India has a dynamic healthcare industry that will only make further progress in the coming years. However, like most healthcare systems across the globe, India’s healthcare has its fair share of shortcomings and tremendous scope for improvement.
Moreover, a considerable proportion of its populace remains alienated from the system, and equal access to healthcare for all citizens remains a major concern for the country. The government, therefore, aims to combat this issue through a number of programmes and schemes, one of which is the Central Government Health Scheme.
Allow us to offer you a clearer picture of this scheme so that you can understand its ins and outs.
The Government of India in 1954 introduced the Central Govt Health Scheme or CGHS as a healthcare facility for the former and current employees of the central government.
This scheme was explicitly mapped out for the betterment of individuals by rendering comprehensive medical care to its eligible beneficiaries.
Let’s take a closer look at the components of the Central Government Health Scheme:
Furthermore, CGHS extends health care by way of several systems of medicine, namely:
Wondering if you can avail the benefits of this scheme?
As aforementioned, CGHS is offered to central government employees only. Moreover, this scheme covers the following persons:
The Central Government Health Scheme comes with the following advantage for beneficiaries:
1) Reimbursement of expenses for treatment availed under emergency either in private or government hospitals
2) OPD treatment (includes an issue of medicines)
3) Treatment at Empanelled and Government hospitals
4) Specialist consultations at Polyclinic/Govt. Hospitals
5) Cashless facility for treatment in diagnostic centers and empanelled hospitals for pensioners and other eligible beneficiaries
6) Reimbursement of expenses incurred in purchasing hearing aids, appliances, artificial limbs, etc.
7) Medical consultation and purchase of medicines in Homeopathy, Unani, Ayurveda, and Siddha systems of medicine (AYUSH)
8) Maternity and child healthcare services and family welfare
Now, let’s get into the monetary aspect of this scheme.
The cost of availing of the Central Government Health Scheme varies depending on one’s employment status. Here is how it is classified:
For serving employees - A central government employee residing in a CGHS covered region must possess a CGHS card. The department of this employee makes monthly deductions from his/her salary depending upon the pay grade. This amount is contributed to the CGHS facilities.
For pensioners - If pensioners wish to avail the facilities of CGHS, they shall make a contribution based on the pay grade they were entitled to at the time of service. Moreover, this contribution can be made as a yearly or one-time/lifetime contribution.
The table below summarises the CGHS rate list:
|
CGHS treatment procedure |
Rate for NABH |
Rate for non-NABH |
|
OPD consultation |
135 |
135 |
|
Dressings of wounds |
52 |
45 |
|
Inpatient consultancy |
270 |
270 |
|
Suturing of wounds with local anesthesia |
124 |
108 |
|
Aspiration pleural effusion- Therapeutic |
200 |
174 |
|
Aspiration pleural effusion- Therapeutic |
138 |
120 |
|
Joints aspiration |
329 |
285 |
|
Stitch removal |
41 |
36 |
|
Biopsy skin |
239 |
207 |
|
Abdominal aspiration-Therapeutic |
476 |
414 |
|
Abdominal aspiration- Diagnostic |
380 |
330 |
|
Sternal puncture |
199 |
173 |
|
Venesection |
143 |
124 |
|
Dilation of Urethra |
518 |
450 |
|
Phimosis under LA |
1357 |
1180 |
|
Intercostal drainage |
144 |
125 |
|
Varicose veins’ injection |
363 |
315 |
|
Haemorrhoids’ injection |
428 |
373 |
|
Incision and Drainage |
435 |
378 |
|
Peritoneal dialysis |
1517 |
1319 |
|
Intercostal drainage |
144 |
125 |
Furthermore, private hospital wards empanelled under the Central Government Health Scheme are available based on one’s pay grade. This ward entitlement under the scheme is as follows:
Moreover, when it comes to a revised monthly subscription for the CGHS facility, the corresponding levels in the matrix as per 7th CPS and their respective contribution per month is as follows:
Referral from a medical practitioner is necessary for CGHS beneficiaries aged under 75 years seeking OPD consultation. However, those over 75 years, do not need any referrals to acquire the said medical consultation.
The Government of India provides all CGHS beneficiaries and their dependents with a photo ID plastic card called a CGHS card. It contains a unique beneficiary identity number, which an individual must produce to CGHS facilities at any point.
This card is white with a varying-coloured stripe at the top that depicts the cardholder’s status. Therefore, this strip can be any of the following colours:
CGHS cards remain valid until a beneficiary’s retirement date. To extend its validity post-retirement, one must make his/her contribution a year before the completion.
Additionally, after the expiration of this card, the cardholder must surrender the card to the concerned department.
In case you want to renew your CGHS card, you must submit a form and the necessary details.
Under no circumstance can this card be transferred from one employee to another. Furthermore, missing this card will attract penalties, and in extreme cases, strict disciplinary actions.
If eligible to be a CGHS beneficiary, you can apply for a CGHS card either from an authorised wellness center or through online registration. If taking the online route, simply visit the CGHS portal and submit an application form.
So, you can easily procure a CGHS card online if you reside in any of its applicable cities. Some of these cities include:
Premised upon your status, procuring a CGHS card calls for you to furnish the following documents:
Presently, this scheme covers 74 cities all across the country and comprises 38.5 lakh beneficiaries.
The Central Government Health Scheme, through an array of healthcare benefits, extends a helping hand to a sizable chunk of the Indian populace.
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Disclaimer #2: This information is added only for informative purposes and collected from different sources across the Internet. Digit Insurance is not promoting or recommending anything here. Please verify the information before making any decisions.
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