The Ministry of Health and Family Welfare (MoHFW) has released new guidelines about the Central Government Health Scheme (CGHS) Cards. The change in guidelines comes in light of technological advancements and changes in payment modes of contribution for the CGHS.

The Ministry issued an Office Memorandum dated June 27, 2024, detailing that the CGHS cards must now be applied online for serving central government employees and pensioners. A fresh application or renewal can be made by visiting the official website of the CGHS.

Overview Of The Central Government Health Scheme (CGHS)

Feature	Details
Scheme Name	Central Government Health Scheme (CGHS)
Commencement Year	1954
Objective	Providing comprehensive healthcare facilities to central government employees and their families.
Beneficiaries	Central Government employees, pensioners, their families, and dependents.
Coverage Areas	80 cities across India
Types of Medical Systems	Allopathy, Homeopathy, Ayurvedic, Unani, Siddha, Yoga
Ward Eligibility	Based on the employee's basic pay
Facilities Provided	OPD, In-patient care, diagnostics, specialist consultations, emergency services
Empaneled Hospitals	Includes both government and private hospitals across multiple cities
Application Method	Online and wellness centre registration

What Is The CGHS Card?

A CGHS card or Central Government Health Scheme number is an identification card provided to beneficiaries under the Central Government Health Scheme which is a scheme offered by the Department of Health and Family Welfare. This card serves as an entitlement for healthcare services and benefits from the scheme. It has descriptions as to one’s self, likely members of a family and whether one is qualified or not. To obtain health care in the CGHS wellness centres or recognised hospitals, such cards must be made available.

Key Features Of The CGHS Card

• Proof of Identity: The Card proves the identity of the CGHS beneficiary for purposes of treatment

• Coverage: It includes employees of the central government, retired employees pensioners, their dependents and other re-affiliated individuals.

• Once Employed/Cardholder Employees: The card remains valid for the primary Central Government employee/pensioner but after the primary cardholder dies, family members will have to seek new cards.

• Nature of Issued Cards: Issued cards differ in colour for active employees and retired ones who are both issued these cards.

• Web Application: Beneficiaries may now apply for a CGHS card or renewal of the CGHS card online because of the CGHS website.

What Is The Central Government Health Scheme (CGHS)?

The Central Government Health Scheme (CGHS) is a healthcare program designed for central government employees and pensioners, launched in 1954. It aims to provide comprehensive, affordable healthcare services across a variety of medical disciplines, ensuring access to both preventive and curative treatments.

Key Features of the CGHS Scheme

• Eligibility: It is meant for central government servants, pensioners and their dependents, Members of Parliament, serving Judges and some other specific autonomous bodies.

• Medical Systems Covered: In CGHS, treatments of allopathic, ayurvedic, homoeopathy, unani, siddha and yoga systems are included as part of complete healthcare.

Services Covered Under CGHS

• Out-Patient Department (OPD): Visit a general or specialist doctor for a checkup.

• In-Patient Department (IPD): When the patient is admitted to the hospital for an operation or serious treatment.

• Diagnostic Services: Tests including laboratory investigations, X-ray, ultrasound etc.

• Health Education: Periodic health assessments and immunizations.

• Rescue Services: Non-scheduled ambulance vehicles and live attendants at all times and clearance of health emergencies.

Cashless Treatment: Beneficiaries are entitled to cashless treatment for services availed from empanelled hospitals as an outpatient or as an inpatient.

Empaneled Hospitals: More than 120 government and private hospitals are empanelled in CGHS in more than 80 cities which is an extensive network of medical care.

In this way, by taking the CGHS scheme, beneficiary members can get quality treatment by paying only a small amount of relief for their health, their children’s health and the health of other family members.

Eligibility Criteria for CGHS

• Central Government Employees: Both the serving and the retired central government employees and eligible members of their families qualify.

• Dependents: There is a provision for the enrollment of family members such as spouses, children, and dependent parents.

• Special Groups: Other special categories include soldiers, Members of Parliament, retired Supreme Court and High Court judges, and freedom fighters, among others.

Coverage Of Medical Systems

CGHS covers a wide range of medical systems, offering beneficiaries the flexibility to choose treatments from:

• Allopathy: Modern medicine-based treatments.

