msotransparent.nic.in CGHS Central Government Health Scheme : Ministry of Health & Family Welfare

Organization : Ministry of Health & Family Welfare
Service Name : CGHS Central Government Health Scheme
Country: India

Website : http://msotransparent.nic.in/cghsnew/index.asp

What is Central Government Health Scheme?

The “Central Government Health Scheme” (CGHS) provides comprehensive health care facilities for the Central Govt. employees and pensioners and their dependents residing in CGHS covered cities.

Related / Similar Facility : CGHS Plastic CG Health Scheme Identity Card

Started in New Delhi in 1954, Central Govt. Health Scheme is now in operation in Allahabad ,Ahemdabad ,Bangalore , Bhubhaneshwar ,Bhopal ,Chandigarh , Chennai ,Delhi , Dehradun ,Guwahati , Hyderabad , Jaipur , Jabalpur , Kanpur , Kolkatta , Lucknow , Meerut , Mumbai , Nagpur , Patna , Pune , Ranchi , Shillong , Trivandrum and Jammu.

The Central Govt. Health Scheme provides comprehensive health care to the CGHS Beneficiaries in India. The medical facilities are provided through Wellness Centres(previously referred to as CGHS Dispensaries) /polyclinics under Allopathic, Ayurveda, Yoga, Unani, Sidha and Homeopathic systems of medicines.

Facilities of CGHS Scheme

1. All Central Govt. employees and their dependant family members residing in CGHS covered areas.
2. Central Govt Pensioners and their eligible family members getting pension from Central Civil Estimates
3. Sitting and Ex-Members of Parliament
4. Ex-Governors & Lt. Governors
5. Freedom Fighters
6. Ex-Vice Presidents
7. Sitting and Ex-Judges of Supreme Court & High Courts
8. Employees and pensioners of certain autonomous organizations in Delhi
9. Journalists (in Delhi )Accredited with PIB ( for OPD & at RML Hospital)
10. Delhi Police Personnel posted in Delhi
11. Railway Board employees

In how many cities CGHS is presently operative?:
CGHS facilities are available in 25 cities in India:
1. Ahmedabad 2. Allahabad 3. Bengaluru 4. Bhopal 5. Bhubaneswar 6. Kolkata 7. Chandigarh 8 Chennai 9.Dehradun 10.Delhi & NCR 11.Guwahati 12. Hyderabad 13. Jabalpur, 14. Jaipur 15 Jammu 16. Kanpur 17. Lucknow 18. Meerut 19. Mumbai 20. Nagpur 21 Patna 22.Pune 23. Ranchi 24. Shillong 25. Thiruvananthapuram

For CGHS cards , as dependant , what is the meaning of the word “ family”:
The term ‘family’ means and includes:-
1. Husband or wife as the case may be and other dependant family members.
2. Dependant Family Members: parents, sisters, widowed sisters, widowed daughters, minor brothers and minor sister, children and step-children wholly dependent upon the Government Servant and are normally residing with the Government Servant. Also now included , dependent divorced / separated daughters ( including their dependant minor children) and step-mother.
3. The term dependency means that income from all sources including pensions and pension equivalent of DCRG benefit is less than Rs.3500/- plus amount of DA on Basic pension of Rs3500/-per month. However, there is no such clause as dependency in respect of spouse.

What is the procedure to register with the CGHS?:
Pensioners:
1. One can get a CGHS card made from the office of AD / JD of the City.
2. Forms can be downloaded from CGHS Website or can be taken from office of AD / JD of city.

3.Documents required
i. Application in prescribed format
ii. Proof of Residence /proof of Stay of dependents
iii. Proof of age of son
iv. Disability certificate, if any in case of sons aged 25 & above, who would otherwise cease to be a beneficiary.
v. Photos of eligible family members
vi. Surrender Certificate of CGHS Card while in service ( only in those cases where CGHS Card was issued while in service)
vii. Attested copies of PPO & Last Pay Certificate
viii. Draft for required amount towards CGHS contribution – in the name of ‘P.A.O., CGHS New Delhi’ in Delhi-and in the name of ‘AD, CGHS of the city’.
ix. In case PPO is not ready for any reason there is option to get a provisional card on the basis of Last Pay Certificate.
x. The data is entered through computers and entered in data base and a print out is issued same day for immediate use. Plasticcards are subsequently sent to the residence of the card holder by post.

