I am a serving employee residing in a place close to a city covered under CGHS. Can I get CGHS card issued from the nearest CGHS city? 

There is no provision to avail CGHS facilities in respect of serving government employees residing in non-CGHS covered areas. They are covered under CS(MA) Rules 1944. 

I retired in 1998 from Central Govt. but, I never made a CGHS card. Can I get a card now? 

Pensioners can apply for CGHS card with relvant documents. However, the subscriptions as applicable at current rates shall have to be paid. 

My husband/wife is also employed under Central Government and is eligible for a separate CGHS Card. Is it necessary that separate cards are to be obtained? 

No. Spouse drawing higher pay shall make the card and other spouse is eligible to avail CGHS benefits as member. 

I have retired from Delhi. Now I want to settle at city where no CGHS facility is available . How to cover my family for medical care? 

Pensioners are eligible for CGHS facilities and can obtain CGHS card from the nearest CGHS covered city. 

My husband / wife retired in 2002. He /she was paying CGHS subscription every year. After his death can I get Card on my name. Do have I to pay extra. Shall I get Life Time Valid card?
Yes, the ownership of card can be transferred in the name of spouse on submission of required documents. Addl. Director of concerned city shall transfer the ownership of Card in the computer Data base and same CGHS plastic cards with same Beneficiary ID can be used. 

No extra payment to be made, in case of life time cards. 

However in other cases one has to pay 10 years subscription for life time card 

For example, if the spouse had contributed for seven years before he expired , balance payment for the remaining three years is to be paid for a life time card. 

Documents required : 

i) Application in prescribed format 

ii) Proof of Family Pension with its break up from Bank 

iii) Prescribed contribution if, card is not for life time 

How to transfer CGHS card from one WC to other in the same city? 

If there is any change in residential address, CMO i/c may be approached with proof of residence for transferring the data from one Wellness Centre to another in the same city. 

CMO i/c of the new Wellness Centre will accept the data of transferred card. 

In respect of serving employees the request is to be forwarded by his/her office / department. 

I am CGHS beneficiary at Kanpur. Visiting Mumbai for 6 months. Can I get CGHS facilities at Mumbai .Can same card of Kanpur continue or a separate card to be made. From where to get permission for the same? 

Subsequent to computerization no separate permission is required and CGHS card is valid for availing facilities from any CGHS Wellness Centre in India. For any assistance , Addl. Director of the city may be contacted. 

Who is competent to delete name of sons who have crossed age of 25 years? 

CMO i/c of Wellness Centre is competent to delete the name of son aged 25 yrs and above. Computer system does not allow sons aged 25 and above to avail medical facilities. 

After retirement in 2007 I got a Life time Pensioner CGHS card made in Delhi. Now I am shifting to Dehradoon. Can I use the same card. Do I pay again? 

Pensioners shifting from one CGHS covered city to another, will have to apply to the Addl. Director of concerned city for transfer of card. The card shall be transferred online and a receipt will be issued to the beneficiary , on the basis of which , Addl. Director of new city ( say Dehradun) shall receive the data. Same Plastic cards and same Ben ID will be valid. No contribution is required to be paid in respect of pensioner benfciries holding life time cards. 

I live in Gurgaon but my office is in Saket. Can I avail facilities from both the places because it is convenient for me. 

Yes. Subsequent to computerization CGHS facilities can be availed from any Wellness Centre in India. 

Is there any age limit for sons / daughters as dependant in CGHS Card ? 

Son is eligible till he starts earning or attains the age of 25 years or gets married whichever is earlier. 

However, in case the son is suffering from any permanent disability of any kind (physical or mental) he is eligible for CGHS benefits even after 25yrs . 

Disability means blindness, low vision, leprosy-cured, hearing impairment, locomotor disability, mental retardation, mental illness. A disability certificate from Medical Board is required. 

Daughter is eligible till she starts earning, or gets married, whichever is earlier (irrespective of age)

Are step-children allowed CGHS facilities? 

Yes. If they are dependent on card holder: other conditions as in case of dependant sons and daughters. 

Can dependent in-laws be included under family members for CGHS facilities? 

A lady Government servant will be given a choice to include either her parents or parents –in-law for the purpose of availing the benefits under CGHS subject to the condition of dependence and residence , etc., being satisfied. 

Me and my wife are both central Govt. employees and have dependant brothers / sisters and parents. Can we make separate cards and include family members? 

Yes. Your wife can have her parents as dependant in her card.

Can drugs like antibiotics, if not available in WC, be made available urgently from local Chemist? 

Yes, beneficiary can collect drugs from the chemist counter on the chemist on the basis of authority form issued by WC 

How to get a drug if same is not available in WC & also not supplied by Chemist(ALC)? 

Beneficiary, after authorization by CMO i/c can purchase such drugs from open market & claim reimbursement from ALC. 

What should beneficiary do, if he/ she notice some deterioration in the quality of drugs? 

He /she should return the medicine to WC & get replacement. Samples can be sent for testing through CMOI/C. 

My father is a cancer patient and after operation is bed ridden. Doctors have advised Protein powder. Can I get from CGHS? 

Dietary supplements are not permissible under CGHS.

I am a CGHS Pensioner.My wife was admitted in pvt hospital in emergency state. How to get reimbursement of money spent on her treatment? 

