Central Government Health Scheme (CGHS)

Different Types of Medical Systems Covered Under Central Government Health Scheme

One of the many advantages of the Central Government Health Scheme is that it covers both mainstream and alternative medicinal practices. Let’s take a look at the entire range of medical systems covered by CGHS:

• Indian systems of medicine

• Unani

• Siddha

• Homoeopathy

• Ayurveda

• Allopathy

• Yoga

How to Apply for a CGHS Card?

If you are eligible for the Central Govt Health Scheme, you can apply for a CGHS card by submitting an application along with the supporting documents. The application form is available at www.cghs.nic.in or www.cghs.gov.in. Alternatively, you can also get the form from any of the CGHS wellness centres. Here’s how you can apply for a CGHS card:

• Step 1: Fill out the entire application form with the correct details and attach photos in the designated areas.

• Step 2: Attach all the supporting documents.

• Step 3: Ensure the paperwork is duly endorsed by the Head of the Department or Office for serving employees.

• Step 4: Submit the paperwork to the Additional Director HQ office in Delhi or the Additional Director’s office in any of the other CGHS-covered cities.

If you’re a serving employee who is closer to retirement, you can apply for a pensioner CGHS card. The process you would have to follow in this case is listed below. 

• Step 1: Submit an application along with a bank draft and supporting documents to CGHS from the employee’s office.

• Step 2: 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.

Central Govt Health Scheme Components

The Central Government Health Scheme provides its beneficiaries with a host of health care benefits. Listed below are a few of the benefits that individuals registered under the scheme can avail of:

• Dispensary services and domiciliary care

• Specialist doctor’s consultation at CGHS dispensary, hospital and clinic

• X-Ray, ECG and other laboratory examinations

• Hospitalisations

• Services related to maternity, child health and family welfare  

• Distribution and supply of medicines

• Health Education

Central Government Health Scheme Beneficiaries

People belonging to the below-mentioned categories are eligible to become beneficiaries for Central Government 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

Types of Medical Systems Covered Under CGHS 

The following types of medical systems are covered under the Central Government Health Scheme:

• Allopathy

• Homoeopathy

• Ayurveda

• Unani

• Siddha

• Yoga

• Indian System of Medicine

Facilities Offered Under CGHS

The Central Govt Health Scheme has been designed to offer comprehensive medical care to the registered beneficiaries and their dependents. The list of facilities offered by CGHS-authorised wellness centres are listed below.

• 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

CGHS Eligibility Criteria 

To become eligible for the Central Government Health scheme, one must qualify under the below-mentioned parameters -

• Beneficiary should be a native of India

• Central government employees who receive remuneration from Central Civil Estimates are eligible for this scheme. The benefits of the scheme can also be availed by the family members of government employees.

• Retired employees of the Central Government who receive pensions are also eligible for this scheme. The benefits of the scheme can also be availed by the family members of retired government employees.

• Parliament members, High court & Supreme court judges, ex-governors, ex-vice presidents, freedom fighters, etc., are eligible for this scheme.

• Journalists from Press Information Bureau

• Railway Board employees

• Delhi Police 

• Retired and current employees of autonomous bodies that offer CGHS perks in Delhi

• Employees of Post and Telegraph Department in India

Treatments Not Covered Under Central Government Health Scheme

The Central Government Health Scheme does not cover certain follow-up and in-patient treatments. Let’s take a look at the disallowed treatments:

• A declared emergency - You can avail of the treatment at any hospital, but the reimbursement can only be done at the Additional General’s office where the CGHS card is registered.

• Reimbursement of medical bills - You can avail of 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’s office where the CGHS card is registered.

Cities Covered Under Central Govt Health Scheme

The Central Govt Health Scheme has been made available only in certain specified cities of India. Here’s an overview of the cities that are covered by CGHS. 

Cost Details of CGHS Facilities

To access the facilities offered by the Central Government Health Scheme, you would have to make a contribution. The amount of contribution you’re required to make is dependent on your employment status. The contribution that you would have to make if you’re a serving employee or a pensioner is as follows. 

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

• Pensioners - If you’re a pensioner who wants to avail of the CGHS facilities, you will have to make a contribution according to your pay grade when in service. This contribution can be done annually or as a one-time contribution.

• Annual Contribution - Here, a specific amount (depending on your last pay grade) is contributed towards the CGHS facility.

• One-Time Contribution - Here, the contribution is made only once towards CGHS for 10 years. The amount contributed will be considered a lifetime contribution.

Contribution Towards Central Govt Health Scheme

The entitlement of wards in private hospitals empanelled under the CGHS scheme is based on the pay grade of the individual. Check out the table below for more information on ward entitlement: 

Registration Process for Central Govt Health Scheme

The process that you would have to follow to register for the Central Government Health Scheme varies depending on whether you’re a serving employee or a pensioner. Here’s an overview of the process that you would have to follow: 

1. For Current Employees 

• Step 1: Visit the CGHS online portal. 

