FAQ on Central Government Health Scheme : More questions clarified as FAQ

FAQ on Central Government Health Scheme : More questions clarified as FAQ

FAQ on Central Government Health Scheme : More questions clarified as FAQ

Ministry of Health and Family Welfare issued clarifications in the respect of Central Government Health Scheme in the form of FAQ. Lot of questions and answers is given with detailed references, certainly it could be very useful for the both sides of employees and Department authorities.

FREQUENTY ASKED QUESTIONS WITH ANSWERS ABOUT CGHS 

Who are entitled for CGHS facilities 

All Central Govt. employees and their dependant family members residing in CGHS covered areas. 

Central Govt Pensioners and their eligible family members getting pension from Central Civil Estimates 

Sitting and Ex-Members of Parliament 

Ex-Governors & Lt. Governors 

Freedom Fighters 

Ex-Vice Presidents 

Sitting and Ex-Judges of Supreme Court & High Courts 

Employees and pensioners of certain autonomous organizations in Delhi 

Journalists (in Delhi )Accredited with PIB 

( for OPD & at RML Hospital) 

Delhi Police Personnel in Delhi only 

Railway Board employees 

In how many cities CGHS is presently operative? 

CGHS facilities are available in 25 cities in India 

1. Ahmedabad 2 Allahabad 3 Bengaluru 4 Bhopal 5 Bhubaneshwar 6. Kolkata 7. Chandigarh 8 Chennai 9.Dehradun 10.Delhi & NCR 11.Guwahati 12. Hyderabad 13. Jabalpur, 14. Jaipur 15 Jammu 16. Kanpur 17. Lucknow 18. Meerut 19. Mumbai 20. Nagpur 21 Patna 22.Pune 23. Ranchi 24. Shillong 25. Thirruvananthapuram 

For CGHS cards , as dependant , what is the meaning 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: parents, 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”. 

Also now include , dependent divorced / separated daughters ( including their dependant minor children) and step-mother. 

The term dependency means that income from all sources including pensions and pension equivalent of DCRG benefit is less than Rs.3500/- plus amount of DA on Basic pension of Rs3500/- per month. However, there is no such clause as dependency in respect of spouse. 

What is the procedure to register with the CGHS? 

Pensioners:

One can get a CGHS card made from the office of AD / JD of the City. Forms can be downloaded from CGHS Website or can be taken from office of AD / JD of city between 1000 am to 1230 pm. 

Documents required 

Application in prescribed format 

Proof of Residence 

Proof of Stay of dependents 

 Proof of age of son 

Disability certificate, if any in case of sons aged 25 & above, who would otherwise cease to be a beneficiary. 

Photos of eligible family members 

Surrender Certificate of CGHS Card while in service ( only in those cases where CGHS Card was issued while in service) 

 Attested copies of PPO & Last Pay Certificate 

Draft for required amount towards CGHS contribution – in the name of ‘P.A.O., CGHS New Delhi’ in Delhi-and in the name of ‘AD, 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 is entered through computers and entered in data base and a print out is issued same day for immediate use. Plastic cards are subsequently sent to the residence of the card holder by post. 

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 Addl. Director CGHS of city for preparation of card. Print out is issued for immediate use and 

How long does it take to get the CGHS Cards? 

Normally computerized printout of index card is issued on the same day. Plastic cards are sent to the residence in ‘3’ weeks time. 

Whom Should I approach in case the CGHS Card is not issued to me in the prescribed time? 

Contact Joint Director (HQ), CGHS, Bikaner House, New Delhi in case of Delhi and Addl. Director of City in case of other cities. 

What should I do if I lose my CGHS Cards ? 

Application is to be submitted to AD/JD along with two photographs and a IPO for Rs. 50/- for issue of duplicate card. 

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 

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 Joint Director, CGHS (HQ), and Bikaner House in Delhi and to the Addl. Director, Joint Director of concerned CGHS City in other cities. 

Is there a colour scheme for plastic cards? What are the details? 

CGHS Plastic cards have the following colour at the top: 

Serving Government employees - Blue

Pensioners, ex-MPs , Freedom Fighters, etc., - Green
Member of Parliament - Red

Beneficiaries of Autonomous Bodies / Journalist - Yellow

Whom should I contact if the doctors are not present in the Wellness Centre / Dispensary? 

Contact CMO i/c of the concerned Wellness Centre or Addl. Director, CGHS of concerned city or Director, CGHS.

Can the CMO or the pharmacist give a different brand than the one prescribed by the specialist? 

Medicines are issued at CGHS Wellness Centres by the same brand, if available or by generic name or by any available brand name of equal therapeutic value. 

What is the procedure for getting life saving drugs ? 

In Delhi- through CGHS Medical Store Depot, Gole Market
The documents required are:- 

a. Prescription of spl. of Govt.Hospital or CGHS approved private Hospital. 

b. Photocopy of his/ her token card/ plastic card. 

c. Copy of permission if his prescription is from CGHS approved private Hospital. 

d. Utilization certificate in original during subsequent visit. 

e. Indent is also placed online through CGHS Wellness centre. 

In other cities request is to be submitted to the Addl. Director of City.