Central Government Health Scheme - CGHS Card

What is Covered Under CGHS -  Central Government Health Scheme ?

The Central Government Health Scheme provides comprehensive health coverage which includes the following:

1. Out Patient Department (OPD) treatment including medicines.
2. Expenses incurred for buying hearing aids, appliances, artificial limbs, etc. will be reimbursed.
3. When the beneficiary faces a medical emergency, expenses incurred for treatment availed in public or private hospitals will be reimbursed.
4. Maternity, Family Welfare, and Child Health Care.
5. Medical consultation for all forms of treatments including AYUSH (Ayurveda, Homeopathy, Unani and Siddha).

For treatment in network hospitals, cashless facility is also available for the beneficiaries of CGHS.

As stated above, every beneficiary of the CGHS is provided with a plastic card known as the CGHS card. The card bears the photo and a unique ID number of the beneficiary. This card is a must when availing facilities under the CGHS.

Loss of the CGHS card requires the beneficiary to report to the police and the CGHS authorities. A copy of the FIR, along with an application form to the Additional Director, and a penalty fee of Rs.50 will be needed to obtain a duplicate copy of the card.

How to Obtain a CGHS Card?

Serving employees or pensioners who are eligible for the scheme need to submit a duly-filled application form provided on the sites - www.cghs.nic.in and www.cghs.gov.in. The form can also be obtained from wellness centres.

Serving Employees - Along with the application form mentioned above, documents of proof of residence, age proof of the dependent, proof of stay of the dependent need to be attached. In case the dependent is differently abled, a disability certificate from competent authority needs to be provided.

Pensioners - With respect to pensioners, attested copies of PPO/Provisional PPO/Last Pay Certificate, demand draft payable at "PAO CGHS New Delhi", and the application form duly filled should be submitted to the concerned authority.

Provision for Making CGHS Card while Still in Service - An employee who is currently serving at a central government organisation can apply for his/her pensioner CGHS card while still in service. To do this, the employee just has to forward the application with the enclosures and the demand draft through his organisation. The pensioner card however, will be issued only at the time of his/her retirement.

What is the Eligibility Criteria for CHGS?

All the employees working for the central government, pensioners and their dependents are eligible for the scheme, provided they reside in the CGHS covered areas. Other than this, the below are also eligible for the CGHS scheme:

1. Freedom fighters
2. Ex-governors and Lt. governors
3. Retired judges of High Courts
4. Railway board employees
5. Current and ex-members of Parliament
6. Employees of Post and Telegraph department

Deletion or Addition of Names in the CGHS Cards:

1. Upon marriage or birth of a child, a serving employee can get the spouse/child's name added by submitting the duly endorsed form by his/her department.
2. In case of death of the cardholder, the card will be deemed invalid and the dependent has to apply for a fresh card by attaching the old CGHS card and death certificate.
3. In case a dependent of the cardholder dies, the names on the CGHS card can be deleted by informing the CGHS department.

Validity of the CGHS Card:

The CGHS card of a serving employee is valid till his/her retirement day. To continue validity on annual contribution pensioner cards, the contribution has to be done one year prior to the completion year. The CGHS card is only valid in CGHS cities.

For pensioners living outside the CGHS areas, a regular CGHS card can be obtained from the nearby CGHS city.

Features of CGHS Card:

1. Upon expiry of the card, it has to be surrendered to the concerned department. If it requires renewal, the required form should be filled and submitted.
2. The CGHS card cannot be transferred from one person to another.
3. Any misuse of the card will attract a penalty and disciplinary action will be taken if a government employee misuses the card.
4. The CGHS card is white in colour with a coloured strip at the top. The strips are of 4 colours - red, blue, green, and yellow. The coloured strip denotes the status of the cardholder. Members of parliament are denoted by red while blue indicates that the cardholder is a serving government employee. Freedom fighters, pensioners, retired personnel, and ex-MPs are represented by the green strip colour while yellow represents journalists and beneficiaries of autonomous organisations.