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CGHS: Central Government Health Scheme - Eligibility, Benefits, Application Process & Hospitals List

TeamAckoApr 5, 2024

The central government launched a healthcare initiative called the CGHS or the Central Government Health Scheme. This scheme mainly targets the pensioners and employees of the Indian Government. Hence, the registered pensioners and serving employees can claim different medical benefits by using this scheme.

In this blog, we have broken down the essential elements of the scheme for you. So, read further to know more about CGHS.

central government health scheme (CGHS)

Contents

Government Mandates Linking CGHS with ABHA for Central Govt. Employees
What are the Facilities Offered by the Central Government Health Scheme (CGHS)?
Eligibility Criteria for Central Government Health Scheme (CGHS)
Application Process of Central Government Health Scheme (CGHS) Card
How to Book a Doctor’s Appointment Under the Central Government Health Scheme?
What is the CGHS Empanelled Hospital List?
Final Words
Frequently Asked Questions (FAQs)

Latest Updates on CGHS

Government Mandates Linking CGHS with ABHA for Central Govt. Employees

Linking CGHS beneficiary ID with ABHA as per the Ayushman Bharat Digital Mission starting on 1st April 2024 has been mandated by recent guidelines from the Ministry of Health and Family Welfare. This is meant to bring about efficiency in operations as well foster better integration within these health programs.

CGHS stands for Central Government Health Scheme and is a health insurance plan for central government employees, which provides medical expense coverage up to Rs. 5 lakhs. For example, hip replacement surgery at private hospitals costs between ₹230,000 to ₹500,000, compared to an average of ₹82,000 charged by government hospitals.

Thus, ABHA linking is now required by all CGHS beneficiaries. However, despite over 4.4 million individuals getting benefited by CGHS across 75 cities in India; the linkage with ABHA IDs remains low. By April 2nd, only 21,362 connections had been entered into the CGHS dashboard data.

Steps to link CGHS to ABHA ID:

Go here https://cghs.nic.in and go to Beneficiaries then Beneficiary login.
Then log in using your beneficiary ID after filling in your password together with captcha details.
Proceed to Update and Create/Link ABHA ID
1. Select ‘I don’t have an ABHA ID’ if you do not have an ABHA ID
2. If you already possess an ABHA ID, choose 'Link Using ABHA Number'.
Enter your Aadhaar Number and complete the verification process with an OTP.
If all details are accurate, the linking process will be successful, and you can print your ABHA card.

The ABHA system revolutionises health record management by offering a seamless digital platform. With its unique 14-digit ABHA ID, users can effortlessly store health data, manage insurance information, and even grant access to preferred healthcare providers. This advancement marks a significant stride in India's journey towards digital transformation in healthcare.

What are the Facilities Offered by the Central Government Health Scheme (CGHS)?

Here are some of the facilities the Central Government Health Scheme provides:

Comprehensive Medical Care

Under the Central Government Health Scheme, individuals will be provided with comprehensive medical services. These include diagnostic tests in case of any ailments, based on which individuals can opt for hospitalisation or necessary consultations with medical practitioners.

Financial Protection

Beneficiaries of the scheme can get medical treatments at reasonable rates in the enlisted state government and private hospitals. In some cases, they can also opt for their healthcare services free of cost, which acts as a severe financial protection. Beneficiaries are also eligible to get daily allowances under certain parameters.

Cashless Facility

CGHS provides the beneficiaries with a cashless facility through which they can avail medical treatments free of cost or at reasonable rates. Individuals can get financial coverage for medical treatments of insured members, and they can submit the medical bills to the concerned department of the scheme for settlement.

Preventive Medical Benefits

Individuals opting for the Central Government Health Scheme are also eligible to get preventive medical benefits such as timely healthcare checkups, dental care facilities, immunization and many others that lead to an enhanced quality of life.

Emergency Healthcare services

The beneficiaries of CGHS get the facility of emergency medical attention. It includes critical care service, 24-hour medical service and attention, and much more. Moreover, an ambulance facility is also available in case of emergencies. It is also available for 24 hours.

