Central Government Health Scheme (CGHS) : Article from Sri. K.V.Sridharan

 Central Government Health Scheme (CGHS) : Article from Sri. K.V.Sridharan

(i) CGHS contributions will be recovered every month from pay bill (ii) If the husband and wife are Government employees, the contribution will normally be paid by one who gets higher pay.

(iii) In case of leave exceeding 4 months, one may opt not to contribute and in such cases, the CGHS facilities will not be admissible.

(iv) Pensioners/Family pensioners have to contribute the amount they were subscribing at the time of retirement/death of Government servant. (v) Pensioners/Family Pensioners should pay their contribution for one year in advance either from January to December or July to June. (vi) Pensioners can avail life time facility by paying 10 years contribution in one lump sum at the time of retirement.

(vii) Medical Allowance is not payable if the pensioners are residing in areas where CGHS facility exists.

(Vii) P&T Pensioners who were not CGHS beneficiaries while in service, but residing in CGHS area where there is no P&T dispensary are entitled to Fixed Medical Allowance.

(ii) Conditions for availing the Scheme:

(i) The employee should reside in the area of operation of the Scheme.

(ii) Pensioners residing anywhere may get registered in any dispensary.

(iii) A family photograph of size 6.5 cm x 5 cm should be affixed to the CGHS token card and got attested by the Department. In case CGHS beneficiaries falling sick outside CGHS area, treatment is allowed under CS (MA) Rules in Government Hospitals/Referral Hospitals/Recognised Hospitals

(iv) If both husband and wife are employees and contribute for CGHS, parents of both can be included for the benefits.

(v) Family of the employee can avail the facility if the employee is transferred to another CGHS area or goes to serve abroad and leaves the family at the old CGHS station.

(vi) Family of the employee who continues to stay back at the old station in a CGHS covered area can avail CGHS facilities even after the transfer of the employee to a non-CGHS area, for a maximum period of six months on payment of CGHS contribution in advance for that period.

(vii) Irrespective of age, the dependent permanently disabled/mentally retorted children residing with Government servant are eligible to avail CGHS.

(viii) From 19.01.2012, minor children of widowed/separated daughters can avail up to the age of 18 hours.

(ix) Dependent condition: Less than Rs. 9000/- PM plus the amount of D.A. (x) May avail medical facilities for in-patient treatment and Post-operative following treatment, while residing in or on visit to a non CGHS area subject to conditions.

(xi) Can undertake medical treatment from any hospital recognised under CGHS subject to the condition that the reimbursement shall be allowed as per CGHS/CS (MA) Rules or the actual expenses incurred whichever is less.(xii) If the treatment of a particular disease is available in the same city, he may be permitted to avail of the treatment in any other city of his choice.

(xiii) If the treatment is not available at the same station, he is eligible for the grant of TA/DA

Thanks to Mr. K.V.Sridharan, Ex General Secretary, AIPEU Group C