The Union Budget of 2022-23 reported the number of Central Government employees to be 3.18 million in 2020. Due to such a huge employee workforce, it is crucial to secure the healthcare requirements of serving and retired employees with sufficient medical insurance. To ensure complete coverage against planned as well as emergency medical treatment, the Indian Government has launched various health schemes for State and Central Government employees. These government schemes for employees also cover retired staff and dependent family members. In this article, let us go through the details of government employee health insurance plans.
Launched in 1954, the Central Government Health Scheme provides insurance coverage to current and former Central Government employees. The beneficiaries of the scheme include dependent family members residing in areas covered under CGHS, pensioners, freedom fighters, Delhi police personnel, etc. The Central Government employees insurance scheme offers healthcare facilities such as OPD treatment, specialist consultation, cashless hospitalisation at empanelled hospitals, and maternity cover. Employees can easily opt for the CGHS scheme through the online and offline modes and get the CGHS card to avail the insurance benefits.
The West Bengal Health Scheme is a health insurance welfare scheme for State Government employees. The WBHS scheme was launched in 2008 but underwent a revamp in 2014. The West Bengal Government employees, pensioners and their family members can avail a cashless facility in the event of a medical emergency. Providing a sum insured of ₹1 Lakh, the health plan covers cashless hospitalisation, OPD treatment, out-of-state hospitalisation and reimbursement of treatment costs at non-network centres. The government employee health insurance plan includes 1,000 medical procedures with varying extent of coverage offered based on the type of treatment.
Introduced to secure the healthcare needs of State Government employees of Telangana, the Employees and Journalists Health Scheme was implemented by the Aarogyasri Health Care Trust. Under EJHS, serving government employees, pensioners, journalists and dependent family members can avail a cashless medical facility at empanelled hospitals. A key feature of such health insurance for State Government employees is that there is no upper limit to the coverage offered. Beneficiaries can avail healthcare services such as OPD, in-patient treatment, follow-up facility, post-hospitalisation coverage and more. Government employees can avail the EJHS health card by visiting the official portal to enjoy a cashless cover.
The health insurance schemes for State Government employees are as follows:
Central Government Health Scheme
West Bengal Health Scheme
Employees and Journalists Health Scheme
If you are a State Government employee in West Bengal, your family members are eligible for coverage provided they meet a few conditions:
Dependent parents with an income of less than ₹3,500 per month
Siblings below 18 years of age
Children (Step-children, adopted children, including unmarried, widowed, and divorced daughters)
Dependent sister (Unmarried, widowed, or divorced)
Yes, it is possible to add or delete names on the CGHS card. If the government employee gets married or has a child, they can easily add their spouse/child to the scheme by submitting the endorsed form.
The Central Government Health Scheme provides insurance benefits to dependent sons and daughters. However, there is an age limit applicable which shall differ for your son and daughter.
The dependent daughter is eligible for CGHS benefits until she starts to earn, without any bar on age.
The dependent son is eligible for CGHS benefits till he gets married or starts earning. If he suffers from any permanent disability, he is eligible beyond the age of 25 years.
Yes, the stepchildren of serving employees and pensioners are eligible for insurance cover under EJHS.
Employees or pensioners do not have to make any contribution towards EJHS as the entire cost of the health scheme is borne by the government of Telangana.