FREQUENTY ASKED QUESTIONS WITH ANSWERS ABOUT CGHS
(FAQs
on CGHS are intended to provide general information and guidance needed
for the CGHS beneficiaries to avail CGHS facilities The contents must
be read in conjunction with OMs/Office orders as issued from time to
time. The contents are not intended to be applicable to specific /exceptional
cases and no such claims may be made under it. Whenever any
difference in interpretation of meaning and/or content of the facts stated
here vis-à-vis the original OM/office order arises, the latter will be treated
as final and binding).
1.
Who are entitled for CGHS facilities?
1.
All Central Govt. employees and their dependant family members
residing
in CGHS covered areas.
2.
Central Govt Pensioners and their eligible family members getting
pension
from Central Civil Estimates
3.
Sitting and Ex-Members of Parliament
4.
Ex-Governors & Lieutenant Governors,
5.
Freedom Fighters
6.
Ex-Vice Presidents
7.
Sitting and Ex-Judges of Supreme Court & HighCourts
8.
Employees and pensioners of certain autonomous organizations in
Delhi
9.
Journalists (in Delhi) accredited with
PIB
(for OPD & at RML Hospital)
10.
Delhi Police Personnel in Delhi only
11.
Railway Board employees
12.
Post and Telegraph Depatt. employees
2.
What are the facilities available under CGHS
1.
OPD Treatment including issue of medicines.
2.
Specialist Consultation at Polyclinic/Govt. Hospitals.
3.
Indoor Treatment at Government and Empanelled Hospitals.
4.
Investigations at Government and Empanelled Diagnostic centers.
5.
Cashless facility available for treatment in empanelled hospitals and
diagnostic
centers for Pensioners and other identified beneficiaries.
6.
Reimbursement of expenses for treatment availed in Govt. /Private
Hospitals
under emergency.
7.
Reimbursement of expenses incurred for purchase of hearing aids,
artificial
limbs, appliances etc. as specified.
8.
Family Welfare, Maternity and Child Health Services.
9.
Medical consultation and dispensing of medicines in Ayurveda,
Homeopathy,
Unani and Siddha system of medicines (AYUSH)
3.
What the timings of Wellness Centres/Polyclinics
Wellness
Centers are open from 7:30 AM to 2:00 PM on all working days
except
emergency services wherever applicable.
2 Emergency
services are available in following 4 WCs only in Delhi
o
South Avenue
o
North Avenue
o
Zakir Hussain Road
o
Kingsway Camp
Timings
of WCs with emergency services are as follows
WC
timing 7:30AM to 1:30 PM
Limited
Emergency services 1:30PM to 7:30AM
The
Wellness Centres remain closed on all Central Govt. holidays. However
in
case of three consecutive holidays occurring together, Wellness Centres
will
not be closed for more than 2 consecutive days.
Registration
Timings: The registration is stopped 15 minutes before
scheduled
closing time of dispensary. However, no serious patient is
returned
back unattended in the dispensary.
There
are also 6 First Aid Posts ( FAP) at following locations in Delhi
o
Nirman Bhawan
o
Central Secretariat
o
Vitthal Bhai Patel House
o
Shastri Bhawan
o
Narmada House opposite RML Hospital
o
Supreme Court and
o
Moti Bagh
The
timings of these FAPs is from 9:00 AM to 5 :00 PM
4.
In how many cities CGHS is presently operational?
Following
Cities have CGHS facilities at present
1.
Agartala
2.
Ahmedabad
3.
Aizwal
4.
Allahabad
5.
Bengaluru
6.
Bhopal
7.
Bhubaneshwar
8.
Chandigarh
9.
Chennai
10.
Dehradun
11.
Delhi & NCR
12.
Gandhinagar
13.
Gangtok
14.
Goa
15.
Guwahati
16.
Hyderabad
17.
Imphal
18.
Indore
19.
Jabalpur,
20.
Jaipur
21.
Jammu
22.
Kanpur
23.
Kolkata
24.
Kohima
25.
Lucknow
26.
Meerut
27.
Mumbai
28.