Apply to CMO I/c of WC with : 

MRC forms duly filled in as per Check list 

Copy of Discharge summary 

Hospital bills with break-up 

Receipts in original 

Copy of the valid CGHS Card 

Copies of other documents issued by hospital 

MRC forms are available with CMO I/c and can also be downloaded from CGHS Website http://msotransparent.nic.in/cghsnew/index.asp
Serving employee in similar cases shall submit the medical claim to his department. 

My original papers having bills, Receipts of hospital treatment are lost. Can I claim on duplicate papers? Yes.With affidavits on Stamp paper.Details of Draft for Affidavit may be seen in the instructions sheet appended to Medical Claim Form available at http://msotransparent.nic.in/cghsnew/index.asp and CMO i/c. 

My husband/wife was a CGHS card holder. He/She was sick and died while in hospital. How do I get MRC? 

Apply to CMO I/c of WC with : 

MRC forms duly filled in as per Check list 

Copy of Death summary 

Hospital bills with break-up 

Vouchers in original 

Copy of the valid CGHS Card 

Death Certificate 

Affidavit on Stamp paper of yourself being Legal Heir and NOC from other legal heirs in favour of claimant 

Copies of other documents issued by hospital 

Draft for affidavit may be seen in the instructions sheet appended to the Medical Claim Form available at CGHS Web site at http://msotransparent.nic.in/cghsnew/index.asp

I retired in Dec 2011. Due to certain reasons I had to go to my native place in Uttranchal and could not make pensioner’s CGHS card. In May 2012 I came to Delhi and had Heart attack. In emergency I was treated in pvt hospital .I got CGHS Card made after discharge but I have been refused reimbursement of the expenditure incurred.? 

After retirement three months grace period is given to get CGHS card made. 

(i) The treatment taken and expenditure incurred thereon within the grace period of three months from the date of retirement will be allowed and expenditure reimbursable subject to the condition that the beneficiary has either obtained or applied for CGHS pensioner card with all documents and requisite CGHS subscription within one month of expiry of the grace period of three months. 

(ii) The expenditure on treatment taken after the grace period of three months from date of retirement will not be reimbursable unless the beneficiary has obtained a valid CGHS card or has applied for CGHS pensioner card with all documents and requisite CGHS subscription prior to taking such treatment. 

I went to Hyderabad to visit my son and had fracture of leg bone. I received treatment from a pvt hospital. Shall I get full reimbursement? 

Reimbursement for treatment taken in a private hospital under medical emergency shall be considered as per CGHS rates only. 

Is treatment for IVF reimbursable? 

IVF treatment is approved under CGHS. The details may be seen as per Office Memorandum Z.15025/5/2011/CGHS III/CGHS(P) dated 22.11.2011 , which can be downloaded from CGHS Website at http://msotransparent.nic.in/cghsnew/index.asp

Are ambulance charges reimbursable? 

Yes. Ambulance charges are reimbursable within the city , if there is a 

certificate from treating doctor that conveyance by any other mode would 

definitely endanger patient’s life or would grossly aggravate his/her 

condition. 

I have a Mediclaim Insurance Policy. Due to emergency received treatment in a pvt hospital. Some amount was paid by Insurance Co. can I get balance from CGHS?

Yes.First Bills are submitted to Insurance Company.Duplicate bills with certificate from Insurance Company may be claimed from CGHS by Pensioner CGHS beneficiaries.CGHS shall consider reimbursement at CGHS rates or actual whichever may be less. However, the total reimbursement from both sources should not exceed actual expenditure. 

Serving employees shall submit claim to department for reimbursement. 

I submitted MRC for Rs. 1 Lac 20 thousand but I was reimbursed only Rs. 45,800/-. Why total amount was not reimbursed? 

Expenditure for treatment in private hospitals is considered only if the treatment was taken under emergency at CGHS approved rates. 

In emergency who are all entitled to get treatment at Pvt Empanelled Hospital Any beneficiary holding a Valid CGHS card. 

I want to get my Cataract Surgery done at Pvt empanelled hospital ? 

How can I get it done 

Beneficiaries are required to obtain advice from a Govt. Specialist / CMO i/c for Cataract surgery. Pensioners can apply to CMO I/c of WC for permission to obtain the treatment at one of the empanelled hospitals of his /her choice. 

Serving employees to apply to his / her Department / office. 

Is it necessary that the Govt specialist should write ‘referred to CGHS empanelled Hospital’ for obtaining permission?

Advice of Government specialist is required only for the specific treatment procedure / investigation to be undertaken. There is no need to specifically refer to any empanelled hospital/ diagnostic lab. It is the choice of beneficiary to under treatment / investigations at any of the empanelled hospitals / diagnostic laboratories after obtaining permission from competent authority. 

CMO Incharge does not refer me to Pvt. Hospitals on my request? 

As per CGHS guidelines there is no provision for OPD referrals to private empanelled hospitals except in satellite towns of NCR

I am an accredited journalist with CGHS Card Can I seek treatment in Pvt. empanelled Hospitals in emergency and get credit facility? 

No. Journalists are entitled only for OPD treatment from dispensaries and treatment from Dr.RML Hospital. Journalists are not entitled for reimbursement for treatment from empanelled hospitals. 

I am a serving employee of an autonomous body ,holding CGHS card. who will give me permission for treatment on the recommendation of Govt. specialist? 

Permission for treatment at empanelled hospitals / diagnostic labs shall be granted by the office of the organization where the employee is serving. 

Is Penfill Injection provided under CGHS 

Insulin pen is not supplied under CGHS. But, Insulin Pen Cartridges are supplied under CGHS.