CGHS Serving Employees

Serving employees submit the forms in prescribed format enclosing photos of eligible family members and submit to the Ministry / Department/Office , where he / she is employed. The application form shall be forwarded by the Ministry / Office /Department to the office of Addl. Director CGHS of city for preparation of card. Print out is issued for immediate use.

What is the system for the services of specialists in Dispensaries? :
Prior registration is required appointment with the CGHS Wellness Centre, where specialist services are available. However, In case of emergency contact CMO i/c of dispensary of Wellness Centre for consulting specialist without prior appointment.

Is there any interactive mechanism at dispensary level?:
At the Wellness Centre ‘Local Advisory Committees’ are formed. CMO i/c holds a meeting with Local Advisory Committee members to discuss local dispensary related issues.

How long does it take to get the CGHS Cards?:
Normally computerized printout of index card is issued on the same day. Plastic cards are sent to the residence in ‘3’ weeks time.

Whom Should I approach in case the CGHS Card is not issued to me in the prescribed time?:
Contact Joint Director (HQ), CGHS, CGHS building ,RK Puram Sector-12, New Delhi in case of Delhi and Addl. Director of City in case of other cities.

What should I do if I lose my CGHS Cards ?:
Application is to be submitted to AD/JD along with two photographs and a IPO for Rs. 50/- for issue of duplicate card. Indian Postal Order payable to “ P.A.O. CGHS”.

What should I do if the details on the Card viz. name, date of birth, entitlement, etc. are wrong?:
Kindly bring the anomalies to the notice of Joint Director, CGHS (HQ), and CGHS building, RK Puram Sector-12, New Delhi in Delhi and to the Addl. Director, Joint Director of concerned CGHS City in other cities.

Is there a colour scheme for plastic cards? What are the details?:
CGHS Plastic cards have the following colour at the top:
i. Serving Government employees Blue
ii. Pensioners, ex-MPs , Freedom Fighters, etc.,_ – Green
iii. Member of Parliament – Red
iv. Beneficiaries of Autonomous Bodies / Journalist Yellow

I retired in 1998 from Central Govt. but, I never made a CGHS card. Can I get a card now?:
Pensioners can apply for CGHS card with relevant documents. However, the subscriptions as applicable at current rates shall have to be paid.

My husband/wife is also employed under Central Government and is eligible for a separate CGHS Card. Is it necessary that separate cards are to be obtained?:
No. Spouse drawing higher pay shall make the card and other spouse is eligible to avail CGHS benefits as member.

Are step-children allowed CGHS facilities?:
Yes. If they are dependent on card holder: other conditions as in case of dependant sons and daughters.

Can dependent in-laws be included under family members for CGHS facilities?:
A lady Government servant will be given a choice to include either her parents or parents –in-law for the purpose of availing the benefits under CGHS subject to the condition of dependence and residence, etc., being satisfied. Such option is not available for male Government servants

Features of CGHS Scheme

Central Government Health Scheme (CGHS) is a government-sponsored health insurance scheme for central government employees and their families. The scheme was launched in 1954 and is administered by the Ministry of Health and Family Welfare, Government of India.

CGHS provides comprehensive health care services, including:
** Outpatient care: CGHS covers outpatient care at CGHS dispensaries and polyclinics.
** Inpatient care: CGHS covers inpatient care at CGHS hospitals.
** Prescription drugs: CGHS covers the cost of prescription drugs.
** Outpatient diagnostic tests: CGHS covers the cost of outpatient diagnostic tests.
** Inpatient diagnostic tests: CGHS covers the cost of inpatient diagnostic tests.
** Transport reimbursement: CGHS reimburses the cost of transportation to and from the hospital.
** Cashless treatment: CGHS beneficiaries can avail cashless treatment at empaneled hospitals.