What do I do if I am unwell at odd hours, say late in night? 

CGHS beneficiaries have the option to go to any of the 24 hr functional dispensaries in Delhi, a nearby govt. hospital / empanelled private hospital or even any private hospital , in case of emergency.

What should I do in case of emergency? 

CGHS beneficiaries have the option to go to any of the 24 hr functional dispensaries in Delhi, a nearby govt. hospital / empanelled private hospital or even any private hospital 

What is the time within which my medical claim is to be reimbursed? 

If all documentation is complete medical claims of pensioners are cleared in 45 days. 

What can I do if my claim is unnecessarily delayed?

Pensioner beneficiaries can contact the Additional Directors of concerned city / zone on any Wednesday between 11 A.M. and 1 P.M. 

What should I do if the empanelled hospital refuses to entertain or give a step-motherly treatment? 
Contact CMO i/c of the concerned Wellness Centre or Addl. Director, CGHS of concerned city or the nodal officer for grievances. 

What should I do if the Wellness Centre/Dispensary does not give all the medicines? 

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

How long does it take to get the medicines ? 

Medicines available in the dispensary are issued immediately. If any medicine is not available and is to be indented through Authorized Local Chemist the same are issued on the next day. 

What are the facilities available to me if I am a pensioner in a non CGHS area ? 

a) Pensioner residing in non- CGHS covered areas have the option to become CGHS beneficiary and avail CGHS facilities from the nearest CGHS covered city.

b) Pensioners residing in non-CGHS areas have also the option to avail Fixed Medical Allowance of Rs300/- per month and opt not to avail CGHS facility. 

c) Pensioners residing in non-CGHS areas have also the option to avail Fixed Medical Allowance of Rs300/- per month for OPD treatment and obtain CGHS card from nearest CGHS covered city for inpatient facilities under CGHS. No OPD medicines shall be issued in such cases. 

d) CGHS pensioner beneficiaries( and their dependant and eligible family members) who are holding a valid CGHS Card and residing in a non-CGHS area shall be eligible to obtain inpatient medical treatment and also follow up treatment from Govt. Hospitals / CS(MA) /ECHS approved hospitals on proper referral from CGHS dispensary and submit the medical reimbursement claim to the Addl.Director/ Joint Director of CGHS of city where the CGHS card is registered. 

In case of medical emergency , treatment may be obtained from any hospital and medical claim shall be submitted to AD/JD , CGHS of the concerned city. 

Reimbursement shall be limited to the CGHS rates of the city where the card is registered and as per the ceiling rates and ward entitlements or as per actuals, whichever may be less. 

What is the system for the services of specialists in Dispensaries ? 

Prior registration is required appointment with the CGHS Wellness Centre, where specialist services are available. 

However, In case of emergency contact CMO i/c of dispensary of Wellness Centre for consulting specialist without prior appointment. 

Are the prescription of specialists of empanelled hospitals binding on the dispensary ? 

Medicines are issued on the basis of prescriptions of government doctors. However, in permitted cases medicines are issued on the basis of prescriptions of empanelled hospitals and medicines will be issued as per the available brand / generic names. 

What is the maximum period for which medicines can be given in one go ? 
For treatment of Chronic illnesses medicines upto ‘3’ months are issued in one go , provided there is a valid prescription. 

In case of a beneficiary visiting a foreign country , medicines upto ‘6’ months are issued in respect of cronic illnesses , based on valid prescription and documentary support of visit to a foreign country. 

Beneficiary is required to submit an application for obtaining permission from AD/JD along with the following documents:- 

1. Copy of valid CGHS card/ token card. 

2. Valid prescription for six months counter signed by HOD of Specialty of Govt. Hospital. 

3. Proof of station leaving like ticket, Visa etc.

What are the papers to be submitted for any investigation by an empanelled diagnostic centre? 

Original or self attested copy of prescription of CGHS Doctor / Government specialist 

Copy of CGHS Card of the npatient and main card holder (head of  family). 

Which are the categories eligible for cashless treatment ? 

Hospitals shall provide credit facility to the following categories of CGHS beneficiaries (including dependant family members, whose names are entered on CGHS Card): 

• Members of Parliament; 

• Pensioners of Central Government drawing pension from central estimates;
• former Vice-presidents, Former Governors and former Prime Ministers; 

• Ex-Members of Parliament; 

• Freedom Fighters; 

• serving CGHS employees; 

• serving employees of Ministry of Health & Family Welfare 

(including attached / subordinate offices under the Ministry of Health & Family Welfare); and

Is there any interactive mechanism at dispensary level? 
At the Wellness Centre ‘Local Advisory Committees’ are formed. CMO i/c holds a meeting with Local Advisory committee members to discuss local dispensary related issues. 

Are CGHS facilities free of cost? 

For serving employees residing in CGHS covered area obtaining CGHS card is compulsory 

Deduction from salary is made by the department, every month, depending upon their pay  w.e.f 1st June 2009 

Grad Pay	w.e.f 1st June 2009 Contribution
Upto Rs.1650 /-	Rs. 50/-
Rs.1800/-, Rs1900/-, Rs.2000/- , Rs.2400/- and Rs.2800/-	Rs.125/-
Rs.4200/-	Rs.225/-
Rs.4600/-,Rs.4800/-, Rs.5400/- Rs.6600/- Rs.325/- and Rs. 7600/- and above	Rs. 500/-

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 in respect of Pensioners are calculated on the basis of grade pay they are entitled had they been in service , but for superannuation. 

What are the criteria for Entitlement of Treatment endorsed on CGHS Card like General ward / Semi-Pvt ward or Pvt. Ward in CGHS Empanelled Hospitals? 

Endorsement of entitlement for general/semi- private/private ward facility is done according to their basic pay / basic pension as under :

• Upto Rs. 13,950/- per month - Entitlement : General Ward 
• Rs. 13,960/- to 9,530/- per month -Entitlement: Semi-private Ward 
• Rs. 19,540/- and above - per month - Entitlement : Private Ward