• Ayurveda: Traditional Indian medicine using natural remedies.

• Homeopathy: A system of alternative medicine.

• Unani: Traditional medicine practised in South Asia.

• Siddha: An ancient system of medicine originating in South India.

• Yoga: Integrating mental and physical wellness practices for health.

Read more: Ayushman Yojana: Major 2024 Changes, Good News For Middle-Class To Benefit From Free Healthcare!

Benefits Of The CGHS Scheme And CGHS Card

The CGHS card provides numerous benefits to its holders due to its wide beneficiary base. Let us have a look at them!

• Healthcare Accessibility: The scheme is applicable in 80 cities across India and provides accessible healthcare facilities to its beneficiaries. The CGHS Cities list can be accessed here.

• Affordable Healthcare: The treatment provided under the scheme is affordable since the government covers the expenses incurred for most of the treatments.

• OPD Treatment: The scheme applies to outpatient treatments wherein regular OPD appointments and the expenses incurred under them are covered.

• Hospitalisation Expenses: In-patient services such as hospitalisation and surgery are also covered under this government scheme. Furthermore, treatments under AYUSH are also provided.

• Healthcare Devices: The scheme covers the provision of medical devices such as hearing aids, wheelchairs, crutches, etc. This enables a beneficiary to seek proper rehabilitation facilities.

• Maternity and Child Healthcare: Prenatal and postnatal care is covered for both mother and child under the scheme. The scheme covers all maternity treatments required. Women not covered under this scheme can also avail of maternity benefits under the Pradhan Mantri Surakshit Matritva Vandana Yojana.

Read more: आयुष्मान भारत योजना | पीएम मोदी वरिष्ठ नागरिकों को 5 लाख तक मुफ्त स्वास्थ्य सेवा देंगे!

Eligibility Criteria: Who Can Apply For CGHS Card?

The following persons can obtain a CGHS card and avail the benefits of the scheme:

• All central government employees and pensioners, provided they reside in cities covered under this government scheme.

• Ex-Governors and Lieutenant Governors.

• Railway Board Employees.

• Freedom Fighters

• Current and ex-members of the parliament.

• Retired judges of the High Courts.

Who Can Avail Benefits Under This Scheme?

The following people related to the beneficiary are also covered and can avail benefits of the government scheme:

• Husband/Wife (First wife only)

• Dependant parents or parents-in-law

• The first wife of an adoptive father having multiple wives.

• Son till he attains the age of 25 or starts earning; whichever is earlier.

• Daughter till she starts earning or gets married; whichever is earlier.

• Dependent divorced/abandoned or separated from their husband/widowed daughters and dependent unmarried/divorced abandoned or separated from their husband/widowed sisters: irrespective of age limit.

• Dependent minor brother(s) till they attain majority.

• Dependent minor children of widowed/separated daughters till they become majors.

• Dependent family members apart from a spouse, residing with the beneficiary earning less than 9000/-+ DA per month.

• Son who is suffering from any permanent disability of any kind (physical or mental) as defined below: Irrespective of age limit.

Read more: HPV Vaccine In India: A Lifesaving Shield Against Cervical Cancer For Young Children.

What Will Be The Charges For CGHS Cards?

The charges for Central Government Health Scheme (CGHS) cards depend on various factors such as the salary of the employee or the pension amount of retired beneficiaries. Below are the details of CGHS subscription charges:

For Serving Employees

The monthly contribution towards the CGHS is determined based on the employee's basic pay (as per the 7th Pay Commission). Here are the details:

Basic Pay (in ₹)	Monthly Contribution (in ₹)
Up to ₹7,500	₹250
₹7,501 to ₹11,000	₹450
₹11,001 to ₹15,000	₹650
₹15,001 to ₹20,000	₹1,000
Above ₹20,001	₹1,250

For Pensioners

Pensioners can opt for either an annual or lifetime contribution, depending on their pension amounts:

• Annual Contribution: Same as monthly contributions for serving employees but multiplied by 12.

• Lifetime Contribution: 120 times the monthly subscription rate.

