual must understand the basics of the plan before opting for it. Given below are the details of the Central Govt Health Scheme. Take a look:

Every health insurance policy consists of specific components based on the needs and preferences of an employee. Here’s a closer look at the components of the CGHS health scheme:

CGHS Eligibility Criteria

Mentioned below is the eligibility criteria for Central Govt Health Scheme:

  • Employees who acquire wages from the Central civil estimates

  • Beneficiaries of the family members who receive wages from Central civil estimates

  • Dependents of those families who reside in the areas covered under the Central Govt Health Scheme

  • Pensioners of the Central Government

  • Parliament members

  • Former Vice Presidents

  • Formers and Lieutenant Governors

  • Current or retired judges of the supreme court and the high court

  • Post and telegraph department employees

  • Delhi police personnel

  • Freedom fighters

  • Press Information Bureau journalists

  • Railway board employees

There are multiple facilities offered under the Central Government Health Scheme for the betterment of the employees. Take a look at the following facilities provided by the central health scheme mentioned below:

Facilities Offered Under CGHS

  • OPD treatment and medication costs

  • Consultation at the government or polyclinic hospitals

  • Indoor treatment at government or CGHS empanelled hospitals

  • Investigations at government or CGHS empanelled hospitals

  • Cashless facilities in CGHS empanelled hospitals and diagnostic centres

  • Reimbursement for treatments, purchase of products like hearing aids, artificial limbs, appliances, etc.

  • Maternity and child health services and family welfare

  • Medical consultation and dispensing medicines for AYUSH

Different Types of Medical Systems Covered Under Central Govt Health Scheme

Following medical systems are covered under the Central Government Health Scheme:

  • Indian system of medicine

  • Unani

  • Siddha

  • Homoeopathic

  • Ayurveda

  • Allopathic

  • Yoga

Treatments Not Covered Under CGHS

You cannot address the follow-up and in-patient treatments in case of:

  • A declared emergency

You can avail the treatment at any hospital, but the reimbursement can only be done at the Additional General where the CGHS card is registered.

  • Reimbursement of medical bills

You can avail treatment at any hospital, but the claim amount is limited to the rates mentioned under the Central Govt Health Scheme. Again, the claim needs to be done at the Additional General, where the CGHS card is registered.

Cities Covered Under Central Govt Health Scheme

Agartala

Cuttack

Jalandhar

Patna

Vijayawada

Agra

Darbhanga

Jammu

Puducherry

Vishakhapatnam

Ahmedabad

Dhanbad

Jodhpur

Pune

 

Aizwal

Dehradun

Kannur

Raipur

 

Ajmer

Delhi & NCR

Kanpur

Ranchi

 

Aligarh

Dibrugarh

Kohima

Rajahmundry

 

Allahabad (Prayagraj)

Gandhinagar

Kolkata

Saharanpur

 

Ambala

Gangtok

Kochi

Shillong

 

Amritsar

Gaya

Kota

Shimla

 

Baghpat

Gorakhpur

Kozhikode

Silchar

 

Bengaluru

Guwahati

Lucknow

Siliguri

 

Bareilly

Guntur

Meerut

Sonepat

 

Berhampur

Gwalior

Moradabad

Srinagar

 

Bhopal

Hyderabad

Mumbai

Thiruvananthapuram

 

Bhubaneshwar

Imphal

Muzafferpur

Varanasi (Benaras)

 

Chandigarh

Indore

Nagpur

Tiruchirapalli (Trichy)

 

Chennai

Jabalpur

Nellore

Tirunelveli

 

Chhapra

Jaipur

Panaji

Vadodara

 

Cost Details of CGHS Facilities

The cost of Central Govt Health Scheme facilities depends on your employment status. Here’s how it is classified.

1. For Pensioners

If a pensioner wants to avail the CGHS facilities, they will have to make a contribution as per the pay grade that they received when in service. This contribution can be done annually or as a one-time contribution.

 

  • Annual Contribution:

Here, a specific amount (depending on your pay grade) is contributed towards the CGHS facility.

 

  • One Time Contribution:

Here, the contribution is made only once towards the CGHS for 10 years. The amount contributed will be considered as a lifetime contribution.

 

2. For Serving Government Employees

If you are a Central Government employee and serving in CGHS covered location, then you can take a CGHS card. Your department will make monthly deductions from your salary (depending on your pay grade) and contribute it to the CGHS facilities.

Contribution Towards Central Govt Health Scheme

Private hospital wards that are empanelled under CGHS are available based on your (each individual’s) pay grade. The ward entitlement under CGHS is as follows:

Ward Entitlement

Corresponding Monthly Basic Pay Drawn by the Officer in 7th CPC

General Ward

Up to ₹47,600

Semi-Private Ward

₹47,601 to ₹63,100

Private Ward

₹63,101 and above

Registration Process for Central Govt Health Scheme

1. For Current Employees

Follow the steps given below to apply for a Central Govt Health Scheme:

  • Log in to the online portal

  • Submit an application form

The CGHS application form is available on the official website of the Central Government. One can avail it from any of the authorised CGHS wellness centres run by the Central Government of India.