Nagpur
29.
Patna
30.
Pune
31.
Puduchery
32.
Raipur
33.
Ranchi
34.
Shillong
35.
Shimla
36.
Thiruvananthapuram
37.
Vishakhapatnam
5.
For the purpose of making CGHS cards, who are 'dependant', and
what
is definition of the word “family"?
The
term ‘family’ means and includes-
Husband
or wife, as the case may be, and other dependant family
members.
Dependant Family Members include: parents (female
employee
can have either her parents or her parents-in -law as
dependents),
sisters, widowed sisters, widowed daughters, minor
brothers
and minor sister, children and step-children wholly
dependent
upon the Government Servant and are normally residing
with
the Government Servant (son upto the age of 25 or till his
marriage
whichever is earlier and daughter till she gets married). Also
now
'dependent' includes, dependent divorced /separated daughters
(including
their dependant minor children) and step-mother.
The
term 'dependent' means that income from all sources including
pension
and pension equivalent of DCRG benefit is less than Rs. 9000
+DA
per month. This clause is to be fulfilled for all 'dependent' family
members.
However, there is no such clause as dependency in respect
of
spouse.
6.
Is there any age limit for sons / daughters as dependant in CGHS Card?
Son
is eligible till he starts earning or attains the age of 25 years or gets
married
whichever is earlier.
However,
in case the son is suffering from any permanent disability of
any
kind (physical or mental) he is eligible for CGHS benefits even after
25yrs.
Daughter
is eligible till she starts earning, or gets married, whichever is
earlier
(irrespective of age)
7.
Who is competent to delete name of sons who have
crossed
age of 25 years from CGHS Card?
CMO
i/c of Wellness Centre is competent to delete the name of son aged
25
yrs and above. Computer software does not allow sons aged 25 and
above
to avail medical facilities and automatically blocks their ID .
8.
Who is responsible for deletion of the names of ineligible dependents?
It
is the responsibility of various departments/offices forwarding the
application
for CGHS card to ensure that the names of only genuine and
eligible
persons are included in the CGHS token cards.
It
is the responsibility of the employees concerned to apply for a deletion of
the
name of the dependent from the CGHS card, when the ward is no more
entitled
to the benefit under the scheme for example a son /daughter getting
married,
son attaining age of 25 or the son getting employed.
9.
What is the role of a beneficiary in providing information regarding
any
change in data regarding his card?
It
is the responsibility of the beneficiary to provide information to CGHS
authorities
regarding any changes required in the beneficiary database
especially
related to death, marriage, earning status (see dependency
criteria)
of any card holder in the family.
10.
Are the family members of Central Government Servant not residing with
him
eligible for CGHS facilities?
Family
members who are wholly dependent upon the Central Government
employee
are normally expected to reside with the primary card holder.
However,
during a visit to another CGHS covered city they are eligible for
CGHS
facilities on the basis of individual Plastic Card issued to the dependent
family
member.
11.
What is the grace period for getting CGHS card for availing treatment
facility/
reimbursement for indoor treatment by pensioners immediately
after
retirement?
Pensioners
are permitted period of three months from the date of
superannuation
to obtain a CGHS pensioner Card for consideration of
reimbursement
for the treatment taken during grace period , subject to the
condition
that Application complete with all documents and requisite CGHS
subscription
is submitted to the office of Additional Director during the fourth
month
after retirement for issue of CGHS pensioner card. In case , CGHS
pensioner
card is not made in the 4th month after retirement , no
reimbursement
for the expenditure incurred for treatment during grace
period
of three months is permissible.
12.
Who is defined as a 'Person with disability'?
A
'person with disability' as defined in 'The Persons with Disabilities
(Equal
Opportunities, Protection of Rights and Full Participation) Act,
1995'
as, a person suffering from not less than forty percent (40%) of any
disability
(as given below), certified by a medical authority. "Medical
authority"
means any hospital or institution specified for the purposes of
this
Act by notification by the appropriate Government. A disability
certificate
from Medical Board of a Government Hospital is required to
be
submitted in CGHS with application form to continue availing
facilities
for disabled dependant.