For example:

• Pensioners with a basic pension of ₹15,000 per month will pay ₹1,000 monthly or 120 times this for a lifetime subscription (i.e., ₹1,20,000).

Additional Costs

• Plastic Card Charges: A nominal fee may be charged for issuing the CGHS plastic card.

The charges are subject to revisions and may differ slightly based on government updates. It’s advisable to check with the official CGHS website or your local wellness centre for the most up-to-date information on charges.

Document Requirements For CGHS Scheme

To apply for the Central Government Health Scheme (CGHS), some documentation has to be handed over for verification. The kind of documentation that needs to be provided will depend on whether the applicant is a serving central government official or a pensioner. Here is a list of the general documents that are required:

For Serving Employees

• Duly filled CGHS application form (available on the net or at the wellness centre)

• Identity Proof: Aadhaar Card, PAN Card, or any government ID

• Address Proof: Light and Heating bills, passport, Aadhaar card or any official papers confirming the residence

• Employment Certificate: Issued by the employer

• Passport sized photograph

• Dependent documents: For enrolling dependents (parents, children), submit a copy of identification, age proof and income details if applicable

• Pay Slip/Salary Certificate: Submission is required for Pay level and necessary for CGHS subscription calculation(DEBUG log)

For Pensioners

• Pension Payment Order (PPO): Issued at the time of retirement and contains the details of pension lump sum and regular payment.

• Duly filled CGHS application form

• Identity Proof: Aadhaar Card, PAN Card, etc.

• Address proof: Same as for serving employees.

• Photograph of the applicant: Sized to passport.

• Bank Account details: Pensions are paid into the bank accounts maintained by the pensioners.

• Spouse/Dependent Documents: In case of family coverage, a copy of the spouse's Aadhaar card or any other proof along with a birth certificate or dependant document for children is required.

For Dependent Family Members

• For Parents: Residing Children Affidavit both parents’ income (net income must be less than rupees nine thousand plus dearness allowance).

• For Spouse and Children: Aadhaar Card, children's birth certificate, Adult children's income proof, spouse's marriage certificate

Additional Documents

• In case of fresh pensioners: Provisional Pension Payment Order PPO or Last Pay Certificate.

All documents must be completed and lodged with the application filed at the CGHS wellness centre so that it can be attended to as required.

Application Procedure For CGHS Scheme: A Step-By-Step Guide

The CGHS Cards can be applied for in an online mode. Let us take a look at the steps that need to be followed:

• Visit the official website at www.cghs.nic.in.

• Generate a temporary reference number.

• Fill in the personal details required and relevant documents such as employment certificate, address and ID proofs.

• Submit the form and take a print of the submitted application.

• Submit the hard copy to your respective departments.

• Beneficiaries already in possession of a CGHS card need to attach a self-attested copy of such card along with the application form.

• The application will be processed and submitted to the Additional Director of CGHS in the respective covered city.

How To Download Central Government Health Scheme (CGHS) Card

Downloading the CGHS card involves a few simple steps that can be done online. Follow the steps below to download the CGHS card:

Visit the Official Website

• Open your browser and go to the CGHS official portal: CGHS Website.

Login to Your Account

• Use your beneficiary ID and the password to log in to your CGHS account.

• If you do not have a password or have forgotten it, you can generate a One-Time Password (OTP) using your registered mobile number.

Navigate to the CGHS Card Section

• After logging in, you will see an option for "Print Card" or "Download CGHS Card" in the user dashboard.

• Click on this option.

Download the Card

• You will be prompted to select your details (like the cardholder’s name or family member details).

• After selection, you can choose the "Download" option to save the CGHS card in PDF format.

Print the CGHS Card

• Once downloaded, you can take a printout of the card, which is valid for use at any CGHS wellness centre or empanelled hospital.

Ensure that all details on the downloaded card are accurate. If there are any discrepancies, you may need to contact your nearest CGHS office for corrections.

How To Delete Or Add Names In Central Government Health Scheme Cards

To add or delete names in a CGHS (Central Government Health Scheme) card, you can follow the steps below:

For Adding Names To CGHS Card (like newborn children, spouse, or dependent parents)

Step 1: Visit CGHS Wellness Centre: In case you want to add a new family member, you have to visit any of the CGHS wellness centres or its official CGHS website to do so.