Documents Required for Employee Registration

  • Application form in the prescribed format

  • Photographs of beneficiary family members

  • Necessary documents of the family members

2. For Pensioners

A pensioner can register for the Central Govt Health Scheme and get a CGHS card by visiting the office of the Joint Director or Additional Director of their city.

Documents Required for Pensioner Registration

  • Application form in the prescribed format

  • Address proof of the pensioner

  • Address proof of the pensioner’s dependant

  • Age proof of the pensioner's dependant

  • Photographs of the beneficiary family members

  • Disability certificate, if applicable

  • Surrender certificate, if the pensioner has an active CGHS card

  • Attested copies of Last Pay Certificate

  • Provisional card, if PPO is not provided

  • Draft for the required amount towards CGHS contribution

The government has also launched the Ayushman Bharat Yojana to make health and wellness centres (HWCs) accessible to the underprivileged segments of society. For Ayushman Bharat Yojana registration and eligibility check, you can head to the official PMJAY website. Let’s have a look at how to book the CGHS appointment online.

CGHS Online Appointment Process

To book CGHS online appointment, follow the steps below:

 

  1. Visit the official CGHS online portal.

  2. Enter your ID (beneficiary ID) and Generate OTP (One-Time Password).

  3. Enter the OTP you receive on the registered mobile number and select ‘Proceed’.

  4. Here, your (the beneficiary’s) details will be displayed. Proceed in case the details shown are correct or select ‘Not You’. If you select the ‘Not You’ option, you will have to do CGHS login again to proceed.

  5. If the details shown are accurate, the next page allows you to choose Specialty, CGHS Dispensary, and Doctor. Click on ‘Proceed’ after doing the needful.

  6. Here, a calendar will be displayed for you to choose the date of your appointment according to the availability of the selected doctor.

  7. After choosing your CGHS online appointment date, the screen will display slot timings and available appointments. Choose your desired slot timing.

  8. Select ‘Proceed to Book Appointment’. Know that you can always go back and make the necessary changes by choosing ‘Change the Speciality’.

  9. Upon proceeding to book CGHS online appointment, your details, along with the summary of your CGHS appointment, will be displayed on the screen for confirmation.

  10. Choose ‘Confirm to Book Appointment’ and a confirmation status will appear in no time. This confirmation receipt can be printed, or another CGHS online appointment can be booked (if necessary). The system will also send a confirmation SMS to your registered contact number.

What is a CGHS Card?

A CGHS card is a plastic card provided to each employee by the Indian government. It consists of a photo ID and a beneficiary ID number. When an employee presents the CGHS card, they receive the benefits of the scheme. The employees need to report to the police station and CGHS authorities in case they lose the card. In order to obtain a duplicate card, the employee needs to submit a copy of the FIR, application form, and a penalty of ₹50.

The CGHS plastic card is white, having a coloured stripe at the top. This strip can be of any of the following colours and depicts the status of the cardholder:

 

  1. Red – Is a member of the parliament.

  2. Blue – Is a serving government employee.

  3. Green – Is a freedom fighter, pensioner, retired personnel, or an ex-MP.

  4. Yellow – Is a journalist and beneficiary of an autonomous company.

Features of the CGHS Card

Here are the salient features of the CGHS card:

 

  • After the CGHS card expires, it needs to be surrendered to the concerned department. In case of renewal, a form and necessary details should be submitted.

  • The CGHS card cannot be transferred from one employee to another.

  • Misusing the CGHS card will attract penalties and disciplinary actions (in extreme cases).

How to Apply for a CGHS Card?

People who are eligible under CGHS have to submit an application form available on the www.cghs.nic.in or www.cghs.gov.in websites. The application form is available at the CGHS wellness centres as well.

Though you cannot upload the supporting documents online, you can submit the application form on the official CGHS website. Here’s how you can apply for the CGHS card online:

 

  • Fill the entire application form with the correct details and attach photos in the designated areas.

  • Submit the application form online and take a printout.

  • Attach supporting documents.

  • Ensure the paperwork is duly endorsed by the Head of the Department or Office for serving employees.

  • Submit the paperwork to the Additional Director HQ office in Delhi or Additional Director’s office in other cities.

Serving employees can apply for a pensioner CGHS card in the following way:

 

  • Submit an application with bank draft and enclosures to the CGHS from the employee’s office.

  • The pensioner card will be issued on the retirement day and activated the next day if the application was completed six weeks before the retirement date.

Documents Required for CGHS Card

Based on the applicant’s status, the following documents are required along with a duly filled application form:

Type of Applicant

Documents

For Serving Employees

  • Proof of residency

  • Age proof of the dependent

  • Proof of stay of the dependent

  • Disablement certificate from a valid authority in case the dependent is differently-abled

For Pensioners

  • Proof of residency

  • Age proof of the dependent

  • Proof of stay of the dependent

  • Disablement certificate from a valid authority in case the dependent is differently-abled

  • Attested copies of PPO/Provisional PPO/Last Pay Certificate

  • Surrender Certificate, if CGHS card was issued during service

  • Demand Draft

 Validity of the CGHS Card

  • For serving employees, the CGHS card is valid until the day of their retirement.