Disability
means blindness, low vision, leprosy-cured, hearing
impairment,
locomotor disability, mental retardation, mental illness. For
the
exact definition of each disability please refer to 'The Persons with
Disabilities
(Equal Opportunities, Protection of Rights and Full
Participation)
Act, 1995' chapter 1, section 2a. to 2z.
13.
Are step-children allowed CGHS facilities?
Yes.
if they are dependent on card holder and other conditions being
fulfilled
as in case of dependant sons and daughters.
14.
Can dependent in-laws be included under family members for CGHS facilities
A
lady Government servant will be given a choice to include either her
parents
or parents –in-law for the purpose of availing the benefits under
CGHS
subject to the condition of dependence and residence , etc., being
satisfied.
15.
My wife and I are both central Government employees and have
dependant
brothers / sisters and parents. Can we make separate cards
and
include family members?
Yes.
If both husband and wife are in central Govt. service, spouse has the choice
to make his/ her parents and brothers/sisters as dependants in her card. However
if only one person i.e. either husband or wife are in service than he/she
has the choice to make either his/her parents or his/her parents - in-law
as dependants in his/her card.
6
16.
What is the procedure to register with the CGHS?
Pensioners:
One
can get a CGHS card made from the office of Additional Director of the
City. Forms can be downloaded from CGHS Website. They are also available
in the office of Additional Director of city (Additional Director Headquarter
in case of Delhi).
Documents
required:
1.
Application in prescribed format
2.
Proof of residence
3.
Proof of stay of dependents
4.
Proof of age of son
5.
Disability certificate, if any in case of sons aged 25 & above,
who
would otherwise cease to be a beneficiary.
6.
Individual passport size photos of eligible familymembers
7.
Surrender Certificate of CGHS Card while in service ( only in
those
cases where CGHS Card was issued while in service)
8.
Attested copies of PPO & Last Pay Certificate
9.
Draft for required amount towards CGHS contribution – in the
name
of ‘P.A.O., CGHS New Delhi’ in Delhi and in the name of
‘Additional
Director, CGHS' of the city.
In
case PPO is not ready for any reason, there is option to get a provisional
card
on the basis of Last Pay Certificate. The data uploaded in the data
base
and a print out is issued on the same day for immediate use. Plastic
cards
are sent to the Wellness Centres and the beneficiaries collect the
cards
from there. The plastic card numbers are displayed on the notice
board
of the Wellness Centre for the information of the beneficiaries.
SMS
is sent to the mobile number of the beneficiaries reminding them to
collect
their plastic cards.
Serving
employees:-
Serving
employees submit the forms in prescribed format enclosing
photos
of eligible family members and submit to the Ministry/
Department/
Office, where he/ she is employed. The application form
shall
be forwarded by the Ministry/ Office /Department to the office of
Additional
Director CGHS of city for preparation of card. The plastic cards
are
distributed through the Wellness Centres as in case of pensioners.
SMS
is sent in case of serving employees also.
17.
Can I apply for the card online?
Yes
online application can be made by visiting CGHS website cghs.gov.in or
CGHS
portal cghs.nic.in. All the required documents can be uploaded and
CGHS
contribution can be paid online by pensioners.
18.How
long does it take to get the CGHS Cards made?
Normally
computerized printout of index card is issued on the same day.
Usually,
it takes 3 to 4 weeks for the plastic card to be made after which
it
is delivered to the Wellness Centre, for collection by beneficiaries.
However
the facility to print your own card is available by visiting CGHS
portal
cghs.nic.in. A colored print out on the card may be taken and
laminated
for use as a plastic card. The services can also be availed by
showing
the printout of index card is issued on th day the application is
submitted.
19.
Whom should I approach in case the CGHS Card is not issued to me in
the
prescribed time?
You
may contact Additional Director CGHS (HQ), in case of Delhi and
Additional.
Director of City in case of other cities.
20.What
should I do if I lose my CGHS Card ?
