GOVERNMENT PROPOSED NEW HEALTH SCHEME - CGEPHIS (Central Government Employees & Pensioners Health Insurance Scheme)

Central Government Health Scheme (CGHS) is a scheme for providing health care to serving Central Government employees and their dependant family members. Over the years, the scheme has been extended to cover central government pensioners, their dependant family members and certain other categories like members of parliament and ex-members of parliament, freedom fighters etc. Employees of some select autonomous bodies as also PIB accredited journalists have also been extended CGHS facilities on cost-to-cost basis in Delhi.

Central Government Health Scheme is available in 25 cities [Delhi (including Noida, Gurgaon, Faridabad, and Ghaziabad), Ahemdabad, Allahabad, Bangalore, Bhopal, Bhubaneshwar, Chandigarh, Chennai, Dehradun, Guwahati, Hyderabad, Jabalpur, Jaipur, Jammu, Kanpur, Kolkata, Lucknow, Meerut, Mumbai, Nagpur, Patna, Pune, Ranchi, Shillong and Thiruvanthapuram]. Central Government Employees living outside the CGHS areas are entitled to reimbursement for medical attendance and treatment under the Central Services (Medical Attendance) Rules [CS(MA) Rules]. Pensioners of the Central Government are not covered under these rules. At present, Central Government Pensioners living in non-CGHS areas are paid a sum of Rs. 100 p.m. for meeting their medical expenditure. Consequently, there has been a long standing demand from Central Govt. pensioners residing in non CGHS areas for medical services at par with those available to Central Govt. pensioners in CGHS areas. The VIth Pay Commission has recommended the introduction of a health insurance scheme in lieu of the CGHS.

Government of India, therefore, proposes to provide inpatient health care services to their all personnel of the Central Government including All India Service officers, serving and retired, and others who are covered under the existing CGHS (Central Government Health Services) and under CS (MA) Rules [Central services (Medical attendance) Rules] through a Health Insurance Scheme catering to their health care requirements. The proposed scheme shall be on voluntary basis for current set of employees & pensioners but compulsory for future employees & pensioners. The existing CGHS beneficiaries will have an option to avail CGHS facilities for OPD requirements and the insurance scheme for inpatient treatment.

With the introduction of health insurance scheme, the Central Government Employee (existing/ retired) will have the choice to select the best available health facilities for meeting their health care and can get best available treatment in areas in the close proximity. Click here to download expression of interest published by ministry of health.