The Central Government Health Scheme (CGHS) is a government-run health insurance scheme designed specially for the central government employees and their dependents. The scheme also covers pensioners who retired from the central government services and their dependents. The CGHS scheme was rolled out by the Ministry of Health and Family Welfare under the government of India in 1954. It offers a comprehensive medical cover to meet the health requirements of employees serving or have served in central government offices. The medical facilities under the CGHS can however, be availed only in CGHS covered cities. As of now, CGHS facilities are operational in 25 cities in India.
For the benefit of the individuals enrolled in the scheme, an official website has been created for the CGHS. The enrolled beneficiaries can log in to the CGHS site and access information regarding the benefits, features, eligibility, treatment procedures, reimbursement claims, etc.
Features of the CGHS:
CGHS is targeted at securing the health of beneficiaries in all four towers of democracy - judiciary, legislature, press, and executive. The scheme boasts of a broad beneficiary base and has the following features:
- CGHS covers allopathic, homeopathic, and AYUSH treatments.
- The enrolled beneficiaries will be given a plastic CGHS card containing the beneficiary's photo and a unique ID number.
- Under the scheme, expenses for Out Patient Department (OPD) and cost of medicines are also covered.
- Both cashless and reimbursement facilities are available for treatment in empanelled hospitals.
- Costs of hearing aids, artificial limbs, etc. will also be reimbursed under the scheme.
- In case of emergency hospitalisation at any hospital other than empanelled hospital, the reimbursement will be done based on the CGHS rates and not on the hospital rates.
- 2 pre-operative and post-operative consultations, hospital room rent, cost of medicines, and all other hospital related expenses are covered under this scheme.
- The scheme is self-funded and depending on the pay, a certain amount is deducted every month from the serving employee’s salary. For pensioners who wish to avail the CGHS benefits, they can make a one-time payment (for 10 years) or make a yearly contribution.
- Family welfare, child health, and maternity services can also be availed under the scheme.
Who is Eligible for the CGHS scheme?
As stated above, all the employees, pensioners, and the dependents of individuals serving/have served in central government offices are eligible for the scheme. Apart from that, the following are also entitled to avail benefits under the scheme:
- Current and Ex-Members of Parliament.
- Freedom fighters.
- Lt. Governors and Ex-Governors.
- Judges and Ex-Judges of Supreme Courts and High Courts.
- Ex-Vice Presidents.
- Employees of Railway Board.
- Employees and pensioners of specific autonomous bodies in Delhi.
- Journalists in Delhi accredited with Press Information Bureau (PIB).
- Delhi Police staff posted in Delhi.
How to Login to the CGHS site and Access Details?
The CGHS has introduced an online facility where enrolled beneficiaries can login and view details of their medical history, check status of medicines and reimbursement claims, etc. To log in to the site and access details, the steps given below need to be followed:
Step 1: Visit the site - www.cghs.nic.in.
Step 2: You will find a tab on the right side of the page that says ‘Beneficiary Login’.
Step 3: On clicking the tab, a new window will be opened that says ‘Beneficiary Sign in’.
Step 4: Under which you will find a tab to enter your beneficiary ID and password. If you do not have the password, you can generate one by clicking on ‘Generate Password’. Or, if you have forgotten your password, you can use the ‘Forgot Password’ option to reset your password by following the instructions provided.
Step 5: After receiving your password, you can use your login credentials (beneficiary ID and password) and view your details, the status of your claims, your medical history, etc.
Step 6: You can also update your Aadhaar number by clicking on the tab ‘Update Aadhaar No.’ and click on ‘Save’.
Enrollment for CGHS:
Employees currently serving under the central government offices simply need to submit the necessary forms, along with the photographs of eligible family members to the office/department/ministry where he/she is employed. The documents will be forwarded to the Additional Director of CGHS in the city, by the department/office/ministry.
Pensioners can directly approach the office of Additional Director and submit the required form and documents, to get themselves enrolled in the scheme.