Central govt employees, pensioners alert! CGHS Card rules revised – Check new rates, eligibility

New CGHS Card to serving employees and pensioners (Representational image: Freepik)

The Ministry of Health & Family Welfare has issued fresh guidelines for the issue of CGHS Card to serving employees and pensioners, according to an Office Memorandum (OM) issued on June 27. It said that the revised guidelines have been issued in view of technological changes and changes in payment methods of contribution for the Central Government Health Scheme (CGHS).

What is CGHS Card and who are its beneficiaries?

CGHS is providing comprehensive medical care to the central government employees and pensioners enrolled under the scheme. Presently approximately 42 lakh beneficiaries are covered by CGHS in 80 cities all over India and the endeavour is to include more cities to improve the accessibility of the services.

All central government employees and their dependent family members residing in CGHS-covered areas are beneficiaries of this card.

Fresh guidelines for issuance of CGHS card for serving employees:

“Serving employees will need to mandatorily apply for a new CGHS card online (www.cghs.nic.in) to generate a temporary reference number. After online submission of the application form, they should take a printout of the same and submit the hard copy duly signed and photographs affixed thereon, to the department currently employed, for processing and onward submission to the concerned Office of Additional Director, CGHS for issuing the cards,” according to the Office Memorandum of the health ministry.

It further said that one copy is to be forwarded to the Additional Director of the concerned city and the other copy is to be retained by the Employer Department of the Central Government (hereinafter referred to as ‘sponsoring authority’) for CGHS benefits.

The requisition shall be sponsored by the head of department/head of office of the employee, it added.

Documents verification for CGHS application:

The CGHS shall scrutinize the application based on the documents provided by the applicant. These documents include a pay slip indicating 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. Additionally, a disability certificate for any dependent, if applicable, must be submitted. Furthermore, photographs of the applicant and their dependent family members are required to complete the application process.

Guidelines for issuance of CGHS card for pensioners:

CGHS card(s) will be issued to eligible pensioners and family pensioners, drawing pension from Central Civil Estimate and his/her dependent family members, when the pensioner is not availing the Fixed Medical Allowance (FMA), the OM said.

The pensioners also has the option for availing Fixed Medical Allowance with a CGHS card (IPD Card) by paying the full subscription, however, the CGHS ‘IPD only’ card shall be valid only for ‘cashless’ indoor treatment at CGHS Empanelled Private Hospitals/designated Government Hospitals. The beneficiary of ‘IPD only’ CGHS card shall also be eligible for reimbursement of expenses incurred for indoor treatment at any government/private hospital only in case of a medical emergency.

The pensioners can submit his/her duly filled application form for the new Pensioner CGHS card, in the new card application form to the Additional Director of CGHS city concerned, as per the memorandum.

It further said that the applications shall be accompanied with payment of CGHS contribution on Bharat Kosh, along with the Challan generated from Bharat Kosh as proof of payment.

The contribution (equivalent to 120 times i.e. 10 years of existing CGHS contribution rate, at the time of retirement). The existing rates shall be as per the details provided below:

CGHS shall scrutinize the application based on the documents provided:

1. Self-attested PPO/ Provisional PPO or Last pay certificate.
2. Aadhaar card ID/PAN card or any other valid document as per RBI guidelines as ID proof for Self and dependent family members.
3. Disability Certificate of Dependant (If applicable).
4. Photographs of self and dependent Family Members.
5. Copy of Bharat Kosh Challan for CGHS subscription paid
6. Proof of availing/non-availing FMA (if applicable).