All About Central Government Health Scheme (CGHS)

The Central Government Health Scheme (CGHS) has been providing medical care to central government employees as well as eligible pensioners for the past six decades, since its launch in the year 1954. The scheme covers beneficiaries from all four democratic pillars, namely Judiciary, Legislature, Press and Executive.

Currently, about 42 lakh beneficiaries are covered under this scheme in 80 cities of the country. CGHS provides health care services through the following systems of Medicine:

• Homeopathic
• Allopathic
• Indian system of Medicine:

1. Unani
2. Ayurveda
3. Siddha and
4. Yoga

Key Features of CGHS 

The following facilities are available under CGHS:

• Healthcare Coverage: CGHS provides a wide range of healthcare services, including outpatient and inpatient treatment, specialist consultations, diagnostic tests, medicines, and hospitalization.
• Empaneled Healthcare Providers: CGHS impanels a network of private hospitals, clinics, diagnostic centers, and government hospitals to provide medical services to beneficiaries.
• Subsidized Rates: CGHS beneficiaries pay a nominal monthly contribution to avail of these healthcare services. The rates for services and medicines provided under CGHS are highly subsidized, making healthcare more affordable for government employees and pensioners.
• Coverage for Family Members: CGHS coverage extends to the family members of eligible beneficiaries, including spouses, dependent children, and sometimes even dependent parents.
• Pensioners’ Scheme: CGHS also caters to retired central government employees and pensioners, ensuring they have access to quality healthcare services even after retirement.
• Wellness Centers: CGHS operates wellness centers in various cities and towns across India. These centers provide basic medical services, issue medicines, and offer health check-up facilities.
• Online Facilities: CGHS has introduced online services for beneficiaries, including appointment booking, prescription submission, and tracking of claims.
• Special Provisions: CGHS offers special provisions for certain categories of beneficiaries, such as Members of Parliament (MPs), freedom fighters, and journalists.
• Cashless Transactions: Many empaneled hospitals offer cashless transactions for CGHS beneficiaries, eliminating the need for upfront payments during hospitalization.
• Reimbursement: In cases where beneficiaries seek treatment at non-empaneled hospitals or facilities, they can often claim reimbursement for eligible medical expenses from CGHS.

Eligibility for CGHS 

The following individuals are eligible for CGHS facilities:

• Central Government Employees: All serving employees of the Central Government and their dependents are eligible for CGHS. This includes employees from various ministries, departments, and organizations under the Central Government.
• Pensioners: Central Government pensioners receiving a pension from the Central Civil Estimates are eligible for CGHS. This includes family pensioners.
• Members of Parliament: Sitting Members of Parliament (MPs) are also eligible for CGHS facilities.
• Ex-Governors and Lieutenant Governors: Former Governors and Lieutenant Governors are eligible for CGHS facilities for themselves and their dependents.
• Judges of the Supreme Court and High Courts: Judges of the Supreme Court and High Courts are eligible for CGHS facilities.
• Freedom Fighters: Freedom Fighters and their dependent family members are eligible for CGHS benefits.
• Journalists: Accredited journalists and their dependent family members are eligible for CGHS coverage under certain conditions.
• Specific Categories: Certain specific categories of individuals may also be eligible, depending on the specific rules and orders issued by the government from time to time.

One can visit the CGHS website – https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml to learn further eligibility criteria.

Online Appointment (Self-Registration) Process

Follow the below-mentioned steps to book an online appointment under the CGHS scheme:

• First, go to the official website of the CGHS scheme, that is, https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml  (CGHS portal).
• On the top menu bar, click the option – Beneficiary Corner
• Select Beneficiary Login from the pop-up menu.
• Enter your beneficiary ID and password for signing in to your account. In case you’re new or have lost the password, generate/reset a new one.
• Check the beneficiary details, go to the next page, select an option from CGHS dispensary, specialty, and doctor, and then click on ‘Proceed’ to go to the next page.
• Book an appointment on the displayed calendar and select proceed. You will receive a confirmation message. Confirm the appointment and you’ll again receive confirmation on your registered mobile number.

CGHS Card

The benefits of the CGHS scheme can be availed with the help of the CGHS card. It is a white-colored card with your (beneficiary) photo on it. The card also contains the beneficiary number and a strip that can be one of the following in color:

• Yellow for beneficiaries of autonomous bodies/journalists
• Blue for serving government employees
• Green for pensioners, freedom fighters, ex-MP, etc.
• Red for members of the Parliament of India

This card is valid till retirement. It can be renewed, but the scheme cannot be transferred.

CGHS Card: Terms and Conditions

• The misuse of the card results in penalties and disciplinary actions.
• Upon the card’s expiry, it should be surrendered to the concerned department.
• For its renewal, you will need to fill out the form with other necessary details.
• Only the eligible person/cardholder can enjoy the benefits.

How to Apply for the CGHS Card?

If you are eligible for the scheme, you can apply for the card online as well as offline.

Online:

• Visit the earlier-mentioned website, fill out the online application form, and attach your photos in the given designated areas
• Attach the needed documents to the form
• Submit the same with documents online
• Download the form and then take out its printout

Offline:

• To submit the application form offline, you need to ensure that the form is endorsed by the HOD (head of the department) of serving employees. The form is to be submitted to Delhi’s Additional Director headquarters office. The form, along with all documents, can be sent to the Additional Director’s office in other cities.
• In case you’re a serving employee, submit the application with a bank draft and enclosures to the CGHS from the employee’s office.

One may further note that the CGHS card has some validity and does not come completely free of cost. A central government employee can avail of its benefits post-retirement by making a contribution a year before completion. The card is valid in all impaneled govt/private hospitals (hospitals that come under the CGHS scheme regions) for hospitalization, diagnosis, and medications.

Coming to the card’s transfer, here are some points to note:

• If the cardholder is a central government employee who is being transferred to a non-CGHS region, the card will be used for 6 months by the beneficiary’s family if a contribution has been made beforehand.
• If the transfer is done in the same city, the requisite changes are made by the concerned department in the employee database.
• Also, a transfer permit is needed to receive treatment in another CGHS city for life-saving medications.

Documents Required for the Scheme

Documents to be attached to the application form are:

For pensioners:

• Bank demand draft
• (Pension Payment Order) PPO/Provisional PPO/Last pay certificate (LPC) copies

For serving government employees:

• Address proof
• Dependent’s residential proof
• Dependent’s age-proof
• A certificate of disablement from a valid authority, in case the dependent is physically disabled

Conclusion

The CGHS or Central Government Health Scheme has been offering several medical benefits to the beneficiaries and their families. To know more about the scheme, one can always visit the CGHS website and enrich themselves with its salient features and vast list of benefits.