Application
is to be submitted to Additional Director of the city
(Additional
Director, CGHS Headquarters in case of Delhi) along with
two
photographs and a IPO for Rs. 50/- for issue of duplicate card.
Copy
of FIR for the lost cards is also to be submitted with the
application.
Indian
Postal Order payable to “ P.A.O. CGHS Delhi” if in Delhi or
“Additional
Director of the CGHS City “ in respect of other cities
21.
What should I do if the details on the Card viz. name, date of birth,
entitlement,
etc. are wrong?
Kindly
bring the anomalies to the notice of Additional Director, CGHS
(HQ),
in Delhi and to the Additional Director of concerned CGHS City in
other
cities, along with the necessary documents to rectify the error.
22.
Is there a colour scheme for plastic cards? What are they?
CGHS
Plastic cards have any one of the following colour strips at the
top
indicating the category:
Serving
Government employees -Blue
Pensioners,
exMPs ,FreedomFighters, etc. -Green
Member
of Parliament -Red
Beneficiaries
of Autonomous Bodies/Journalists -Yellow
23.Are
CGHS facilities free of cost?
No,
they are not. For serving Central Government employees residing
in
CGHS covered area, obtaining a CGHS card is compulsory.
The
following deductions from salary of the employees are made by
the
department, every month, depending upon their pay in the pay
8
matrix
of 7th Pay commission (wef 1/1/2017)
Corresponding
levels in Pay Matrix
as
per 7th CPC
Contribution
per
month
Level
1-5 Rs. 250
Level
6 Rs. 450
Level
7-11 Rs. 650
Level
12 and above Rs. 1000
Pensioners
who want to avail CGHS facilities can make contribution
either
on yearly basis or one time ( ten yrs ) contribution for whole life
validity.
Payment
can be made by Demand Draft in favour of “ P.A.O. CGHS
Delhi”
if in Delhi or “ Additional Director of the CGHS City “
Contribution
to be made by the Pensioners/Family Pensioners would be
the
amount that they were subscribing at the time of their retirement or
at
the time of the death of government servant
24.What
are the criteria for Entitlement of ward endorsed on CGHS Card
in
CGHS Empanelled Hospitals?
Entitlement
of wards in private hospitals empanelled under CGHS is as under
S
N Ward Entitlement
Corresponding
Basic pay
drawn
by the officer in 7th
CPC
per month
1
General Ward Upto Rs. 47,600/-
2
Semi Private Ward Rs. 47,601 to 63100/-
3
Private Ward Rs. 63101 and above
25.
I am a serving employee residing in a place close to a city
covered
under CGHS. Can I get CGHS card issued from the
nearest
CGHS city?
There
is no provision to avail CGHS facilities in respect of serving
government
employees residing in non-CGHS covered areas. They are
covered
under CS(MA) Rules 1944.
26.
How can the family members of Central Armed Police Forces personnel
who
are transferred out from CGHS covered areas to J&K State and Left Wing
Extremism
affected areas, avail CGHS services if they stay back?
CGHS facilities are extended to the eligible dependent family
members
of such CAPFs personnel.
9
CGHS contributions shall be paid in advance on annual basis, by the
CGHS
beneficiary through bank DD, drawn in favour of the AD/JD of
the
concerned CGHS city where his family is residing/place where
the
CGHS beneficiary was last posted.
The annual CGHS subscription will have to be paid within two months
from
the date of posting of the CAPF personnel.
A certificate from the Ministry of Home Affairs confirming the
residence
of the family and dependent members in CGHS covered
city/area
will be required, along with the posting order.
27.
What are the different options for availing CGHS services to pensioners?
Pensioners Residing in CGHS covered areas:
a)
They can get themselves registered in CGHS dispensary
after
making requisite contribution and can avail both OPD
and
IPD facilities.
b)
Such Pensioners are not eligible for Fixed Medical
Allowance
in lieu of CGHS.
Pensioners residing in non-CGHS areas:
a)
They can opt for availing Fixed Medical Allowance (FMA) @
Rs.