  • To extend/continue the validity of the CGHS card after retirement, a contribution has to be made a year prior to the completion year. Note that the CGHS card is valid in application cities only.

  • For employees transferred to non-CGHS covered regions, the CGHS card shall be valid for family members for up to 6 months after the transfer, if the contribution was made beforehand.

  • CGHS card is valid in all CGHS covered regions for hospitalisation, treatment and investigation. Thus, a transfer permit to get treatment in another CGHS city is required only for high-value medicines that are classified as lifesaving or restricted supply medicines.

Transfer of CGHS Card

  • For the transfer of serving employees from one department or ministry to another in the same city, the current CGHS card can be used. The necessary changes shall be made in the employee database.

  • For the transfer of serving employees from one CGHS covered city to another, the same CGHS card can be used. An application along with the transfer order needs to be submitted to the AD of the present CGHS city.

The transfer of the card to the new city shall be completed online. The employee can then validate the card by submitting the application and supporting documents to the AD of the new CGHS city.

CGHS Card for Pensioners Residing Outside CGHS Cities

  • Pensioners living outside CGHS covered cities can use the regular CGHS Card or an Indoor Treatment (IPD) CGHS card with a fixed medical allowance from the nearby CGHS city.

  • Moreover, IPD cardholders cannot seek OPD treatment or receive medicines from CGHS wellness centres.

Printing CGHS Card

An acknowledgement letter will be issued to the applicant after the application for a CGHS plastic card has been accepted. The letter containing the card number and the Ben. ID of all family members can be used to avail healthcare services at the CGHS wellness centre.

Plastic cards are available one month after application at the parent wellness centre. The beneficiary can also self-print the CGHS card online through beneficiary login where the e-CGHS card is equivalent to the CGHS plastic card. You can download the e-CGHS card for you and your dependents in a PDF format and get a colour printout to laminate it. Following the below steps to self-print the card:

 

  1. Visit the official CGHS online portal (https://cghs.nic.in/).

  2. Click on the ‘Beneficiaries’ option present in the top menu bar and select ‘Beneficiary Login’.

  3. Enter your beneficiary ID, password and the correct captcha code to sign in.

  4. Click on ‘Print Card’ for the members who require the CGHS card.

  5. Input the OTP sent to your registered mobile number and click on ‘Print CGHS Card’.

  6. A message requesting a coloured printout along with lamination shall be visible on screen.

  7. Proceed to download and open the e-CGHS card online and print it.

Conclusion

To sum it up, CGHS offers its applicants comprehensive healthcare coverage that is highly beneficial in the long run. CGHS is useful for every citizen, whether you are a Central Government employee or a pensioner, due to the financial assistance and quality services offered under the scheme. Moreover, the security of your dependents enables you to have peace of mind.

You can also read about the PMJAY scheme, which is a game-changer in the public health care sector. This is an initiative started by the government of India to make medical facilities accessible to all citizens of the country.

Apart from these government schemes, you can also give yourself and your loved ones added financial security by opting for health insurance. At Bajaj MARKETS, you can choose from a wide range of health insurance options. So do not put your plans on hold anymore. Get your hands on the best-suited health insurance plan from Bajaj MARKETS now!

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FAQs on Central Government Health Scheme

✔️What is CGHS full form?

The CGHS full form is Central Government Health Scheme.

✔️What is the application process for the Central Govt Health Scheme?

Follow the steps given below to apply for a CGHS Scheme:

Step 1: Log in to the online portal.

Step 2: Submit an application form The application form is available on the official website of the Central Government. One can avail it from any of the authorised wellness centres run by the Central Government of India.

Step 3: Submit the required documents.

✔️Can you add or delete names on the CGHS card?

Yes. In case the employee gets married or has a child, they can get their spouse/child added by submitting the endorsed form. If the cardholder dies, the CGHS card becomes invalid, and the dependent has to apply for a new card by attaching the old CGHS card and death certificate of the previous dependent.

✔️Is there any age limit for sons/daughters as dependent on the CGHS card?

Under the Central Government Health Scheme, the sons and daughters are eligible to obtain the CGHS benefits. However, the age limit for them is different.

The son is eligible to avail CGHS facilities till he starts earning or gets married. In case he suffers from permanent disability, he is eligible to avail the benefits even after crossing 25 years of age.

The daughter can avail the CGHS benefits until she starts earning, irrespective of her age.

✔️Can step-children avail the facilities under CGHS?

Yes. Step-children, when enlisted as dependents, can avail the facilities under CGHS.

✔️How long does it take to get the CGHS card?

Usually, the employee gets a computerised printout of the card on the same day they submit the application. However, it takes up to 3-4 weeks to get the plastic card made and delivered.