• Step 2: Download the application form, fill it and attach all the supporting documents including photographs. 

• Step 3: Get the application form duly endorsed by the Head of your Department or your Office.

• Step 4: Submit the same at the Additional Director HQ office in Delhi or the Additional Director’s office in any of the other CGHS-covered cities. 

Note: The application form can be taken from any of the authorised CGHS wellness centres run by the Central Government of India as well. 

Documents to be Submitted by Current Employees 

• The 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 to be Submitted by Pensioners

• The application form in the prescribed format

• Address proof of the pensioner

• Address proof of the pensioner’s dependants

• Age proof of the pensioner's dependants

• Photographs of the pensioner’s 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

CGHS Online Appointment Process

You can quickly book a CGHS online appointment for a wellness centre online. All that you need to do is follow the steps listed below.

• Step 1: Visit the official CGHS online portal.

• Step 2: At the CGHS login, enter your ID (beneficiary ID) and generate an OTP (One-Time Password).

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

• Step 4: Here, your details will be displayed. Proceed in case the details shown are correct, otherwise select ‘Not You’. If you select the ‘Not You’ option, you will have to do CGHS login again to proceed.

• Step 5: If the details shown are accurate, the next page allows you to choose the speciality, the CGHS dispensary, and a doctor. Click on ‘Proceed’ after doing the needful.

• Step 6: A calendar will be displayed, which you can use to choose the date of your appointment according to the availability of the selected doctor.

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

• Step 8: Select ‘Proceed to Book Appointment’. You can always go back and make the necessary changes by choosing ‘Change the Speciality.

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

• Step 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 central government employees. It consists of a photo ID and a beneficiary ID number. Employees with the CGHS card can avail the benefits of the scheme by presenting it at an authorised wellness centre. 

Cardholders need to report to the police station and the 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, and application form, and pay a penalty of ₹50.

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

• Red – The cardholder is a Member of the Parliament (MP)

• Blue – The cardholder is a serving government employee

• Green – The cardholder is a freedom fighter, pensioner, retired personnel or an ex-MP

• Yellow – The cardholder is a journalist and beneficiary of an autonomous company

Features of the CGHS Card

The Central Government Health Scheme (CGHS) card has several salient features. Check out a few of them below. 

• Limited Validity - The CGHS card is valid only for a limited period of time. After the CGHS card expires, it either has to be surrendered to the concerned department or renewed. In case of renewal, a form and necessary details should be submitted.

• Non-Transferable -  Once a CGHS card is issued to an employee, it continues to remain with the employee and cannot be transferred from one employee to another.

• Available Only to Beneficiaries - The benefits are only available to the beneficiaries listed on the card. Misusing the CGHS card will attract penalties and disciplinary actions (in extreme cases)

Documents Required for CGHS Card

The documents that you’re required to submit as part of the Central Govt Health Scheme application process may vary depending on whether you’re a serving employee or a pensioner. Here’s an overview of the list of documents required for the card. 

1. For Serving Employees 

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

• Proof of stay of the dependent

• Age proof of the dependent

• Proof of residency

2. For Pensioners

• Proof of residency

• Age proof of the dependent

• Proof of stay of the dependent

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

• Attested copies of PPO, Provisional PPO or Last Pay Certificate

• Surrender Certificate, if CGHS card was issued during service

• Demand Draft

Validity of the CGHS Card

In the case of serving employees, the CGHS card is valid until the day of their retirement. To extend or continue the validity of the CGHS card after retirement, a contribution has to be made a year prior to the completion year. Here’s something that you should note. The CGHS card is valid only in specified cities.

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

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

Transfer of CGHS Card

In the case of a 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 city covered by CGHS to another, the same CGHS card can be used. However, an application along with the transfer order needs to be submitted to the Additional Director of the present CGHS city. The transfer of the card to the new city needs to be completed online. Once that’s done, the employee can then validate the card by submitting an application and supporting documents to the Additional Director of the new CGHS city.

CGHS Card for Pensioners Residing Outside CGHS Cities

The Central Govt Health Scheme is only available in a few notified cities. If you’re a pensioner living outside cities covered by CGHS, you can use the regular CGHS Card or an Indoor Treatment (IPD) CGHS card with a fixed medical allowance by travelling to a nearby city covered by the scheme. That said, IPD cardholders cannot seek OPD treatment or receive medicines from CGHS wellness centres.

Printing CGHS Card

Once your application for a CGHS plastic card is accepted, you will receive an acknowledgement letter. This letter contains the card number and the Beneficiary ID of all the family members, which can be used to avail of healthcare services at the CGHS wellness centre.

Plastic CGHS cards are available one month after application at the parent wellness centre. Alternatively, you can download the e-CGHS card for you and your dependents via the beneficiary login, get a colour printout and laminate it. To self-print the card, follow the steps below. 

• Step 1: Visit the official CGHS online portal https://cghs.nic.in/

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

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

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

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

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

• Step 7: Proceed to download the e-CGHS card, print it in colour and laminate it.

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