Central Government Health Scheme (CGHS)

Discover the comprehensive guide to the Central Government Health Scheme

The Government of India has introduced the Central Government Health Scheme (CGHS) to provide medical care to central government employees, pensioners, and their families. It was launched in 1954 to ensure that beneficiaries receive quality healthcare services at reasonable costs. 

With a network of wellness centres and empanelled hospitals nationwide, CGHS plays a crucial role in promoting health and well-being among its members. Keep reading to learn more about CGHS benefits, features, coverage, and more.

What is CGHS?

CGHS, or Central Government Health Scheme, is a health insurance scheme that facilitates medical treatment coverage for central government employees. Individuals with CGHS cards can avail themselves of medical benefits such as indoor treatment, child health services, OPD treatment, and tests at CGHS-affiliated or government hospitals.

What are the Features and Benefits of CGHS?

The features and benefits of CGHS are as follows:

• CGHS aims to promote the health of a wide range of populations by covering multiple health needs, reimbursements, and providing cashless treatments. 
• This comprehensive health insurance policy offers access to top-quality medical care and financial coverage for critical treatments.
• Beneficiaries of the CGHS policy get cashless treatment at the network hospitals and OPD expense reimbursements. Policyholders can also get reimbursements for specific medical expenses.
• With CGHS, beneficiaries can access several facilities like round-the-clock medical assistance, ambulance services, critical care services, and more.
• It also offers preventive health care facilities such as immunization, health check-ups, dental care facilities, etc.

What is the Mandatory CGHS Initiative by the Government of India?

As per the Ayushman Bharat Digital Mission, the Ministry of Health and Family Welfare has mandated linking the beneficiary ID of CGHS with ABHA from 1st April 2024. This will help integrate the health programs in a better way. 

Central government employees receive health insurance coverage of ₹5 Lakhs under this scheme to cover their medical expenses. As per records, nearly 4.4 million individuals are availing the benefits of CGHS throughout 75 Indian cities. Linking the CGHS with ABHA allows the maintenance of a database of policyholders and provides them with hassle-free treatment facilities when needed.

Here are the steps to follow while linking CGHS to ABHA ID:

1. Visit https://cghs.nic.in. 
2. Navigate to "Beneficiaries" and then log in using your ID and password.
3. You will need to fill out a CAPTCHA.
4. Next, select "Proceed to Update and Create/Link ABHA ID".
5. Candidates with an ABHA ID need to click "Link Using ABHA Number."
6. You need to enter the Aadhaar Card number to receive an OTP for verification.
7. You can print the ABHA card upon successful completion of the linking procedure.
8. Those who do not have an ABHA ID, click on "I don't have an ABHA ID."

What are the Different Types of Central Government Health Schemes?

When we say various types of CGHS schemes, we do not refer to multiple traditional insurance plans. Instead, we refer to a vast range of coverage the CGHS card offers, such as AYUSH treatment, inpatient hospitalization fees, child and maternity healthcare, OPD expenses, etc.
However, ineligible candidates can opt for alternative health insurance plans from private companies like Star Health to avail of benefits like OPD expenses, treatment coverage, etc.

What are the eligibility criteria for Applying for CGHS?

The Central Government of India has set the following criteria for an individual to become eligible for CGHS:

• Ex-Vice presidents
• Members of the Parliament
• Employees get their salary from Central Civil.
• Pensioners, their family members, or the members dependent on pension
• Ex or L.T Governors 
• Retired High Court and Supreme Court judges
• Freedom fighters
• Railway board employees
• Personnel of Delhi Police
• Press Information Bureau accredited journalist
• Postal Department employee
• Employee or pensioner of autonomous or statutory bodies, etc.

How to Apply for a CGHS Card?

Applying for CGHS is a straightforward process:

1. Eligible individuals can download the application form from the official CGHS website: cghs.gov.in. 
2. Applicants can also visit the nearest CGHS wellness centre to obtain the application form.
3. Complete the application form with the necessary details about family members.
4. Attached are the required documents, such as identity proof, address proof, dependent's proof, age proof, pension payment order, last pay certificate, and photographs.
5. Visit the wellness center between 7:30 am and 2:00 pm from Monday to Saturday and submit the application for verification.
6. Once approved, beneficiaries will receive a CGHS card that allows them to access services under the scheme.
7. This card remains valid till the primary applicant is retired. After his retirement, the card needs to be renewed.

Which Hospitals are Empaneled Under CGHS?

Here are a few of the empaneled hospitals under the CGHS scheme:

Note: Apart from these, there are several other CGHS empaneled hospitals. You can check with your nearest healthcare centers and hospitals while using the CGHS card. 

What are the Limitations of CGHS?

Despite its numerous benefits, CGHS faces several challenges:

Infrastructure Issues

Some wellness centres lack adequate facilities and staff, leading to long waiting times for patients.

Awareness

Many eligible individuals remain unaware of their entitlements under CGHS, limiting participation in the scheme.

Quality of Care

There have been concerns regarding the quality of care provided at some empanelled hospitals.

The Central Government Health Scheme has significantly impacted public health in India by providing millions with access to essential healthcare services. By ensuring that central government employees and their families receive timely medical attention without financial strain, CGHS contributes to a healthier workforce and society overall.

Additionally, as ongoing improvements are made to address existing challenges within the scheme, it continues to be an essential pillar of India's healthcare system.