Central Government Health Scheme

About Central Government Health Scheme – CGHS

For the last six decades Central Government Health Scheme is providing comprehensive medical care to the Central Government employees and pensioners enrolled under the scheme. In fact CGHS caters to the healthcare needs of eligible beneficiaries covering all four pillars of democratic set up in India namely Legislature, Judiciary, Executive and Press. CGHS is the model Health care facility provider for Central Government employees & Pensioners and is unique of its kind due to the large volume of beneficiary base, and open ended generous approach of providing health care. 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.

The scheme offers OPD, IPD, specialist consultations, medicines, diagnostic tests, and cashless treatment at empanelled hospitals in major cities across India.

About NHA

National Health Authority (NHA) Is The Apex Body Responsible For Implementing India’s Flagship Public Health Insurance/Assurance Scheme Called “Ayushman Bharat Pradhan Mantri Jan Arogya Yojana” & Has Been Entrusted With The Role Of Designing Strategy, Building Technological Infrastructure And Implementation Of “Ayushman Bharat Digital Mission” To Create A National Digital Health Eco-System. NHA Is Leading The Implementation For Ayushman Bharat Digital Mission (ABDM) In Coordination With Different Ministries/Departments Of The Government Of India, State Governments, And Private Sector/Civil Society Organizations.

Facilities of Central Government Health Scheme – CGHS

• Cashless treatment at empanelled hospitals.
• OPD Treatment at WCs including issue of medicines.
• Specialist Consultation at Polyclinic/Govt. Hospitals and at CGHS empanelled hospitals after referral by CGHS.
• OPD/ Indoor treatment at Government and empanelled Hospitals.
• Investigations at Government and empanelled Diagnostic centers.
• Cashless facility available for treatment in empanelled hospitals and diagnostic centers for Pensioners and other identified beneficiaries.
• Reimbursement of expenses for treatment availed in Govt. /Private Hospitals under emergency and specific treatment advised by Govt. Specialist or Specialist of Pvt. HCOs duly endorsed by CMO/MO of WCs.
• Reimbursement of expenses incurred for purchase of hearing aids, artificial limbs, appliances etc., after obtaining permission.
• Family Welfare, Maternity and Child Health Services.
• Medical consultation. Dispensing of medicines in Ayurveda, Homeopathy, Unani and Siddha system of medicines (AYUSH)

Eligibility for Joining CGHS

Persons Eligible under the Central Government Health Scheme

1. All Central Government employees paid from the Central Civil Estimates (except Railways and Delhi Administration), including their families.
2. Pensioners of Central Government (except pensioners belonging to Railways and the Armed Forces) and their families.
3. Central Government Pensioners retiring with Contributory Provident Fund benefits and their families.
4. Widows of Central Government pensioners receiving family pension.
5. Delhi Police personnel and their families (in Delhi only).
6. Railway Board employees.
7. Civilian employees of Defence paid from Defence Service Estimates (except in Mumbai where the scheme is operational).
8. Child drawing pension on death of a Central Government employee including minor brothers and sisters of such child.
9. Ex-Governors and Lt. Governors and their families.
10. Ex-Vice Presidents and their families.
11. Central Government servants deputed to semi-government and autonomous bodies receiving substantial grants from the Central Government.
12. Central Government employees on deputation to statutory/autonomous bodies during deputation period.
13. Military Officers on deputation to civil departments receiving emoluments from Central Civil Estimates.
14. Families of Government servants transferred to non-CGHS areas (maximum six months with advance CGHS contribution).
15. Families of IAS Officers (North-Eastern & J&K Cadre) staying in Delhi under prescribed conditions with advance contribution.
16. Parliamentary Secretaries of the Central Government and their families.
17. Members of Parliament and their families.
18. Ex-Members of Parliament.
19. Sitting and former Judges of Supreme Court and High Courts.
20. Work Charged and Industrial Staff in establishments run by Central Government Ministries/Departments.
21. Employees of Kendriya Vidyalaya Sangathan in specified cities (Delhi & NCR, Kolkata, Chennai, Hyderabad, Mumbai, Bengaluru).
22. Employees of Ordnance Factory Board Headquarters (Kolkata) and Ordnance Equipment Factories Headquarters (Kanpur).
23. All India Service pensioners retiring while serving under the State (at their option).
24. Freedom Fighters and family members receiving Central Pension under Swatantrata Sainik Samman Pension Scheme.
25. Family members of deceased Ex-Members of Parliament.
26. Pensioners of Ordnance factories.
27. Members of Staff Side of National Council of Joint Consultative Machinery.
28. Persons employed in semi-government and autonomous bodies permitted to join CGHS.
29. Accredited Journalists (with Press Council of India certificate) for OPD and RML Hospital treatment.
30. Retired Divisional Accountants of Indian Audit and Accounts Department whose pay/pension is borne by State Governments.
31. PSU absorbees who commuted 100% pension and restored 1/3rd after 15 years.
32. Employees of Statutory/Autonomous Bodies receiving Central Civil Pension.
33. Serving and retired Railway Audit Staff.
34. Retired Divisional Accounts Officers and Divisional Accountants of Comptroller and Auditor General of India.
35. CISF personnel and CAPF personnel posted in CGHS cities.
36. Employees of Supreme Court Legal Services Committee and India Pharmacopoeia Commission, and their families.
37. Family/dependent members of CGHS beneficiaries staying back in CGHS areas after transfer to specified regions (with advance annual contribution).
38. Defence Industrial Employees of Naval Dockyard, Central Ordnance Depot and AFMSD (Mumbai).

How to Apply / Check Eligibility

• Apply through the official CGHS portal
• Login using registered credentials
• Submit required documents online
• Track application status via portal

Documents Required

1. Service Certificate / Pension Payment Order (PPO)
2. Aadhaar Card
3. Residential Address Proof
4. Passport-size Photograph
5. Mobile Number for communication

Application Process (Offline & Online)

Online: Register on the CGHS portal, upload documents, and generate CGHS card after approval.

Offline: Submit application form and documents at the nearest CGHS wellness centre.

Exclusions

• Treatments outside empanelled hospitals without referral
• Cosmetic procedures not medically necessary
• Non-covered therapies not approved under CGHS guidelines

Frequently Asked Questions

Q: Is CGHS treatment cashless?
Yes, treatment at empanelled hospitals is cashless.

Q: Can pensioners apply for CGHS?
Yes, central government pensioners are eligible.

Q: Is CGHS available in all cities?
No, it operates in notified cities only.