1000/- per month by not paying any contribution.
b)
They can also avail benefits of CGHS (OPD and IPD) by
registering
themselves in the nearest CGHS city after making
the
required subscription. In such cases no Fixed Medical
Allowance
is given
c)
They also have the option to availing FMA for OPD
treatment
and CGHS only for IPD treatments after making the
required
subscriptions as per CGHS guidelines.
28.
I have retired from Delhi. Now I want to settle at city where no CGHS
facility
is available. How do I cover my family for medical care?
Pensioners
are eligible for CGHS facilities and can obtain CGHS card from
the
nearest CGHS covered city.
29.
I retired in 1998 from Central Government service but, I never made
a
CGHS card. Can I get a CGHS card now?
Pensioners
can apply for CGHS card with relevant documents. However,
the
subscriptions as applicable at current rates shall have to be paid.
30.
My husband/wife is also employed under Central Government and is
eligible
for a separate CGHS Card. Is it necessary that separate cards are
to
be obtained?
No.
Spouse drawing higher pay shall make the card and other spouse is
eligible
to avail CGHS benefits as member.
31.
My husband / wife retired in 2002. He /she was paying CGHS
subscription
every year. After his death can I get the card transferred in
my
name ? Do have I to pay extra ? Shall I get Life Time Valid card?
Yes,
the ownership of card can be transferred in the name of spouse on
submission
of required documents. Additional Director of concerned city
shall
transfer the ownership of Card in the computer database and same
CGHS
plastic cards with same Beneficiary ID can be used.
No
extra payment is to be made, in case of life time cards. However in
other
cases one has to pay total 10 years subscription for life time card
For
example, if the spouse had contributed for seven years before he
expired
, balance payment for the remaining three years is to be paid for
a
life time card.
Documents
required :
i)
Application in prescribed format
ii)
Proof of Family Pension with its break up from the bank
having
his/her pension account.
32.
How to transfer CGHS card from one Wellness Centre to other in the
same
city?
If
there is any change in residential address, CMO I/c may be approached
with
proof of residence for transferring the data on-line from one
Wellness
Centre to another in the same city. CMO I/c of the new Wellness
Centre
will accept on-line, the data of transferred card.
In
respect of serving employees the request is to be forwarded by his/her office
/ department.
33.
I am CGHS beneficiary at Kanpur and I am visiting Mumbai for 6
months.
Can I get CGHS facilities at Mumbai? Can the same card of
Kanpur
continue or is a separate card to be made? From where do I get
permission
for thesame?
Subsequent
to computerization no separate permission is required and
CGHS
card is valid for availing facilities from any CGHS Wellness Centre in
India.
For any assistance, Additional Director of the city (Additional
Director
CGHS HQ in case of Delhi) may be contacted.
34.
After retirement in 2007 I got a Life time Pensioner CGHS card made
in
Delhi. Now I am shifting to Dehradun. Can I use the same card? Do I
payagain?
Pensioners
shifting from one CGHS covered city to another, will have to
11
apply
to the Additional Director of concerned city for transfer of card. The
card
shall be transferred online and a receipt will be issued to the
beneficiary,
on the basis of which, Additional Director of new city ( say
Dehradun)
shall receive the data. The same Plastic cards and same Ben ID
will
be valid in the new city. No contribution is required to be paid in
respect
of pensioner beneficiaries holding life time cards.
35.
I live in Gurgaon but my office is in Saket. Can I avail facilities from
both
the places because it is convenient for me?
Yes.
Subsequent to computerization CGHS facilities can be availed from any
Wellness Centre in India.
36.
What are the rules on domiciliary visit?
The
Medical Officer will pay domiciliary visit wherever considered necessary
owing
to the inability of the patient to attend the dispensary.
Domiciliary
visits except in case of emergency will normally be made before or after
the dispensary working hours.
Lady
Medical Officers are exempted from paying domiciliary visits from 8 p.m. to
6 a.m.
37.
Are there any special provisions to CGHS beneficiaries aged 80 years and
above?
Following
special provisions have been given to such beneficiaries
a.
Consultation of Doctor at CGHS Wellness Centre without standing in
From : ITEF MUMBAI
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