07 Jun, 2023 10:56 AM

Central Government Health Scheme (CGHS): A Comprehensive Guide

Central Government Health Scheme (CGHS): A Comprehensive Guide


India's healthcare industry continues to evolve, with a focus on improving access to quality healthcare for all citizens. To address this pressing concern, the Indian government has implemented various health programs and schemes. One such initiative is the Central Government Health Scheme (CGHS), a government-backed program aimed at bridging the healthcare gap and providing equal healthcare opportunities to the population. In this article, we will delve into everything you need to know about the CGHS and its benefits.

  1. What is the Central Government Health Scheme (CGHS)?
    The CGHS, initiated by the Indian Central Government in 1954, offers healthcare benefits to registered employees and pensioners of the Central Government of India. It provides exclusive medical insurance through reimbursement and cashless facilities, with a focus on comprehensive healthcare for beneficiaries from different sectors.

  2. CGHS Coverage:
    A Diverse Range of Medical Systems The CGHS covers a wide range of medical systems, including traditional Indian medicine (Ayurveda, Yoga, Unani, Siddha), allopathy, and homeopathy. This comprehensive approach ensures that beneficiaries have access to various medical treatments and therapies.

  3. Understanding the CGHS Card
    The CGHS card, issued by the Government of India, serves as a photo ID plastic card with a unique beneficiary identity number. The card must be presented at CGHS facilities for availing services. Different colors of the card indicate the status of the cardholder, based on their profession or role.

  4. Who can be beneficiaries of the Central Government Health Scheme?
    he CGHS extends its benefits to a wide range of individuals, including central government employees, pensioners, members of parliament, judges, and their immediate family members. The scheme also covers employees from specific departments, railway board employees, freedom fighters, and more.

  5. Documents Required for CGHS Enrollment
    o obtain a CGHS card, applicants need to provide specific documents based on their eligibility. Pensioners, for example, may need to submit copies of their Provisional PPO/PPO/Last Pay Certificate, while serving employees require proof of residence, age, and dependent's residence.

  6. Coverage and Benefits of the Central Government Health Scheme
    The CGHS provides a comprehensive range of medical services, including consultations, treatments at CGHS dispensaries, specialised doctor consultations at empanelled hospitals, laboratory examinations, hospitalization, medication coverage, and more. Maternity, childcare, and family welfare services are also covered.

  7. Features and Facilities for CGHS Beneficiaries
    CGHS beneficiaries enjoy various facilities, including reimbursement of medical treatment expenses, reimbursement for hearing aids and artificial limbs, coverage for maternity and childcare services, cashless treatment at empanelled hospitals, coverage for AYUSH treatments, OPD treatment coverage, and consultations with health experts.

  8. Exclusions from CGHS Coverage
    While the CGHS offers extensive coverage, it's important to understand the limitations. Emergency treatments are covered at any hospital, but reimbursement benefits are provided only for treatments obtained at registered CGHS hospitals. Reimbursement amounts for medical treatment are predetermined for pensioners and eligible beneficiaries.

  9. Cost of Obtaining the CGHS Card
    The cost of accessing the CGHS varies based on the employment status of the beneficiary. Serving employees contribute a monthly amount based on their pay grade, deducted from their salary. Pensioners contribute based on their pay grade during their service, either annually or as a one-time/lifetime contribution.

  10. How to Apply for the CGHS
    The application process for the CGHS involves obtaining the application form, completing it with accurate information, attaching necessary documents, and submitting it to the appropriate CGHS office. Retiring employees follow a slightly different process for obtaining a pensioner CGHS

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