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Exclusive Wellness Benefits

Central Government Health Scheme (CGHS) For Government Employees in India

What is the Central Government Health Scheme?

Eligibility Criteria to Apply for CGHS

SL. NO Eligibility Criteria
1 Central Government Pensioners and their families who benefit from Contributory Provident Fund.
2 Pensioners of Central Government and their families
3 Civilian employees of Defence
4 Delhi Police personnel and their families
5 Ex-Lt. Governors and Governors, as well as their families
6 Former members of Parliament
7 Former Judges of High Courts and the Supreme Court
8 Industrial Staff working in establishments run by Ministries or Departments of the Central Government
9 Pensioners of Ordnance factories
10 Members of the Staff Side of the National Council of the Joint Consultative Machinery, even though not serving as Central Government employees
11 Serving and retired Divisional Accountants and Divisional Accounts Officers
12 Absorbees of Statutary Bodies or Autonomous Bodies of Central Govt., who are in receipt of Central Civil Pension
13 Employees of Ordnance Factory Board Headquarters, Kolkata and Ordnance Equipment Fcatories Headquarter, Kanpur
14 Central Government employees residing in CGHS covered areas, and their family members.
15 Post and telegraph department employees
16 Freedom Fighters and their family members receiving a pension under the Sainik Samman Scheme
17 Central Government employees deputed to semi-government or autonomous bodies receive significant finance by or grant from the Central Government
18 Families of Governments employees transferred to a non-CGHS area
19 Kendriya Vidyalayas Sangathan’s employees stationed at Delhi and NCR, Chennai Kolkata, Bengaluru, Mumbai, and Hyderabad
20 IAS Officer's family members on the North-Eastern Cadre are staying back in Delhi even after the officer's repatriation to the North-Eastern Cadre. This is also applicable to the family members of IAS Officers of J&K Cadre
21 Central Government’s Parliamentary secretaries and their families
22 Indian Pharmacopoeia Commission’s employees and their families
23 Serving and retired Railway Audit Staff
24 Supreme Court Legal Services Committee’s employees
25 Defence Industrial Employees of Naval Dockyard Central OrdnanceDepot and AFMSD, in Mumbai
26 Persons employed in semi-governmental and autonomous bodies who are allowed to join the CGH Scheme
27 Employees of the Railway Board
28 Journalists who are members of the Press Association
29 Widows of Central Government pensioners, in receipt of family pension
30 Ex-Vice Presidents of India and their families
31 Members of Parliament, including their families
32 Judges of the Supreme Court and High Court of Delhi
33 Family of a Central Govt. employee and CGHS beneficiary who stay back in CGHS covered area after the employee’s posting to North Eastern region
34 Family members of deceased Ex-Members of Parliament
35 Retired Divisional Accountants of the Indian Audit and Accounts Department whose pay and pension are borne by state governments
36 CISF and CAPF personnel posted in CGHS-covered areas and their families
37 PSU absorbees who commuted 100 per cent of their pension and have been restored one third portion of their pension after 15 years
38 All India Service Pensioners who retire while serving under the State at their option.
39 An Accredited Journalist who produces a certificate from the Press Council of India stating that he is a member of the Press Association, New Delhi (for OPD and at RML Hospital.

What is the Cost of Central Government Health 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 anaesthesia

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:

  • Private ward: Rs.63,101 and above
  • Semi-private ward: Rs.47,601-Rs.63,100
  • General ward: Up to Rs.47,600

Moreover, when it comes to a revised monthly subscription for the CGHS facility, the corresponding levels in the matrix as per the 7th CPS and their respective contribution per month are as follows:

  • Level 12 and above: Rs.1000
  • Level 7-11: Rs.650
  • Level 6: Rs.Rs.450
  • Level 1-5: Rs.250

Referral from a medical practitioner is necessary for CGHS beneficiaries aged under 75 years seeking OPD consultation. However, those over 75 years, old do not need any referrals to acquire the said medical consultation.

Benefits of the Central Government Health Scheme (CGHS)

The Central Government Health Scheme (CGHS) offers several advantages to its beneficiaries. The following services are the benefits of CGHS:

Benefit

Description 

Comprehensive Medical Care

Through the scheme, individuals will receive comprehensive medical care, including diagnostic tests for any ailments that may require hospitalisation or necessary consultations with medical professionals.

Financial Protection

The scheme's beneficiaries can receive medical treatments at reasonable rates in state government and private hospitals. In certain cases, they can opt for free healthcare services, a severe form of financial protection.  Under certain conditions, beneficiaries can also receive daily allowances.

Cashless Facility

CGHS offers a cashless system that covers medical expenses for its members. Beneficiaries can receive treatment at no cost or reduced rates at participating healthcare providers and submit bills to the scheme for reimbursement.

Preventive Medical Benefits

People participating in the Central Government Health Scheme can also receive preventive medical benefits, such as timely health checkups, dental care, immunisations, and many other things that improve quality of life.

