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CGHS: Central Government Health Scheme - Eligibility, Benefits, Application Process & Hospitals List

TeamAckoJan 20, 2025

The Central Government Health Scheme (CGHS) is a healthcare program offering services to central government employees, pensioners, and their families. The services provided by the CGHS health program Include consultations, treatments, diagnostics, medications, hospitalisation, surgery, pre and postnatal care, deliveries, and immunisations. The CGHS health program can be accessed through a network of wellness centres and empanelled hospitals.

In this blog, we have broken down the essential elements of the scheme for you. So, read further to know more about CGHS.

central government health scheme (CGHS)

Contents

Government Mandates Linking CGHS with ABHA for Central Govt. Employees
What Are the Facilities Offered by the Central Government Health Scheme (CGHS)?
Who Are the Beneficiaries of CGHS?
- Eligibility Criteria for Central Government Health Scheme (CGHS)
Application Process of Central Government Health Scheme (CGHS) Card
How to Book a Doctor’s Appointment Under the Central Government Health Scheme?
What is the CGHS Empanelled Hospital List?
Final Words
Frequently Asked Questions (FAQs)
Term Insurance for Family’s Financial Security

Government Mandates Linking CGHS with ABHA for Central Govt. Employees

Linking CGHS beneficiary ID with ABHA as per the Ayushman Bharat Digital Mission starting on 1st April 2024 has been mandated by recent Ministry of Health and Family Welfare guidelines. This is meant to bring about efficiency in operations and foster better integration within these health programs.

CGHS stands for Central Government Health Scheme and is a health insurance plan for central government employees, which provides medical expense coverage up to Rs. 5 lakhs. For example, hip replacement surgery at private hospitals costs between ₹230,000 to ₹500,000, compared to an average of ₹82,000 charged by government hospitals.

Thus, ABHA linking is now required by all CGHS beneficiaries. However, despite over 4.4 million individuals benefiting from CGHS across 75 cities in India, the linkage with ABHA IDs remains low. By April 2nd, only 21,362 connections had been entered into the CGHS dashboard data.

Steps to link CGHS to ABHA ID:

Go here https://cghs.nic.in and go to Beneficiaries, then Beneficiary login.
Then log in using your beneficiary ID after filling in your password and the captcha details.
Proceed to Update and Create/Link ABHA ID
- Select ‘I don’t have an ABHA ID’ if you do not have an ABHA ID
- If you already possess an ABHA ID, choose 'Link Using ABHA Number.'
Enter your Aadhaar Number and complete the verification process with an OTP.
If all details are accurate, the linking process will be successful, and you can print your ABHA card.

What Are the Facilities Offered by the Central Government Health Scheme (CGHS)?

The ABHA system revolutionises health record management by offering a seamless digital platform. With its unique 14-digit ABHA ID, users can effortlessly store health data, manage insurance information, and grant access to preferred healthcare providers. This advancement marks a significant stride in India's journey towards digital transformation in healthcare.

Here are some of the facilities the Central Government Health Scheme provides:

Comprehensive Medical Care

Under the Central Government Health Scheme, individuals will receive comprehensive medical services. These include diagnostic tests in case of any ailments, based on which individuals can opt for hospitalisation or necessary consultations with medical practitioners.

Financial Protection

Beneficiaries of the scheme can get medical treatments at reasonable rates in the enlisted state government and private hospitals. In some cases, they can also opt for their healthcare services free of cost, which acts as a severe financial protection. Beneficiaries are also eligible to get daily allowances under specific parameters.

Cashless Facility

CGHS provides the beneficiaries with a cashless facility through which they can avail of medical treatments free of cost or at reasonable rates. Individuals can get financial coverage for medical treatments of insured members, and they can submit the medical bills to the concerned department of the scheme for settlement.

Preventive Medical Benefits

Individuals opting for the Central Government Health Scheme can also get preventive medical benefits such as timely healthcare checkups, dental care facilities, immunization, and many others, leading to an enhanced quality of life.

Emergency Healthcare services

The beneficiaries of CGHS get emergency medical attention. It includes critical care service, 24-hour medical service and attention, and much more. Moreover, an ambulance facility is also available in case of emergencies. It is also available for 24 hours.

Who Are the Beneficiaries of CGHS?

The Central Government Health Scheme (CGHS) covers the following individuals:

Central government employees
Their dependent family members who live in CGHS-covered areas
Retired Central government pensioners
Members of Parliament
Former Vice Presidents
Former and Lieutenant Governors
Current or retired judges of the Supreme Court and the High Court
Employees of the post and telegraph department
Delhi police personnel
Freedom fighters

Family members who are dependents are usually expected to live with the primary cardholder. However, they can use CGHS facilities in other CGHS-covered cities with their plastic card.

To apply for a CGHS card, serving employees can submit a form with photos of eligible family members to their Ministry, Department, or Office. The office will then forward the application to the Addl. Director CGHS of the city to prepare the card.