Step 2: Submit Required Documents: For adding a name the following documents will be needed:

• For a newborn child: You must enclose the child's birth certificate and your CGHS card.

• For a spouse: You must provide a marriage certificate as well as your CGHS card.

• For dependent parents: Age proof, income declaration and dependency certificate stating their income not exceeding the qualifying criteria.

Step 3: Application Submission: There is a form which is to be filled out concerning the member who is being added.

Step 4: Card Update: After all the documents are checked, the new member will be added to their CGHS card.

For Deleting Names From CGHS Card (In Case Of Death, Or If A Dependent Is No Longer Eligible)

Step 1: Approach CGHS Wellness Centre: The wellness centre can be visited or the online portal can be availed.

Step 2: Submit Supporting Documents: Submit requisite papers for deletion such as:

• Family death: Death certificate.

• Family relationships – (when no longer dependent): Documents proving the status change such as income declaration or other market-based proof.

Step 3: Submit a Written Request: Draft a permanent application to remove the member from the CGHS card that you hold.

Step 4: Report Date on the Card: The Verification received then they shall delete that name.

How To Check The Validity Of CGHS Card

You can check the validity of your Central Government Health Scheme (CGHS) card both online and offline. Here's how:

1. Online Method:

• Step 1: Visit the CGHS official website.

• Step 2: Navigate to the “Beneficiary” section on the homepage.

• Step 3: Select "Check CGHS Card Validity."

• Step 4: Enter your Beneficiary ID and other required details.

• Step 5: Click on Submit. The portal will display the current status and validity of your CGHS card.

2. Offline Method:

• Step 1: Visit your nearest CGHS Wellness Centre with your CGHS card.

• Step 2: Request the wellness center staff to check the validity status of your CGHS card.

• Step 3: They will verify the card's validity in their system and provide the details.

Features Of CGHS Card

The CGHS cards have a few features that are important for the employees and pension holders of the central government and allow them to avail medical assistance in the CGHS wellness centers and the prescribed hospitals. Here are some of the features.: Below are some of the features.

Medical Coverage Across Various Disciplines:

• This includes treatment for Allopathic, Homeopathy, Ayurveda, Unani, Siddha and Yogic therapies, you name it and they cover it.

Cashless Treatment:

• For pensioners, ex-MPs as well as some other classes, beneficiaries are eligible for in-patient treatment without any payment at empaneled hospitals linked with the CGHS card.

Out-Patient Department (OPD) Services:

• Medicine prescriptions, OPD consultations, and diagnostics are covered under the CGHS card and are made available at the wellness centres and clinics.

Medical Care In Terms Of Hospitalization:

• The card provides coverage of indoor as well as outdoor treatment in general hospitals as well as in private empaneled hospitals.

Referral System:

• In case, where a specific therapy is needed that the well centre district and the thallicesm turns to the cardholder, they are referred to either super-specialty or empanel.

Pharmacy Benefits:

• Drugs including essential lifesaving are made available to the beneficiaries at no cost at CGHS pharmacies or at their neighborhood private chemists on a CGHS card.

Preventive Healthcare:

• Beneficiaries are entitled to health checks, vaccination services, and select preventive healthcare processes at CGHS wellness clinics.

Validity and Portability:

• The CGHS card is issued for the lifetime of the pensioners but active employees are allowed to renew or extend its validity whenever required. It is portable, meaning, it can be resorted to in any city where CGHS facilities are in existence.

Eligibility for Dependents:

• A CGHS card provides coverage not only to the cardholder but also to dependent family members who include spouses, children within certain satisfied ages, or parents who meet the requirement.

