Your Essential Guide to the Central Government Health Scheme

Healthcare expenses can often put a heavy strain on one’s savings, especially when it comes to prolonged treatments or hospitalisations. For central government employees and pensioners, the Central Government Health Scheme (CGHS) offers a structured and reliable solution. Launched in 1954, CGHS aims to provide affordable comprehensive medical care to eligible individuals and their families.

What is the Central Government Health Scheme (CGHS)?

The CGHS is a healthcare initiative by the government of India that serves retired central government employees and their families. It provides subsidised medical care across various cities through its vast network of wellness centres and approved hospitals. If you're unsure where to begin, simply search for a CGHS hospital near me to find the nearest centre in your location.

Government mandates linking CGHS with ABHA for Central Govt. employees

Here are the steps to link CGHS with ABHA ID:

1. Visit CGHS official website.
2. Log in with your CGHS beneficiary ID.
3. Choose the option to create or link your ABHA ID.
4. Enter your Aadhaar and complete OTP verification.
5. Once done, you can download or print your ABHA card.
   

Facilities offered by the Central Government Health Scheme (CGHS)

The CGHS scheme ensures end-to-end healthcare services under one umbrella. Here’s what CGHS covers:

Features of the Central Government Health Scheme

Central Government Health Insurance Scheme brings several unique features that enhance healthcare delivery:

• Cashless treatment for CGHS beneficiaries wellness centres and hospitals.
• Reimbursement facility for treatment in non-empanelled hospitals under emergency.
• A plastic card will be issued to each beneficiary and will be valid in all CGHS cities.
• Digital health record integration with ABHA.

Who are the beneficiaries of CGHS?

CGHS covers a wide list of eligible individuals:

• Central Government employees (serving and retired).
• Pensioners and family pensioners.
• Members of Parliament and former Vice Presidents.
• Retired Supreme Court and High Court judges will get the Central Government Health Insurance Scheme for senior citizens.
• Delhi Police personnel.
• Employees of the Postal and Telegraph Department.
• Accredited journalists with the Press Information Bureau.
• Freedom fighters and employees of certain autonomous bodies.
  

Eligibility criteria for Central Government Health Scheme

To be eligible for CGHS, you must meet any of the following:

• Be a serving or retired Central Government employee.
• Be a pensioner receiving a central pension.
• Be a dependent family member living in a CGHS-covered city.
• Be a Member of Parliament, former Vice President, or judge.
• Be an employee from approved departments like Delhi Police or Railway Board.
  

Application process of Central Government Health Scheme (CGHS) card

Applying for a CGHS card is straightforward:

1. Visit the CGHS website to apply online for Central Government Health Scheme plastic card through the official CGHS portal and download the application form.
2. Fill in personal details and attach recent photographs.
3. Submit the form and documents to the Additional Director of CGHS in your city.
4. The card will be issued once the documents are verified.

Benefits of the Central Government Health Scheme

Here are some of the CGHS benefits:

• Low-cost or cashless medical care in government and empanelled hospitals.
• Subsidised medicines at CGHS wellness centres.
• Specialist consultations and diagnostics at no additional cost.
• Preventive care like annual check-ups and vaccinations.
• Surgical and maternity care support.

How to book a doctor’s appointment under the CGHS?

For CGHS registration follow the below steps:

1. Go to CGHS official site.
   
2. Log in using your beneficiary ID and OTP.
   
   
3. Select the wellness centre, doctor and speciality.
   
   
4. Choose the date and time slot.
   
   
5. Confirm and download your appointment slip.

What is the CGHS empanelled hospital list?

CGHS has tie-ups with several renowned hospitals across the states. Some CGHS empanelled hospitals include:

The full list is available on the CGHS website and is updated regularly.

FAQs

1. Can I use CGHS services in a city where I am not posted?

Yes, if you have a plastic CGHS card, you can use services in any CGHS-covered city.

2. Are dependents of employees also covered?

Yes, dependent family members living in CGHS cities are eligible.

3. How can pensioners apply?

Pensioners need to submit an application form with a copy of their PPO and ID proof to the CGHS office.

Conclusion

The Central Government Health Scheme is a healthcare plan for millions of central government employees and their families. However, while CGHS covers a wide range of services, there are still situations where you may need health insurance plans.

In the case of treatments in non-empanelled hospitals, expensive surgeries abroad or coverage gaps during emergencies outside CGHS cities, a health insurance plan acts as a safety net. Also, for your ageing parents who may not qualify for CGHS or need broader coverage, health insurance for parents can help cover unexpected bills, costly medicines and specialised treatments not included under CGHS.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.