The Pensioners residing in the non- CGHS covered areas have a option to become CGHS beneficiary. The available service for CGHS facilities from the nearest CGHS covered city.
2. The Pensioners residing is allowed in non-CGHS areas have also the option to available Fixed Medical Allowance of Rs300/- per month but the available CGHS facilities are not to be allowed in other areas.
3. The Pensioners residing in non-CGHS areas have a option to available Fixed Medical Allowance of Rs300/- per month for OPD treatment and use CGHS card from nearest CGHS covered cities for inpatient facilities under CGHS. No OPD medicines shall be issued from Wellness Centres in such cases.
4. The CGHS pensioner beneficiaries and their dependant eligible
family members who are holding a valid CGHS Card with residing in a non-CGHS area shall be eligible to obtain inpatient medical treatment and also follow up treatment facility by central Government. The
approval hospitals on their proper referral from CGHS Wellness Centre and submit the medical reimbursement claim to the Additional. The Director
of the CGHS of the cities where the CGHS card is registered.
In case of medical emergency , treatment may be obtained from any hospital and medical claim shall be submitted to Additional Director, CGHS of the concerned city.Reimbursement shall be limited to the CGHS rates of the city where the card is registered and as per the ceiling rates.
Q-1 The maximum period for which medicines can be given in one go ?
For the treatment of Chronic illnesses the medicines provide upto ‘3’ months are issued in
one go, provided there is a valid prescription.
In case of a valid beneficiary visiting to foreign country , the medicines provided upto ‘6’ months.There
are an issued in respect of chronic illnesses , based on valid prescription and
documentary support of visiting to a foreign country.
Beneficiary is required to submit an application for obtaining permission from
Additional Director of city/zone along with the following documents:
Q-2 How long does it take to get the medicines ?
The Medicines available in the Wellness Centres are issued immediately. If any
medicine is not available and is to be indented through Authorized Local
Chemist the same are issued on the next day.
Q-3 Which are the categories of CGHS beneficiaries, eligible for cashless treatment ?
The Private empanelled hospitals is also called Health Care Organizations or HCOs
shall be provide credit facility to the following categories of the CGHS beneficiaries
including their dependant family members
i. Members of Parliament
ii. Pensioners of Central Government drawing pension from central estimates
iii. The Former Vice-presidents, Former Governors and former Prime Ministers and Ex-Members of Parliament
iv. Freedom Fighters
v. Serving CGHS employees
vi. Serving employees of Ministry of Health & Family Welfare
(including attached / subordinate offices under the Ministry of
Health & Family Welfare
Q-3 I am a CGHS Pensioner. My wife was admitted in a private hospital in emergency
state. How to get reimbursement of money spent on her treatment?
Apply to CMO I/c of the Wellness Centre where your CGHS card is registered,
within 90 days of discharge of the treatment. The procedure along with
the following documents
1) Medical Reimbursement Claim (MRC) forms duly filled in
2) Check list
3) Copy of Discharge summary
4) Original Hospital bills with break-up
5) Receipts in original
6) The Copy of the valid CGHS Card
7) Copy of cancelled cheque showing bank details for ECS payment
along with mandate form.
8)All Copies of other documents issued by hospital.
The whole set of MRC documents is to be submitted in duplicate