Eligibility Criteria for Central Government Health Scheme (CGHS)

The main target of the CGHS facility is to improve the healthcare service provision within India. So, you need to satisfy a few eligibility parameters set by the Central Government to be able to register for it. The criteria include the following:

You must be among the Parliament Members.
If you are among the Ex-Vice Presidents.
If you are one of the employees receiving wages from Central Civil.
If all your dependents' family members receive their earnings from Central Civil and reside in a CGHS-covered area.
You must be among the pensioners or family pensioners or a dependent member of a pensioner.
If you are one of the Ex-Governors and L.T. governors.
You must be among the retired or sitting judges of high courts and Supreme Courts
If you are one of the freedom fighters.
If you are a journalist accredited with the Press Information Bureau.
If you are an employee of the Railway Board.
If you are a Delhi Police personnel.
If you are a pensioner and employee of specific statutory or autonomous bodies.
In case you are an employee of the Postal Department.

Application Process of Central Government Health Scheme (CGHS) Card

As you are aware, current Central Government employees, in addition to retirees, are also eligible for the Central Government Health Scheme. The procedures to take are as follows: first, you must register yourself in order to receive the benefits of this plan.

Open the official CGHS website on your phone or computer.
Navigate to the “Downloads” option and continue to download the application form.
You will get a page asking for your personal details and information. Fill that accordingly.
Submit the application form along with your recent photograph and necessary documents to the Additional Director's office in any one of the CGHS-covered cities.

How to Book a Doctor’s Appointment Under the Central Government Health Scheme?

To opt for a doctor’s consultation, you need to book an appointment at the centre online by following the given steps:

Visit the official website of CGHS.
Log in with your beneficiary ID and the OTP received.
You will be shown your details. Click on "Agreed" if all your details are correctly displayed. Otherwise, you can also click on the "Not me" option.
After proceeding to the next page, you must fill in the CGHS dispensary, doctor and the speciality.
Select the date of your appointment according to the selected doctor’s availability.
Select your desired slot.
Click on the “Proceed to Book Appointment” option.
Preview the details given, then click on “Confirm”.
The system will generate a confirmation receipt. You can take a printout of it to take to the centre on the appointment day.

What is the CGHS Empanelled Hospital List?

The following are some of the enlisted hospitals under the Central Government Health Scheme.

State	Hospital
Delhi	Vivekananda Hospital
Delhi	Ashwini Hospital
Madhya Pradesh	Navjeevan Hospital
West Bengal	Narayana Multispeciality Hospital
Kerala	Dr. Ramachandran’s Diagnostic Services
Mumbai	Shantiniketan Hospital
Mumbai	Swami Sarvanand Hospital
Bihar	Anupama Hospital
Chennai	CSI Kalyani General Hospital

Please note that numerous other hospitals are enlisted under the Central Government Health Scheme apart from the CGHS hospital list mentioned above. You can check your nearest enlisted hospital on the official CGHS website.

Final Words

Overall, CGHS is one of the significant initiatives to accelerate the healthcare ecosystem in India. You can have access to the data of various registered healthcare practitioners. Therefore, the scheme aims to improve the healthcare economy of Indian citizens by providing them with a CGHS health card. The most crucial thing to understand is that the recipients receive financial support for their medical care thanks to the unique identification number.

Frequently Asked Questions (FAQs)

The answers to commonly asked questions about the Central Government Health Scheme

1. Can an unmarried daughter of a beneficiary avail the CGHS benefits?

Yes. Unmarried or dependent daughters of a serving employee or pensioner can seamlessly enjoy the benefits of CGHS facilities.

2. What is a central government health scheme card?

Central Government Health Scheme Card (CGHS) card acts as a financial protection for the beneficiaries, through which they can get healthcare services in the enlisted hospitals free of cost or on a reimbursement basis, along with many other preventive medical services.

3. Is there any maximum limit for CGHS?

Yes, there is a maximum limit depending on the pay scale and entitlement of the employee. An employee with higher entitlement can avail higher numbers of healthcare benefits from the scheme and vice versa. You can check the authorised medical dispensary to confirm the details of entitlement.