Eligibility Criteria for Central Government Health Scheme: Check CGHS Scope, Benefits and Eligibility

753

5 min read

Central Government Health Scheme (CGHS) is a special health insurance scheme introduced in 1954 for central government employees and their family members to offer them a holistic and inclusive healthcare facility. Let’s learn more about this plan in this post. 

What is CGHS meaning?

CGHS, or the Central Government Health Scheme, is a comprehensive health policy available with specific terms and conditions for the employees (both working and retired) of the Central Government as well as their dependent family members.

The CGHS scheme is termed one of the largest central government health insurance schemes for two reasons:

  1. India being one of the most populated countries, has the largest number of central government employees in both active and retired categories
  2. The scheme is almost 70 years old and is still operational. This signifies the popularity of this policy as a comprehensive plan covering almost the entire nation.

Scope of Central Government Health Scheme

The scope of CGHS goes much beyond the traditional treatment of allopathy. Thus, along with allopathy, the policyholders of CGHS can avail of treatment under Ayurveda, Siddha, Homeopathy, Unani and Yoga & Naturopathy.

Benefits Available Under Central Government Health Scheme

Various CGHS card benefits can be availed by central government employees who are working currently or those who are retired. Here are some benefits:

  • The plan allows the policyholder to avail OPD treatment at any of the impanelled hospitals
  • It offers doctor consultations at central government hospitals and clinics
  • Cashless treatment can be availed at the impanelled hospitals and diagnostic centers for retired employees as well as other beneficiaries notified under the plan
  • The policyholder is also entitled to reimbursements for treatments availed at private/government hospitals in case of emergency medical conditions
  • Maternity and child health care services are also available under the plan
  • The policyholder can avail reimbursement of expenses incurred for hearing aids, artificial limbs, etc.

Who is Eligible for the Central Government Health Scheme?

CGHS insurance policy can be availed by all central government employees. Below are people who come under CGHS eligibility:

  • Employees living in areas covered by the scheme and who are working under the central government
  • Those who are dependents of policyholders
  • Retired employees who are on a pension under the central government
  • Current and former members of Parliament
  • Former Governors and Lieutenant Governors who served in any of the Indian states
  • Freedom Fighters who fought for the country
  • All past Vice Presidents of India
  • Supreme and High Court judges, both current and former
  • PIB-accredited journalists (for Delhi)
  • Police personnel working in Delhi
  • Employees of the Railway Board, etc.

Which cities offer the Central Government Health Scheme?

CGHS provides health insurance benefits to central government employees in the following cities:

Agartala

Agra

Ahmedabad

Aizawl

Ajmer

Aligarh

Allahabad

Ambala

Amritsar

Baghpat Bengaluru Bhopal
Bhubaneshwar Chandigarh Chennai

Dehradun

Delhi & NCR

Gandhinagar Guwahati

Hyderabad

Jabalpur

Jaipur Jammu

Kanpur

Kolkata

Lucknow Meerut

Mumbai

Nagpur

Patna Pune

Ranchi

Shillong

Shimla Thiruvananthapuram

How to Register With CGHS? 

The registration process is very simple. You just need to download the CGHS application form and fill it with complete and correct details. You would need copies of the below documents:

  • Address proof
  • Proof of dependents’
  • Age-proof of children
  • Disability Certificate if any child is disabled and above the age of 25 years
  • Passport-size photos of dependent family members
  • Retired individuals need attested copies of the PPO and last pay certificate

You need to send a demand draft of CGHS contribution to PAO, CGHS, New Delhi (for Delhi) or Additional Director, CGHS, of the respective city.

Process for Existing Employees

The employees working currently under the central government can duly fill out the application form. They can collect all the copies of the required documents and submit the same to the concerned department where they are working. The department, in turn, will forward the same to the Additional Director of the respective city.