Emergency Healthcare services

The Central Government Health Scheme offers its beneficiaries a cashless facility that allows them to receive medical treatments at no cost or a reasonable cost. Additionally, people can get financial coverage for the medical treatments of insured members and submit the medical bills to the relevant department of the scheme for settlement.

What is a CGHS Card?

How to Apply for Central Government Health Scheme (CGHS) Card?

If eligible to be a CGHS beneficiary, you can apply for a CGHS card either from an authorised wellness centre or through online registration. If taking the online route, simply visit the CGHS portal and submit an application form. The Central Government Health Scheme is available to current and retired Central Government employees. The application process steps to follow are as follows: 

  • Step 1: To start enjoying the plan's benefits, register first. 
  • Step 2: Open the CGHS official website on your PC or phone. 
  • Step 3: Download the application form by selecting the "Downloads" option. 
  • Step 4: A page requesting your personal information will be sent to you. Fill that out appropriately. 
  • Step 5: Send the application to the Additional Director's office in any of the CGHS-covered cities, along with your most recent photo and the required paperwork.

You can easily procure a CGHS card online if you reside in any of its applicable cities. These cities include:

Agartala Agra Imphal
Kozhikode Aligarh Allahabad (Prayagraj)
Amritsar Ranchi Rajahmundry
Bengaluru Bareilly Berhampur
Kannur Lucknow Kanpur
Dehradun Delhi and NCR Hyderabad (Trichy)
Ahmedabad Srinagar Guwahati
Shimla Silchar Puducherry
Panaji Siliguri Nashik
Thiruvananthapuram Nagpur Sonepat
Moradabad Panchkula Shillong
Varanasi (Banaras) Tirunelveli Mysuru
Saharanpur Kota Vijayawada
Kolkata Nellore Kohima
Muzaffarpur Jammu Jabalpur
Darbhanga Indore Dhanbad
Gorakhpur Guntur Gwalior
Gangtok Chanderpur Cuttack
Chennai Chhapra Bhopal
Ajmer Chandigarh Aizwal
Raipur Jalandhar Dibrugarh
Ambala Gandhinagar Patna
Baghpat Gaya Vadodara
Jaipur Coimbatore Meerut
Vishakhapatnam Bhubaneshwar Tiruchirapalli (Trichy)
Mumbai Chhatrapati Sambhaji Nagar Kochi
Jodhpur Pune

Documents required for CGHS card

Medical Packages Under CGHS

The CGHS has various packages under it. Follow the list below to see the detailed number of packages per procedure or condition:

S.No. Facility Number of Packages
1 OUT PATIENT 39
2 SKIN 9
3 E.N.T. 16
4 EYE 16
5 ORTHOPAEDIC AND PLASTER WORK 29
6 PHYSIOTHERAPY 18
7 DENTAL 10
8 OTHERS 9
9 X-RAY 30
10 ULTRASOUND INVESTIGATIONS 9
11 CLINICAL PATHOLOGY 16
12 HAEMATOLOGY 23
13 BLOOD BANK 8
14 BIOCHEMISTRY 30
15 HISTOPATHOLOGY 7
16 BACTERIOLOGY & SEROLOGY 13
17 ICU/CCU CHARGES Special Care Cases 16
18 OXYGEN CHARGES 4
19 BURN DRESSING 6
20 OBSTETRIC CASES 37
21 GENERAL SURGERY 37
22 HEAD & NECK 47
23 BREAST 6
24 CHEST 19
25 ABDOMEN 55
26 GENITOURINARY 37
27 OESOPHAGUS 9
28 PLASTIC SURGERY 35
29 CARDIAC SURGERY 2
30 ORTHOPAEDIC SURGERY PROCEDURE 53
31 NEURO - SURGERY 11
32 VASCULAR SURGERY 27
33 PAEDIATRIC SURGERY 34
34 GYNAE, OPERATION CHARGES 22
35 INVESTIGATIONS 38
36 CARDIOLOGY 21
37 CHEST MEDICINE 6
38 ONCOLOGY (NEW CLEAR MEDICINE) 9
39 CARDIO THORACIC SURGERY (CTS) 72
40 NEPHROLOGY 12
41 UROLOGY 73
42 ORTHO 6
43 NEURO SURGERY 66
44 COBALT 60 THERAPY 4
45 LINEAR ACCELERATORS 3
46 BRACHYTHERAPY 4
47 CHEMOTHERAPY CHARGES 3
48 LAPAROSCOPIC PROCEDURE 41
49 OPHTHALMOLOGY 56
50 CARDIO RESPIRATORY PROCEDURES 26
51 CHEST 18
52 EAR 17
53 NOSE 20
54 THROAT 9
55 NECK 7
56 LARYNX 6
57 HEAD AND NECK CANCER 13
58 GYNAE OPERATIONS 8
59 HYSTEROSCOPY 11

How to Find a Hospital List Under CGHS Scheme?

Hospitalisation Process Under CGHS Scheme

How to Book a Doctor’s Appointment Under the Central Government Health Scheme?

How to Link CGHS with ABHA for Central Government Employees?

CGHS Toll-Free Number and Address

FAQs about Central Government Health Scheme