Which States/Cities Can You Avail Of CGHS Facility

The Central Government Health Scheme (CGHS) is available in several states and cities across India, offering healthcare facilities to central government employees, pensioners, and their dependents. Here's a list of some of the cities where CGHS services are available:

State/UT	City
Assam	Guwahati
Andhra Pradesh	Visakhapatnam
Bihar	Patna
Chhattisgarh	Raipur
Delhi	Delhi
Goa	Panaji
Gujarat	Ahmedabad, Gandhinagar
Haryana	Faridabad, Gurgaon
Himachal Pradesh	Shimla
Jammu & Kashmir	Jammu
Jharkhand	Ranchi
Karnataka	Bengaluru
Kerala	Thiruvananthapuram
Madhya Pradesh	Bhopal, Jabalpur, Indore
Maharashtra	Mumbai, Nagpur, Pune
Manipur	Imphal
Meghalaya	Shillong
Mizoram	Aizawl
Nagaland	Kohima
Odisha	Bhubaneswar
Puducherry	Puducherry
Rajasthan	Jaipur
Sikkim	Gangtok
Tamil Nadu	Chennai
Telangana	Hyderabad
Tripura	Agartala
Uttarakhand	Dehradun
Uttar Pradesh	Lucknow, Meerut, Kanpur
West Bengal	Kolkata, Jalpaiguri
Chandigarh (UT)	Chandigarh

Types Of Medical Systems Covered Under The CGHS Scheme

The Central Government Health Scheme (CGHS) also comprehensively cover a complete range of healthcare services across different systems of healthcare to meet the request of their clientele. These systems are as follows:

Allopathy:

• Allopathy is the most standard among the systems of medicine that is provided under the cover of CGHS. This is a system of healing where various diseases are diagnosed and treated usually through medications, physiotherapy and even surgery.

Homeopathy:

• Homeopathy is a system of medicine that is not conventional medicine and is a system of tolerating powers: that are like cures. Homoeopathic treatments are provided through CGHS wellness centres for several acute and chronic diseases.

Ayurveda:

• Ayurveda is India’s ancient healthcare system which employs natural herbs and remedies to heal a person whole tantamount in mind, body and spirit. Basic Ayurvedic treatments like herbal medications, dietary guidelines and lifestyle modifications are also offered to beneficiaries as part of CGHS

Unani:

• Unani medicine also known as indigenous medicine also comes from the humors of Islam which is the philosophy that suffices the ratio of body fluids. This system incorporates all of modern and many elemental arguments including herbal medicine, dieting, and multiple other therapeutic measures for different species atypical from those in praxis.

Siddha:

• Practiced in the southern states of India, Siddha is often termed as an ancient science that employs plants, minerals and metals for preparing medicines. Siddha treatments are also available in some of the CGHS wellness centers.

Yoga:

• Yoga involves the integration of body positions, breath control, and meditation practices so that it can be classified under the health promotion activities included in CGHS provisions. This is often recommended as an adjunct in preventive health care.

Treatments Not Covered Under CGHS Scheme

The Central Government Health Scheme (CGHS) is very comprehensive when it comes to offering a diverse amount of medical treatments to the beneficiaries as it has its limits. Inapplicability of certain features is what these exclusions refer to:

Plastic Surgery:

• There are some surgeries done for beauty purposes only. An example of these would be facelifts, liposuction and transplants among other surgeries.

In Vitro Fertilization:

• Include but are not limited to procedures or medicines for infertility problems such as IVFs, artificial insemination and all forms of assisted reproductive operations.

Non Harris Non-allopathic Treatments:

• Irrespective of Akree or Kiraly, or any recognized traditional system such as Allopathic, Ayurveda, Homeopathy, Unani, Siddha and yoga, no non-allopathic treatment will be covered. Claims for Naturopathy and Acupuncture treatment until and unless the institute is licensed to practice medicine are excluded.

Genetic Research:

• There is no reimbursement available for the patients for any type of genetic screening or genetic counseling when classical genetic conditions or predispositions are searched for.

Diagnosis Outside CGHS – Private Doctor Consultation :

• Treatments taken from any private authorities or a consultant other than the specified empaneled cgsh network is own charge.

Executive Health Check-Ups Other than CCD – Exclusive template:

• Health checkups for any other medical or non-medical reasons that are not part of the preventive ‘health care benefits’ of the CGHS are excluded except to the extent that such health checks may be advised by a sanctioned health practitioner or for identifiable health reasons.

Personal Comfort Services:

• It does not provide coverage for additional care that includes private nursing, personal attendants or other such comfort related facilities within a hospital.”