Process for Retired Employees

The retired employees should duly fill out the application. Next, they can take copies of the required documents as mentioned above. Similar to the above process of existing employees, the retired individuals must also submit the documents along with the application to the Additional Director, Headquarters (for Delhi) or Additional Director of your city. You must also attach the CGHS surrender certificate (in case it was issued during the service period)

Once the concerned department receives the application, they will process the CGHS Card. When the card is ready, it is sent to the Wellness Centre of the respective city before it reaches you.

What is a CGHS card? How Long Does It Take to Receive the CGHS Card?

CGHS card is the Central Government Health Scheme card. It takes about three to four weeks to prepare the plastic card, while the printout of the index card can be obtained on the same day. Once you receive the actual card, you need to check all the details to see if they are valid. If there is an issue or any error in the record, one needs to approach the Joint Director CGHS (HQ) in Delhi.

Colour Code of CGHS Cards

CGHS health cards come in one of four colors:

  • Blue – existing CGHS employees
  • Green – former government employees, MPs, and freedom fighters
  • Red – existing MPs
  • Yellow – PIB accredited journalists

What are the charges for a CGHS Card?

The contribution is automatically deducted from the salary every month depending on the grade of the employee:

Grade pay

Amount to be contributed 
Up to INR 1650

INR 50

INR 1800 – INR 2800

INR 125

INR 4200

INR 225

INR 4600 – INR 6600

INR 325

INR 7600+

INR 500

Popular Health Insurance Companies 2024

To Sum 

The CGHS is a government employee health insurance scheme offering high-standard healthcare treatment to its policyholders. The benefits under the scheme are similar to those offered by premium health insurance companies in India.

Related Articles

Found this post informational?

Browse PayBima Blogs to read interesting posts related to Health Insurance, Car Insurance, Bike Insurance, Term Life Insurance, and Investment section. You can visit PayBima to Buy Insurance Online.

Try PayBima Calculators –

Also, Check out the PayBima Guide and Glossary section –

FAQs: Eligibility Criteria for Central Government Health Scheme

Who all are termed as ‘dependent’ under the Central Government Health Scheme?

Dependents under CGHS include people who earn an income less than INR 9000 per month, including DA or Dearness Allowance.

Does CGHS offer any age limit for the dependent child?

For a male child, the eligibility of being dependent is until he turns 25 years. However, if the child suffers from any mental or physical disability, he becomes eligible for being dependent even after 25 years of age. In the case of a female child, she stays dependent until employed or married, whichever takes place earlier, without any age barrier.

How can I apply for the CGHS online?

To apply online, one needs to visit the official website of the scheme at https://cghs.nic.in/
or https://cghs.gov.in/. You can fill out the application duly, which is available in the portal. Also, you can avail of this form from wellness centres enlisted under the policy.

Can I avail cashless facility under the Central Government Health Scheme?

The CGHS beneficiaries can avail cashless treatment only in the impaneled hospitals.

Does AIIMS come under the Central Government Health Scheme?

Yes. CGHS beneficiaries can get cashless/reimbursement facilities at AIIMS.

What is CGHS full form?

CGHS means Central Government Health Scheme

Other Health Insurance Products

Jul 23, 2023
SHARE THIS ON
Author Bio
Author Image

PayBima Team
PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

Related Blogs

Would love to hear from you

Share your candid feedback. Your email address won’t be published, we promise!

All fields are required

Find your suitable insurance plan

Speak to our advisor

Latest Posts

Mahindra Insurance Brokers Limited (A Mahindra Group Company) - Unit-202, A-Wing, 2nd Floor, Amiti Building, Agastya Corporate Park, Kamani Junction, LBS Marg, Kurla West, Mumbai - 400070. Tel: +91 22 66423800

Licenced by IRDAI License No. 261; License Validity : 17-05-2025; Category : Composite Broker; CIN : U65990MH1987PLCO42609 Member of Insurance Brokers Association of India (IBAI).

Insurance is the subject matter of solicitation.

For a seamless experience, use the latest version of Chrome/Firefox/Internet Explorer.

Copyright © 2024 Mahindra Insurance Brokers. All Right Reserved.

Get A Call Back
Get A Call Back