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How to get CGHS card?

  • Author :
  • TATA AIG Team
  • Published on :
  • 30/01/2024
  • 2 min read

For healthcare for government employees in India, the Central Government took numerous measures. One of them is CGHS, which offers comprehensive medical coverage. It was established in 1954 as a health care initiative by the Government of India primarily for its current and former employees.

A handy element of this scheme is the CGHS card, which allows a range of healthcare facilities for eligible beneficiaries. This blog covers all about the CGHS card, outlining its benefits, eligibility criteria, necessary documentation, application process, and renewal procedures.

What is a CGHS Card?

The Central Government Health Scheme (CGHS) card is a Plastic healthcare card that serves as a document for current and former employees of the Central Government of India. It allows beneficiaries to access a wide range of medical services under the CGHS, which is an extensive healthcare program established for government employees and pensioners.

It enables government employees and pensioners to avail of medical services at CGHS wellness centres, government hospitals, and empanelled private hospitals.

Benefits of CGHS Scheme

Central Government Health Scheme is known for providing comprehensive medical care, including hospitalisation, diagnostic tests, consultations, and more. It offers several benefits as follows:

Comprehensive Medical Care: Beneficiaries receive a wide range of medical services, from outpatient care to hospitalisation.

Affordable Medical Care: CGHS aims to provide cost-effective healthcare solutions to its beneficiaries.

Cashless Service: In many cases, beneficiaries can avail of medical services at empanelled hospitals of CGHS dispensaries without needing to pay upfront; the bills are settled directly by the CGHS.

Preventive Healthcare Benefits: The scheme also focuses on preventive healthcare measures.

Emergency Medical Care: CGHS provides coverage for emergency medical situations, ensuring beneficiaries have access to necessary healthcare services when needed.

Additionally, the scheme covers various medical systems, including both mainstream and alternative medicinal practices, ensuring a broad spectrum of healthcare options for its users.

CGHS Eligibility Criteria

Central Government Employees:

Employees who work for the central government and receive payment from the central civil estimates are eligible. This also includes their family members whose salaries are paid by the Central Civil Estimates.

Central Government Pensioners:

Individuals who receive pensions from the central government, along with their families, are eligible for the CGHS card.

Specific Employee Groups:

The scheme covers specific groups like Railway Board employees, employees of the post and telegraph department, civilian defence employees, and employees of the Supreme Court Legal Services Committee.

Former and Current High-Profile Officials:

This includes former Vice Presidents of India, current and former Governors and Lieutenant Governors, and their immediate family.

Parliament Members:

Current and former members of Parliament are eligible.

Judiciary:

Current and former judges of the Supreme Court and High Court.

Special Categories:

Freedom fighters receiving pensions under the Sainik Samman Scheme, widows receiving family pensions from central government pensioners, and CISF and CAPF personnel posted in CGHS-covered areas along with their families are also eligible.

Educational Institutions:

Employees of the Kendriya Vidyalayas Sangathan stationed in specific significant cities like Delhi, Chennai, Mumbai, Kolkata, Hyderabad, and Bengaluru are included.

Additional Categories:

The scheme extends to other specific groups like retired Divisional Accountants, Divisional Accounts Officers, and family members of deceased Ex-Members of Parliament.

Documents Requirement for a CGHS Card

  • Completed application form provided by CGHS online portal or local service offices in the required format.

  • Proof of your residence or proof of the residence of your dependents.

  • If applicable, a document that proves the age of your son. In cases where a son aged 25 or above has a disability, a relevant disability certificate is required to continue eligibility.

  • Include recent photographs of all eligible family members.

  • If a CGHS card was issued while in service, the surrender certificate of that card.

  • Attested copies of the Pension Payment Order (PPO) and Last Pay Certificate. If the PPO is not available for any reason, a provisional card is based on the Last Pay Certificate.

  • Draft for the required CGHS contribution amount. The draft should be in the name of ‘P.A.O., CGHS New Delhi’ in Delhi or the name of ‘AD, CGHS’ followed by the name of your city for other locations.

Process to Apply for a CGHS Card

  • Go to the CGHS website.

  • Complete the online application form available on the CGHS portal. Make sure to fill in all necessary details accurately.

  • After applying online, you need to print it out.

  • Collect and attach the required supporting documents. If you are a serving employee, these documents must be endorsed by the Head of your Department or Office.

  • For serving employees, submit the printed application form and documents through your department for proper approval. For pensioners, the application with attachments should be submitted to the Additional Director (HQ) in Delhi or the concerned Additional Director in other cities.

  • If applicable, make a payment through Bharat Kosh or via Demand Draft in the name of the concerned PAO of the city.

  • Once your application is approved, you can print your CGHS card and those of your dependents online through the Beneficiary login. This e-CGHS Card can be printed in colour and laminated for future use. The plastic cards are also sent by post to the cardholder's residence.

Renewal of CGHS Card

Renewal for Serving Employees: The CGHS card for serving employees is usually valid as long as the employee is in service. The card must be surrendered when the employee retires.

For Pensioners: The pensioner's CGHS card is valid for a lifetime after the payment of the lifetime subscription.

Update of Information: In case of transfer, retirement, or change in residential address, the cardholder must inform the nearest CGHS wellness centre for necessary updates to the card.

It is essential to do a CGHS card validity check online in case of such events. The process of renewal of a CGHS card is similar to its application process, except instead of a fresh application, a renewal form for the card has to be filled out.

Conclusion

CGHS remains a crucial factor in the government's welfare initiatives, demonstrating a sustained commitment to the health and well-being of its employees and retirees. It is important to note that the CGHS card is not a commercial health insurance product but a government-sponsored scheme aimed at providing healthcare benefits to a specific group of individuals.

For other citizens, Tata AIG brings out health insurance policy that can be made according to the needs of the user. These individual health insurance plans are extensive, with the addition of insurance drivers to choose from.

While CGHS shares similarities with traditional medical insurance plans, such as providing healthcare coverage and reducing out-of-pocket expenses, the CGHS card is made for the needs of government employees and pensioners, providing them with a unique form of health insurance coverage.

FAQS

Can I use my CGHS card at private hospitals?

Yes, CGHS beneficiaries can use their CGHS card at private hospitals, but only at those hospitals which are empanelled with the CGHS. These empanelled hospitals offer cashless treatments for beneficiaries, subject to the terms and conditions of the scheme.

What is the CGHS Claim Process?

The Central Government Health Scheme (CGHS) Claim process involves submitting relevant medical bills and documents to the CGHS offices for reimbursement of medical expenses.

Is there an age limit for dependent children to be covered under the CGHS card?

Dependent children are covered under the CGHS card up to the age of 25 years. However, for sons, if they are not employed or married and are pursuing studies, only then they remain eligible until they are 25. Daughters are covered until they get married or employed, irrespective of their age.

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