CGHS facilities?
The Central Government Health Scheme (CGHS) is a comprehensive healthcare scheme established in 1954 by the Government of India. It is designed to provide affordable and quality medical services to central government employees, pensioners, and their dependents. The scheme operates through a network of dispensaries (wellness centers), empaneled private and government hospitals, diagnostic centers, and pharmacies across major cities in India.
Key Features of CGHS Facilities
- Outpatient Department (OPD) Services
Beneficiaries can avail of consultations with general physicians and specialists at CGHS wellness centers. - Hospitalization Services
Cashless hospitalization is available at empaneled government and private hospitals for specific categories, including pensioners and dependents. - Diagnostic and Laboratory Services
Tests like X-rays, blood work, and other diagnostics are available at wellness centers or empaneled diagnostic labs. - Medicines
Beneficiaries can obtain prescribed medicines free of cost at CGHS dispensaries or empaneled pharmacies. - Preventive Care
The scheme offers health check-ups and wellness programs to encourage preventive care among beneficiaries. - Referral Services
Patients requiring advanced treatment are referred to empaneled hospitals and specialists.
Eligibility for CGHS
- Serving Employees
Central government employees of KVS residing in CGHS-covered areas. - Retired Employees
Pensioners of central government services. - Family Members
Dependents of eligible employees, including spouse, children, and dependent parents. - Other Groups
Certain autonomous bodies, such as Kendriya Vidyalaya Sangathan (KVS), have also been included in the scheme.
Frequently Asked Questions (FAQs)
1. Who is eligible for CGHS facilities?
CGHS facilities are available to serving and retired central government employees, their dependents, and other eligible groups like KVS employees.
2. How do I enroll in CGHS?
Beneficiaries must apply online or offline at the CGHS office. They need to submit personal details, pay a subscription fee, and obtain a CGHS card for availing services.
3. What is the subscription fee for CGHS?
Subscription fees vary based on the pay grade or pension of the employee. For pensioners, a one-time contribution can be made for lifetime coverage.
4. What services are covered under CGHS?
CGHS covers outpatient care, hospitalization, diagnostic tests, medicines, preventive care, specialist consultations, and emergency services.
5. Are CGHS facilities available in all cities?
CGHS is operational in select cities, primarily urban areas. It is gradually expanding to cover more regions.
6. Can retired employees avail cashless hospitalization?
Yes, retired employees and their dependents are eligible for cashless treatment at empaneled hospitals under CGHS.
7. How does the referral system work in CGHS?
For specialized treatments or hospitalization, beneficiaries need a referral from a CGHS doctor. The referral is mandatory for availing services at empaneled hospitals.
8. What is an empaneled hospital?
Empaneled hospitals are those recognized by CGHS to provide treatment at discounted or agreed-upon rates for beneficiaries.
9. Can CGHS services be availed in emergencies without prior approval?
Yes, in emergencies, beneficiaries can directly approach empaneled hospitals for treatment. Post-treatment, necessary approvals can be obtained.
10. What happens if CGHS facilities are unavailable in my city?
Employees and pensioners residing in non-CGHS-covered areas can opt for Fixed Medical Allowance (FMA) to cover medical expenses.
11. Can Kendriya Vidyalaya Sangathan employees avail CGHS?
Yes, both serving and retired KVS employees have recently been granted CGHS facilities. They can enroll and access services like other central government employees.
12. What documents are required for CGHS enrollment?
- Identity proof (e.g., Aadhaar Card).
- Address proof.
- Pay or pension slip.
- Dependents’ details and proof of relationship.
13. What if a CGHS card is lost or damaged?
Beneficiaries can apply for a duplicate card by submitting an application along with a nominal fee at the CGHS office.
14. Are dental treatments covered under CGHS?
Yes, limited dental services such as extractions and scaling are covered. For specialized dental treatments, the cost is reimbursable as per CGHS norms.
15. Can private sector employees avail CGHS?
No, CGHS is exclusively for central government employees, pensioners, and specific groups like KVS staff.
Conclusion
The CGHS is a lifeline for millions of central government employees and their families, providing them with accessible, affordable, and reliable healthcare services. The recent extension of CGHS facilities to Kendriya Vidyalaya Sangathan employees further emphasizes the government’s commitment to improving healthcare access for all public servants. With its wide-ranging benefits and focus on quality care, CGHS continues to set a benchmark for public healthcare systems.