Eligibility Criteria for Central Government Health Scheme (CGHS)

The main target of the CGHS facility is to improve the provision of healthcare services within India. So, you need to satisfy a few eligibility parameters set by the Central Government to register for it. The criteria include the following:

You must be among the Parliament Members.
If you are among the Ex-Vice Presidents.
If you are one of the employees receiving wages from Central Civil.
If all your dependents' family members receive their earnings from Central Civil and reside in a CGHS-covered area.
You must be among the pensioners or family pensioners or a dependent member of a pensioner.
If you are one of the Ex-Governors and L.T. governors.
You must be among the retired or sitting high courts and Supreme Courts judges.
If you are one of the freedom fighters.
If you are a journalist accredited with the Press Information Bureau.
If you are an employee of the Railway Board.
If you are a Delhi Police personnel.
If you are a pensioner and employee of specific statutory or autonomous bodies.
In case you are an employee of the Postal Department.

Application Process of Central Government Health Scheme (CGHS) Card

Current Central Government employees and retirees are also eligible for the Central Government Health Scheme. The procedures to follow are as follows: First, you must register yourself to receive the benefits of this plan.

Open the official CGHS website on your phone or computer.
Navigate to the “Downloads” option and download the application form.
You will get a page asking for your details and information. Fill that accordingly.
Submit the application form, your recent photograph, and necessary documents to the Additional Director's office in any CGHS-covered cities.

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

To opt for a doctor’s consultation, you need to book an appointment at the centre online by following the given steps:

Visit the official website of CGHS.
Log in with your beneficiary ID and the OTP received.
You will be shown your details. Click on "Agreed" if all your details are correctly displayed. Otherwise, you can also click on the "Not me" option.
After proceeding to the next page, you must fill in the CGHS dispensary, doctor and the speciality.
Select the date of your appointment according to the selected doctor’s availability.
Select your desired slot.
Click on the “Proceed to Book Appointment” option.
Preview the details given, then click on “Confirm”.
The system will generate a confirmation receipt. You can take a printout to the centre on the day of the appointment.

What is the CGHS Empanelled Hospital List?

The following are some enlisted hospitals under the Central Government Health Scheme.

State	Hospital
Delhi	Vivekananda Hospital
Delhi	Ashwini Hospital
Madhya Pradesh	Navjeevan Hospital
West Bengal	Narayana Multispeciality Hospital
Kerala	Dr. Ramachandran’s Diagnostic Services
Mumbai	Shantiniketan Hospital
Mumbai	Swami Sarvanand Hospital
Bihar	Anupama Hospital
Chennai	CSI Kalyani General Hospital

Please note that numerous other hospitals are enlisted under the Central Government Health Scheme besides the above CGHS hospital list. You can check your nearest enlisted hospital on the official CGHS website.

Final Words

Overall, CGHS is one of the significant initiatives that will accelerate the healthcare ecosystem in India. You can access the data of various registered healthcare practitioners. Therefore, the scheme aims to improve the healthcare economy of Indian citizens by providing them with a CGHS health card. The most crucial thing to understand is that the recipients receive financial support for their medical care thanks to the unique identification number.

Frequently Asked Questions (FAQs)

The answers to commonly asked questions about the Central Government Health Scheme

1. Can an unmarried daughter of a beneficiary avail the CGHS benefits?

Yes. Unmarried or dependent daughters of a serving employee or pensioner can seamlessly enjoy the benefits of CGHS facilities.

2. What is a central government health scheme card?

Central Government Health Scheme Card (CGHS) card acts as a financial protection for the beneficiaries, through which they can get healthcare services in the enlisted hospitals free of cost or on a reimbursement basis, along with many other preventive medical services.

3. Is there any maximum limit for CGHS?

Yes, there is a maximum limit depending on the pay scale and entitlement of the employee. An employee with higher entitlement can avail higher numbers of healthcare benefits from the scheme and vice versa. You can check the authorised medical dispensary to confirm the details of entitlement.

4. Is there any time limit for claiming the medical bills?

Yes, within a time span of 3 months, you need to claim the reimbursements of medical bills. After that, you will not be eligible for the same.

5. What are the key features of the CGHS health scheme?

Key features of CGHS facilities include:

Cashless treatment
Emergency medical facilities
Reimbursements of treatments
Maintaining healthcare of dependent children

6. How many cities in the country do the CGHS health scheme cover?

Central Government Health Scheme CGHS covers 71 cities in India and presently has around 35 Lakhs beneficiaries in the country.

7. Can pensioners claim for the reimbursement of medical bills?

Yes, pensioners can claim reimbursement for medical bills. They must submit the bills and their claim at their nearest CGHS welfare centre.

Term Insurance for Family’s Financial Security

While healthcare programs such as CGHS offer a range of medical services to central government employees, pensioners, and their families, they can also look into life insurance policies, such as term plan insurance, to secure their family's future while benefiting from the affordable and wide-ranging healthcare facilities offered under CGHS.

Opting for the best term insurance plan for 1 crore can provide significant financial protection against unforeseen circumstances. A term insurance calculator helps determine the premium for a suitable policy.

This integrated strategy guarantees that substantial life insurance coverage addresses financial risks related to unforeseen events, providing a comprehensive safety net.