About Us


  Objective of the Scheme

    The Central Government Health Scheme(CGHS) was started in 1954 with the objective of providing:-
         (a) Comprehensive medical care facilities to the Central Government employees and their family members;
         (b) To avoid cumbersome system of medical reimbursement.

Extent of Application

Besides Central Government employees, the scheme also provides services to:
(i) Members and Ex-members of Parliament
(ii) Judges of Supreme Court and High Court(sitting and retired)
(iii) Freedom Fighters
(iv) Central Government Pensioners, Employees of Semi-Autonomous bodies/Semi Government Organisations
(v) Accredited Journalists
(vi) Ex-Governors and Ex-Vice Presidents of India.

Coverage

The scheme was initially started in Delhi. Subsequently CGHS Services were extended to the following 17 cities:
Allahabad, Ahmedabad, Bangalore, Bombay, Calcutta, Hyderabad, Jaipur, Jabalpur, Lucknow, Madras, Meerut, Nagpur,
Patna, Pune, Kanpur, Thiru- vananthapuram and Guwahati.
In addition, employees of the Accountant General of India are being provided CGHS coverage at Bhubaneshwar and Ranchi. There are 241 Allopathic dispensaries for 9.4 lakh card holders and 42.76 lakh beneficiaries of CGHS. In addition to the Allopathic dispensaries, the CGHS facilities to the beneficiaries has also been provided for Indian Systems of Medicine through dispensaries/ units in Ayurveda, Homoeopathy, Unani, Siddha and Yoga. The number of dispensaries in each system is as follows: Ayurvedic dispensaries/Units 31, Homoeopathic dispensaries/ Units 34, Unani dispensaries/Units 8 +1 ( at Bangalore being set up), Siddha dispensaries/ Units 2, Yoga 3, Total (78+1). There are 19 polyclinics, 71 laboratories and 17 dental units functioning under C.G.H.S.

Facilities

The following facilities are being provided to the beneficiaries through dispensaries, polyclinics, and Government/recognised hospitals
(i) Out Patient care facilities in all systems
(ii) Emergency services in Allopathic system
(iii) Free supply of necessary drugs
(iv) Lab. and Radiological investigations
(v) Domiciliary visits to seriously ill patients
(vi) Specialist consultation both at the dispensary and hospital level
(vii) Family Welfare Services
(viii) Treatment in specialised hospitals both Govt. and private recognised reputed hospitals
(ix) 90% advance for undergoing specialised procedures after admission in hospitals when required.

Special facilities for Pensioners

Special Facilities for Pensioners are as follows :
(i) Option to join CGHS
(ii) Option of obtaining a 'whole life' CGHS card by paying ten years' subscription
(iii) Card valid in any CGHS covered city
(iv) Those living in non-CGHS areas can have a CGHS card in the nearest CGHS covered city
(v) Separate queue for senior citizens in CGHS dispensaries

Simplification of Procedure of Referral & Reimbursement

The beneficiaries now have the option of availing specialised treatment at a CGHS recognised hospital of their choice after a specialist of CGHS/Government hospital has recommended the procedure. The reimbursement is, however, restricted to the package rates/ceiling laid down by the Government for such procedure. The expenditure over and above this is to be borne by the beneficiary himself/herself. Officers drawing a basic of Rs.4,000/-(pre-revised) and above per month are entitled for direct consultation with the specialists in Government/State Government hospitals.

In case of Serving Government Servants, after the Specialist has advised a procedure in writing, the permission letter for taking such treatment in a CGHS recognised private hospital/referral hospital of choice in the same city, would be given by the parent Department/ Office of the employee.

In case of Pensioners (including Ex-M.Ps, former Governors, etc.), after the initial advice of a Specialist has been obtained, the permission letter for such treatment would be given by the CMO incharge of the concerned CGHS dispensary, but the bill would be raised in the name of Addl. Director, CGHS concerned, as in the case of pensioners, the payment is to be made by CGHS Directorate.

In case of a medical Emergency, the details of which shall be recorded in writing by the CMO Incharge of the CGHS dispensary, the CMO concerned may directly (i.e even before specialist's advice has been obtained) refer the CGHS beneficiary to a private recognised hospital for further management/treatment.

The expenditure to be reimbursed by the parent department/ office/CGHS, as the case may be, would be restricted to the package deal rates/rates approved by the Government from time to time. The expenditure in excess of the approved rates/ package deal would have to be borne by the beneficiary himself/herself.

In case the beneficiary, in spite of the facility being available in the city, still chooses to get treatment in CGHS recognised institutions in another city, permission may be given, but in such cases TA/DA would have to be borne by the beneficiary himself/herself.

For availing treatment outside the city of residence of a beneficiary, the permission of Director/Addl. Director/Joint Director of the city would have to be obtained.

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