Cost of Hearing Aids, Spectacles and Dentures:

• For example, though CGHS has some medical aids, there is no coverage for advanced hearing supplements, spectacles, and denture appliances beyond level one.

Treatment at Non-Empanelled Hospitals:

• Treatment received from hospitals that are not on the CGHS empanelled list unless in cases of emergencies are excluded from the CGHS cover.

Alternative Medicine Not in the Approved List:

• About number eleven, payment will not be made for treatment with non-conventional medicine not on the approved CGHS lists.

How To Book An Appointment Under CGHS Card

To book an appointment under the CGHS card, follow these steps:

Step-by-Step Guide to Booking a CGHS Appointment:

Visit the CGHS Online Portal:

• Open the official CGHS website at the CGHS Online Appointment Portal.

Login Using Beneficiary ID:

• Click on the 'Beneficiary Login' option and enter your Beneficiary ID.

• You will receive an OTP (One Time Password) on your registered mobile number. Enter the OTP to log in.

Verify Your Details:

• Once logged in, your details (such as your name and CGHS wellness center) will be displayed. Ensure that all the information is correct.

Select Specialist and CGHS Dispensary:

• Choose the specialty and the CGHS wellness center where you want to consult a doctor.

Choose Date and Time Slot:

• Select the preferred date and time slot for your appointment.

• You will see a list of available slots. Choose the one that suits your convenience.

Confirm Appointment:

• After selecting the date and time, click on the 'Confirm' button to book the appointment.

Receive Confirmation:

• Once confirmed, you will receive an SMS confirmation with the details of your appointment, including the time, date, and doctor.

Visit the CGHS Wellness Centre:

• Arrive at the CGHS wellness center with your CGHS card and the confirmation SMS for a smooth consultation process.

How To Claim Benefits Under CGHS Scheme

To claim benefits under the Central Government Health Scheme (CGHS), follow these steps:

Step-by-Step Process to Claim Benefits:

Visit the CGHS Wellness Centre:

• The beneficiary or patient must proceed to any CGHS Wellness Centre close to them, along with their CGHS card.

Consult a CGHS Doctor:

• Doctors are available for consultation at CGHS wellness centers regarding several checkups. The doctor can provide a referral or advice on a service to the patient if further treatment or a diagnostic test is needed.

Referral to Empanelled Hospital or Diagnostic Centre (if applicable):

• Should the treatment involve being admitted, one will be given a referral to a hospital empaneled to the organization which treats injuries or a diagnostic center.

• The prescription will outline the tests and/or treatments requested by the physician.

Availing Treatment at CGHS Empanelled Hospital:

• Carry the referral form provided by the CGHS doctor when you go to the empanelled hospital for treatment.

• Cashless treatment depending on the nature of treatment or surgery recommended will be provided (only to serving Government employees, pensioners and eligible persons dependent on them).

Submission of Medical Claims:

• In cases where you have incurred out-of-pocket costs for treatment or performed tests (only where such situations arise like emergency treatment or non-availability of the cashless facility), medical claims have to be submitted.

• Gather up all the original bills, the prescriptions, the test reports and any other documents that may be useful.

Submitting Claim at the CGHS Wellness Centre:

• Screen Printed Claims and supporting documents are to be submitted at the CGHS Wellness Centre as per registration.

• Provide a claim form as well as the CGHS card photocopy.

Verification and Approval:

• Using the documents listed, the wellness center will assess your claim to determine if there are any discrepancies.

• Once the information is confirmed, the respective reimbursement will be processed, and the beneficiary's account will be credited with the reimbursement amount.

Conclusion

The CGHS scheme provides a bundle of benefits and healthcare and reasonable rates to its beneficiaries. Such schemes ensure employee welfare and promote the generation of such working environments at a national level.

For easier access, the CGHS details and help can be sought through myCGHS App.

To know more about such government schemes and information, stay connected to Jaagruk Bharat. You can also share your thoughts or ask questions with us by reaching our community page.

Important Links

Official Website: https://cghs.gov.in

Contact Details: Mail at director-cghs@cghs.nic.in or dial 011-20863436