The central Government Employees those who are
on the verge of Retirement are having many doubts about joining CGHS after
retirement. Many queries have been raised by our viewers about registering with
CGHS and availing the CGHS facility after retirement. Hence the details of
joining CGHS and entitlement for availing treatments and its benefits, list of
empanelled Hospitals are compiled and given under for viewer’s reference.
Medical Benefits for Retirees
All Central Government pensioners/family
pensioners who were eligible for taking treatment under the Central Government
Health Scheme (CGHS) while in service are eligible for availing CGHS facilities
after retirement, irrespective of whether they were or were not availing CGHS
facilities while in service. Further, it is not necessary that these pensioners
/ family pensioners should be living in the areas covered under the CGHS.
Presently the CGHS facilities are available in the following cities:
Allahabad, Ahmedabad, Bangalore, Bhopal,
Chandigarh, Chennai, New Delhi, Faridabad, Ghaziabad, Gurgaon, Guwahati,
Hyderabad, Jaipur, Jabalpur, Kanpur, Kolkata, Lucknow, Meerut, Mumbai, Nagpur,
Noida, Patna, Pune, Shillong, Thiruvananthapuram.
The Central Govt. Health Scheme provides
comprehensive health care to the CGHS Beneficiaries in India. The medical
facilities are provided through Wellness Centres (previously referred to as
CGHS Dispensaries) /polyclinics under Allopathic, Ayurveda, Yoga, Unani, Sidha
and Homeopathic systems of medicines.
a. 273 allopathic dispensaries, 19 polyclinics, 85 Ayush dispensary/
units
b. 3 Yoga Centres
c. 73 Laboratories
d. 17 Dental Units
b. 3 Yoga Centres
c. 73 Laboratories
d. 17 Dental Units
The
pensioners / family pensioners have to get their names registered with any of
the CGHS dispensaries after submitting an application in the prescribed
proforma for the issue of a CGHS identity card.
Procedure to Register with CGHS
1. One can get a CGHS card made from the
office of AD / JD of the City.
2. Forms can be downloaded from CGHS Website
or can be taken from office of AD / JD of city.
3. Documents required
i. Application in prescribed format
ii. Proof of Residenceroof of Stay of
dependents
iii. Proof of age of son
iv. Disability certificate, if any in case of
sons aged 25 & above, who would otherwise cease to be a beneficiary.
v. Photos of eligible family members
vi. Surrender Certificate of CGHS Card while
in service ( only in those cases where CGHS Card was issued while in service)
vii. Attested copies of PPO & Last Pay
Certificate
viii. 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’.
ix. In case PPO is not ready for any reason
there is option to get a provisional card on the basis of Last Pay Certificate.
x. The data is entered through computers and
entered in data base and a printout is issued same day for immediate use.
Plastic cards are subsequently sent to the residence of the card holder by
post.
DOWNLOAD : Proforma to apply for enrolment in CGHS
DOWNLOAD : ISSUE OF CGHS CARD FAQ
Annual and One Time Life Time fee for joining CGHS
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 New Delhi’ in Delhi-and in the name of ‘AD, CGHS of the 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.
Monthly Contribution for availing CGHS Facility
|
S.No
|
Grade Pay Drawn
|
Contribution(Rupees per Month)
|
|
1
|
Up to Rs.1650/- Per Month
|
|
|
2
|
Rs.1800/-; Rs.1900/-; Rs.2000;- Rs2400/-;
and Rs.2800/- per Month
|
125
|
|
3
|
Rs.4200/- per month
|
225
|
|
4
|
Rs..4600/-; Rs.4800/-;Rs.5400/-; and
Rs.6600/-
|
325
|
|
5
|
Rs.7600/- and above
|
500
|
One Time Payment for Life Time validity
Pensioners have an option
to get their CGHS pensioner Card either by making CGHS Contribution on an
annual basis (12 months Contribution) or by making contribution for 10 years
(120 Months Contribution) for getting a Pensioner Card with Life Time Validity.
Those who are willing to get CGHS card with Life Time validity should Pay the
amount of 120 Months Contribution prescribed for respective Grade pay at the
time of applying for CGHS Card.
Download OM : Contribution for joining CGHS
Entitlement of Wards in Private Hospitals
|
S.No
|
Ward entitlement
|
Pay drawn in Pay Band
|
|
1
|
General Ward
|
Upto Rs. 13950/-
|
|
2
|
Semi-Private ward
|
Rs.13960/–Rs.19530/-
|
|
3
|
Private Ward
|
Rs.19540/- and above
|
Download : Medical Reimbursement Form
Medical Allowance For Retirees Residing In Areas Not Covered Under
CGHS.
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. b.Pensioners residing in non-CGHS areas
have also the option to avail Fixed Medical Allowance of Rs.500/- 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 Rs.300/- 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
i. 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.
ii. 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.
iii. 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.
