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Central Government Health Scheme (CGHS)

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CGHS beneficiary can also claim Health Insurance

The Central government employees - serving and retired, who have subscribed to the Central Government Health Scheme (CGHS) in present and in the past, would now be able to claim reimbursement of their actual hospitalization expenses beyond the CGHS package rates. This is mainly on account of the government easing the regulations and the conditions that enable such government employees to utilize healthcare insurance policies for enhanced spending. As a result, this could spur demand for additional insurance policy covers from the concerned government employees. A recent circular from the Ministry of Health and Family Welfare (MOHFW) states that CGHS beneficiaries will be allowed to claim their hospitalization expenses not only from CGHS/ministry but also from Insurance Companies (or Insurers) provided that the reimbursement being claimed by such an employee does not exceed the total medical expenditure incurred by the beneficiary.

Earlier, CGHS beneficiaries could claim the benefits provided under CGHS Act provided that the incurred amount did not exceed prescribed package rates. For this purpose, CGHS has empanelled select hospitals on their list that follow the package rates provided by it. However, the package rates are much lower than the existing or actual market rates.

The proposed move for introduction of Central Government Employees & Pensioners Health Insurance Scheme (CGEPHIS) by the Government of India, would help the beneficiary to claim his/her medical expenses from an insurer (or Insurance Company) in case the claim is beyond/exceeds the ceiling of the CGHS package rates.

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I PREMASRINIVASAN [70YEARS OLD]RETIRED FROM POSTAL DEPT WITH 35 YEARS SERVICE,RESIDING AT NON-CGHS COVER AREA, SUFERING FROM BLOOD PRESSURE, DIABITIC, AND ORTHO PROBLEM WITH VERTIGO. I AM SPENDING RS.2500/ PER MONTH FOR MEDICENE WHERE AS I AM GETTING MEDICAL ALLONCE RS.300 P/M ONLY. I REQUEST TO GOVT TO ISSUE CGHS CARD OR IMPLIMENT CGEPHIS PLAN.WHEN THE CGEPHIS PLAN WII IMPLIMENT I THINK AFTER MY DEATH ONLY
premasrinivasan44 Thursday, October 30, 2014
I am advised to obtain an essentially certificate for the drugs Jalra 50 mg twice a day and Lamosyn 100 mg twice a day which have to be used along with other drugs used to control diabetes. When the drugs are so important to control the diseases why cannot they be provided by CGHS and why essentiality certificate from NIMS or Gandhi Hospital at Hyderabad are insisted. Is there any form to obtain the essentially certificate?
srideviravi Thursday, March 27, 2014
CGHS Card has been issued in my favor under Kolkata Jurisdiction and availing such facility.Now Issuing of the Plastic CGHS Card is under process but the PIN No. of my residential address is modified recently by State GOVT.[KOLKATA-700157 in place of 700059],KOLKATA-700157 is not covered under CGHS Jurisdiction. How I can be able to get the Plastic Card as well as avail such facility.
adityasinha Tuesday, February 04, 2014
I am central government employee. I am planning to preserve cord blood of my baby. Can i reimburse the cord blood banking charges under central government health scheme ??
sppatel777 Monday, December 09, 2013
I am a CGHS Card holder pensioner retired from CDA[Pension, Kolkata. Can the CGHS clinic refer me to a Damdam Municipal Hospital(which is not shown in the website in empanelled List] Non-Empanelled Hospital for treatment ie.
lilyalld1 Thursday, November 28, 2013
I have to purchase BP apparatus on doctor's prescription kindly guide me the procedure
amarjeetsinghsodhi Thursday, November 14, 2013
is there any further progress on the intended CGEPHIS scheme for which RFP was published in 2010
alagh Saturday, November 02, 2013
CGHS / ESI are the benefits given the govt. I sincerely feel all these facilities are not really giving help to the patients, the long hours of waiting fro the doctors, to collect reports is very hectic. Its not like the work is completed within 1-2 hrs, its a day long process. The way the staff treat as if the patients are beggers. How can a patient alone can go from room to room, floor to floor in search of the doctor, its so indefinite that the doctors will be coming and no information is given. People working in private sector will not get leave if they have to wait for days together its difficult. The plight of the patients is very sad and pathetic. Anyway nothing will happen as long as these corrupted politicians are there but still I wanted to share my views. MY HUMBLE REQUEST IS PLEASE GIVE MERCY KILLING FOR THE PEOPLE WHO ARE SUFFERING at they will die peacefully.
Guest- Thursday, October 10, 2013
I m a defence ministry pensioner[civilian].i m not under CGHS tillnow.how can i get covered under the cghs now i retired in 1993.
B.H.AnanthaMurthy Sunday, September 01, 2013
Respected Sir,
Sir, I retired from PSU[PDIL, Sindri-Noida] and i am pension holder. My age is 65 yrs. Can I get the CGHS benifit? If so kindly help me by citing the process of getting CGHS card and the treatment in which type of hospitals? I am residing in Dhanbad in the state of Jharkhand.

Thanking you,
Sona Ram Rajak

Sona47 Tuesday, August 27, 2013
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