The Ministry of Health & Family Welfare has recently issued new guidelines for the application of CGHS (Central Government Health Scheme) cards by serving government employees and pensioners. These guidelines have been revised to keep up with technological advancements and changes in payment methods for the CGHS.
Under the CGHS scheme, the Central Government provides comprehensive medical care to enrolled government employees and pensioners. Currently, there are approximately 42 lakh beneficiaries covered under CGHS in 80 cities across India, and efforts are being made to include more cities to improve the accessibility of these services.
All central government employees and their dependent family members residing in CGHS-covered areas are eligible to receive the CGHS card.
Application Process for Serving Employees
Serving employees are now required to apply for a new CGHS card online through the official website (www.cghs.nic.in). Upon submission of the online application form, they need to generate a temporary reference number and take a printout of the application. The employee should then submit the signed hard copy of the application, along with affixed photographs, to their current department for processing. The department will forward the application to the concerned Office of Additional Director, CGHS for card issuance.
Two copies of the application should be made – one to be forwarded to the Additional Director of the concerned city, and the other to be retained by the employer department of the Central Government for CGHS benefits. The head of the department or head of office of the employee should sponsor the requisition.
The CGHS will carefully review the application based on the provided documents. These documents include a pay slip showing the pay scale and CGHS deduction, Aadhaar Card, PAN card, or any other valid identification document as per RBI guidelines for both the applicant and their dependent family members. If applicable, a disability certificate for any dependent should also be submitted. Additionally, photographs of the applicant and their dependent family members are required to complete the application process.
Application Process for Pensioners
Eligible pensioners and family pensioners, who are not availing the Fixed Medical Allowance (FMA), can receive the CGHS card. Pensioners also have the option to avail the Fixed Medical Allowance by paying the full subscription, in addition to the CGHS card (IPD Card). However, the CGHS ‘IPD only’ card is valid only for ‘cashless’ indoor treatment at CGHS Empanelled Private Hospitals or designated Government Hospitals. In case of a medical emergency, the beneficiary of the ‘IPD only’ CGHS card can also seek reimbursement for expenses incurred during indoor treatment at any government or private hospital.
To apply for the new Pensioner CGHS card, pensioners should submit the duly filled application form to the Additional Director of the concerned CGHS city. The application should be accompanied by the payment of CGHS contribution on Bharat Kosh, along with the generated Challan from Bharat Kosh as proof of payment.
The following documents should be included with the application:
- Self-attested PPO/Provisional PPO or Last pay certificate.
- Aadhaar Card ID/PAN card or any other valid document as per RBI guidelines for ID proof of self and dependent family members.
- Disability Certificate of Dependant (if applicable).
- Photographs of self and dependent family members.
- Copy of Bharat Kosh Challan for paid CGHS subscription.
- Proof of availing/non-availing FMA (if applicable).
These guidelines aim to streamline the CGHS card application process and ensure that serving government employees and pensioners receive the necessary medical care and benefits.