Articles 383 views January 9, 2020

Central Government Health Scheme (CGHS)

The Central Government Health Scheme (CGHS) is a medical insurance scheme offered by the government of India to all the current as well as previous employees. It is a very affordable and wholesome form of health insurance that the employees and their dependent family members benefit from. The insurance coverage is comprehensive and available at multiple locations across the country. Take a look at this article to know more about the CGHS and how you can also benefit from it.

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Features of the Central Government Health Scheme (CGHS)

Let us begin by checking out the beneficial features of this health insurance scheme:

1. In-hospital care – All expenses related to the hospitalisation of an insured person are covered under the CGHS.
2. Domiciliary care – If the employee or his dependents need domiciliary care (home health care), a claim can be made against the CGHS.
3. Pharmacy expenses – The pharmacy expenses incurred during an illness are also covered under the CGHS. You can get the pharmacy bills reimbursed after you pay the money yourself.
4. Diagnostic tests – If you need to undergo any diagnostic tests such as blood tests, x-rays, etc you can make a CGHS claim.
5. OPD expenses – The expenses incurred when visiting consultant doctors in the OPD department will also be covered under the CGHS.

These are the covers available under the Central Government Health Scheme (CGHS). If you are enrolled in the CGHS, you too shall be entitled to enjoy these beneficial features and covers.

Enrollment in the Central Government Health Scheme (CGHS)

The enrollment in the CGHS can happen in two cases. One, for the existing employees and one for the retired employees. Here’s a detailed lowdown:

1. For existing employees – All existing employees of the Government of India are automatically made a part of the Central Government Health Scheme (CGHS). As an employee, you do not need to do anything special. Your employer will give you the coverage as soon as you start working, from the first day of your employment in the government. A small and almost negligible percentage of your salary will be deducted and it will work as the premium for the health insurance cover.
2. For retired employees – The retired employees need to initiate the CGHS enrollment process. They can opt for a yearly contribution model and pay a fixed sum of money each year to stay covered. Alternatively, they can pay a lump sum amount and stay covered for a term of 10 years. If you are a retired government employee, make use of this scheme and cover yourself as well as your family members under this health insurance scheme.

For both the categories, the dependent family members of the insured are also covered. The dependents receive all the benefits and covers of the CGHS as well.

CGHS Centres

The government has tied-ups with various hospitals and health care centres around the country where an insured can avail the scheme. You must note an important point here – the CGHS scheme is strictly available only at the partner health care centres and not at every hospital in India. It is also restricted to some cities and towns and may not be available at every single location in the country. The towns and cities where you do find the CGHS centres include:

AgartalaDelhi & NCRJammuPuducherry
AhmedabadGandhinagarKanpurRaipur
AizwalGangtokKolkataRanchi
AllahabadGoaKohimaShillong
BengaluruGuwahatiLucknowShimla
BhopalHyderabadMeerutThiruvananthapuram
BhubaneshwarImphalMumbaiVishakhapatnam
ChandigarhIndoreNagpur
ChennaiJabalpurPatna
DehradunJaipurPune

It is always a good idea to check with the hospital before you get admitted. If you find out after the treatment is done that the hospital is not a CGHS listed hospital, there is no way in which you can use the scheme coverage there.

Employees eligible for the Central Government Health Scheme (CGHS)

If you are a present or past employee of the following, you can make use of the CGHS:

  1. The present and ex-employees of the central government and their family members
  2. Pension receivers of the central government and their dependents
  3. Present and ex-parliamentarians
  4. Present and former Indian governors
  5. Freedom fighters
  6. Ex vice-presidents
  7. Former and present Supreme/High Court judges
  8. Police officers employed by the state of Delhi
  9. Railway staff
  10. Postal staff

The list is quite extensive and most of the government employees benefit from this scheme.

To wrap it up

Now that you know more about the Central Government Health Scheme (CGHS), take full advantage of it as an employee of the Indian Government. From hospitalisation expenses to OPD visits, you can get many covers and stay healthy when enrolled in this wonderful health insurance scheme.

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