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GetAll You Need To Know About the Central Government Health Scheme
May 1, 2025
The ever-increasing healthcare costs frequently deter few individuals from seeking quality and timely treatment. This breaks down their well-being and decreases their efficiency, in this manner influencing financial advancement. Keeping in mind the importance of good health, the Government of India started the Central Government Health Scheme (CGHS) for its employees and pensioners. The representatives secured beneath this comprehensive health insurance can profit from quality healthcare without draining their investment funds. This article goes through the highlights and benefits of the Central Government Health Insurance Scheme.
What is the Central Government Health Scheme (CGHS)?
Presented in 1954, the Central Government Health Scheme (CGHS) is an imperative health insurance scheme of the Indian Government. It covers serving government representatives, retired ex-employees and their families, guaranteeing comprehensive and reasonable medical services for the recipients.
The expanding healthcare costs can be a cause of concern for people and families with constrained budgetary assets. Keeping this in mind, CGHS helps beneficiaries get quality healthcare at any empanelled hospital or dispensary without having to worry about the medical bills. The plot cultivates a sense of well-being for the recipients and contributes to a more beneficial, joyful, and productive workforce.
The cashless health insurance is accessible in more than 80 cities all over the nation. It offers scope for diverse sorts of healthcare treatment, including allopathy, homoeopathy, and elective cures (AYUSH). However, the scheme is not completely free and comes with some charges. The recipients must contribute a small sum of INR 250 to INR 1000 monthly towards the scheme, depending on their monthly wages.
Features of the Central Government Health Scheme
The central government health scheme holds some unique features. Here are the aspects that stand out from the rest of the cashless health insurance schemes, making it one of the best health insurance plans in India:-
1. Coverage
The scheme gives comprehensive scope to the recipients and guarantees budgetary security amid medical crises and planned medical procedures. It covers in-patient treatment as well as out-patient office bills, demonstrative tests, doctor’s meeting expenses, price of medicines, etc.
2. Cashless Treatment
Recipients can choose the option for cashless treatment and empanelled clinics and restorative centres all over the nation.
3. Reimbursement of Expenses
During a medical crisis, insured individuals can claim repayment of their medical bills incurred at any hospital in the nation, government or private. Moreover, if a doctor of a private or government healthcare association prescribes treatment at a specific healthcare centre, the bills will be reimbursed.
4. Treatments Covered
Both allopathy and homoeopathy treatments are covered. Along with this, it also uses Ayurveda, Yoga, Unani, Siddha, etc. as a therapeutic procedure.
5. Medical Procedures Covered
The policy covers common surgeries, gynaecological methods, respiratory and gastrointestinal conditions, infectious diseases, ophthalmological strategies, orthopaedical methods, ENT medications, and paediatric conditions.
Eligibility for the Central Government Health Scheme
The Central Government Health Scheme has certain eligibility criteria, as listed below:
• All Central Government employees and their families are eligible, provided the employees' salaries are paid from the Central Civil Estimates, excluding those working in roads and the Delhi Administration.
• Pensioners of the Central Government and their families; pensioners belonging to the Railroads and the Armed Forces aren't included.
• Contributory Provident Fund benefits are accessible for retired Central Government pensioners along with their families
• Widows of Central Government pensioners entering the family pension
• Delhi Police labour force and their families residing in Delhi
• Workers of the Railway Board
• Former Vice Chairpersons and their families
• Present and former members of Parliament, along with their families
• Family members of the departed Members of Parliament
• Former Governors and Lieutenant Governors and their immediate family members
• Parliamentary registers of the Central Government and their families
• Current and retired judges of the High Court and Supreme Court and their families
• Workers of the post and telegraph department and their families
• Freedom fighters and their family members
• Intelligencers from the Press Information Bureau
• Military officers deputised to civil departments
• Current and sheltered Railway Audit Staff
• Pensioners of Ordnance factories
Benefits of the Central Government Health Scheme
1. Wide Coverage
CGHS offers extensive coverage, including hospital bills, OPD expenses, doctor's consultations, diagnostic tests, cashless treatments, emergency medical expenses, specific treatments, medical devices, maternity, child and family healthcare, and AYUSH consultations.
2. Affordable Healthcare
CGHS ensures timely and cost-effective treatment at enlisted government or private healthcare centres for emergencies and planned procedures.
3. Cashless Treatment
Beneficiaries get cashless treatment at empanelled clinics without out-of-pocket payments.
4. Preventive Healthcare
CGHS promotes early detection and timely treatment through regular health check-ups and screening programs.
5. Dental Expenses
CGHS covers dental check-ups and medications, including fillings, extractions, and complex procedures.
6. Pharmacy Services
CGHS runs drug stores all over India, giving endorsed medications to recipients.
Steps to Avail of Central Government Health Scheme (CGHS)
• Visit the official CGHS website and go to the "Downloads" section. Download the operation form for a plastic card.
• Fill out the form correctly. Collect the supporting documents, such as ID evidence, photos, government or pensioner ID card, evidence of hearthstone, evidence of age of the dependents, etc.
• Submit the form and the supporting documents to the office of the fresh Director in any CGHS-covered megacity.
• After registration, you'll receive a print ID plastic card containing the unique number of the beneficiary and CGHS scheme details.
Conclusion
The Central Government Health Scheme (CGHS) is a comprehensive health insurance activity by the Government of India, guaranteeing quality healthcare for its representatives and retirees. With extensive coverage and cashless treatment options, CGHS addresses the increasing healthcare costs and supports the well-being of beneficiaries. By offering in-patient and out-patient department treatment, CGHS fosters a healthier and more productive workforce, contributing to the nation's economic development.
Frequently Asked Questions
Q1. Who can be the beneficiaries under the Central Government Health Scheme?
Serving and retired Central Government employees and their families are eligible for CGHS.
Q2. Is the Central Government Health Scheme cashless?
Yes, CGHS provides cashless treatment at empanelled hospitals and healthcare centres.
Q3. What is the maximum limit for CGHS?
There is no specified maximum limit for CGHS coverage.
Q4. What is the time limit for claiming reimbursement for medical bills?
Medical bills must be claimed within six months from the date of discharge or treatment.
Q5. If both husband and wife are government employees, can they get separate CGHS cards?
Yes, both husband and wife can get separate CGHS cards if they are both Central Government employees.
Q6. Are CGHS facilities free of cost?
No, beneficiaries contribute a small monthly amount towards CGHS, ranging from INR 250 to INR 1000.
Q7. Are critical illnesses covered under CGHS?
Yes, CGHS covers critical illnesses and a wide range of medical treatments.
This blog is intended solely for educational and informational purposes. The content may include outdated information regarding the topic discussed. Readers are encouraged to confirm the accuracy and relevance of the data before making any significant decisions. SBI General Insurance disclaims responsibility for any errors or consequences arising from the use of outdated information provided herein.
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