| 1. |
Who are entitled for CGHS facilities |
|
1. |
All Central Govt. employees and their dependant family
members residing in CGHS covered areas. |
|
2. |
Central Govt Pensioners and their eligible family
members getting pension from Central Civil Estimates |
|
3. |
Sitting and Ex-Members of Parliament |
|
4. |
Ex-Governors & Lt. Governors |
|
5. |
Freedom Fighters |
|
6. |
Ex-Vice Presidents |
|
7. |
Sitting and Ex-Judges of Supreme Court & High
Courts |
|
8. |
Employees and pensioners of certain autonomous
organizations in Delhi |
|
9. |
Journalists (in Delhi )Accredited with PIB
( for OPD & at RML Hospital)
|
|
10. |
Delhi Police Personnel in Delhi only |
|
11. |
Railway Board employees
|
|
|
|
|
| 2. |
In how many cities CGHS is presently
operative? |
|
CGHS facilities are available in 25 cities in
India |
|
|
1. Ahmedabad 2 Allahabad 3 Bengaluru 4 Bhopal 5
Bhubaneshwar 6. Kolkata 7. Chandigarh 8 Chennai 9.Dehradun 10.Delhi & NCR
11.Guwahati 12. Hyderabad 13. Jabalpur, 14. Jaipur 15 Jammu 16. Kanpur 17.
Lucknow 18. Meerut 19. Mumbai 20. Nagpur 21 Patna 22.Pune 23. Ranchi 24.
Shillong 25. Thirruvananthapuram |
|
|
|
|
| 3. |
For CGHS cards , as dependant , what is the meaning
of the word " family " |
|
The term 'family' means and
includes:- |
|
1. |
"Husband or wife as the case may be and other
dependant family members. |
|
2. |
Dependant Family Members:
parents, sisters, widowed sisters, widowed daughters, minor brothers and
minor sister, children and step-children wholly dependent upon the Government
Servant and are normally residing with the Government Servant".
Also now included , dependent divorced / separated daughters ( including
their dependant minor children) and step-mother.
|
|
3. |
The term dependency means that income from all sources
including pensions and pension equivalent of DCRG benefit is less than Rs.3500/-
plus amount of DA on Basic pension of Rs3500/- per month. |
|
4. |
However, there is no such clause as dependency in respect of spouse.
|
| 4. |
What is the procedure to register with
the CGHS? |
|
Pensioners: |
|
1. |
One can get a CGHS card made from the office of AD /
JD of the City. |
|
2. |
Forms can be downloaded from CGHS Website or can be
taken from office of AD / JD of city. |
|
Documents required |
|
|
i. Application in prescribed format
ii. Proof of Residence/proof of Stay of dependents
iii. Proof of age of son
iv. Disability certificate, if any in case of sons aged 25 & above, who
would otherwise cease to be a beneficiary.
v. Photos of eligible family members
vi. Surrender Certificate of CGHS Card while in service ( only in those
cases where CGHS Card was issued while in service)
vii. Attested copies of PPO & Last Pay Certificate
viii. Draft for required amount towards CGHS contribution - in the name of
'P.A.O., CGHS New Delhi' in Delhi-and in the name of 'AD, CGHS of the
city'.
ix. In case PPO is not ready for any reason there is option to get a
provisional card on the basis of Last Pay Certificate.
x. The data is entered through computers and entered in data base and a
print out is issued same day for immediate use. Plastic cards are subsequently
sent to the residence of the card holder by post.
|
|
Serving employees:-
|
|
|
Serving employees submit the forms in prescribed format enclosing photos of
eligible family members and submit to the Ministry / Department/Office , where
he / she is employed. The application form shall be forwarded by the Ministry /
Office /Department to the office of Addl. Director CGHS of city for preparation
of card.
Print out is issued for immediate use.
|
|
|
|
| 5. |
Are CGHS facilities free of
cost? |
|
|
For serving employees residing in CGHS covered area obtaining CGHS card is
compulsory
Deduction from salary is made by the department, every month, depending
upon their pay
| Grade Pay |
Contribution
per month (from
1.6.2009)
|
| Upto Rs.1650 /- |
Rs. 50/- |
| Rs.1800/-, Rs1900/- Rs.2000/- , Rs.2400/- Rs.2800/- |
Rs.125/- |
| Rs.4200/- |
Rs.225/- |
| Rs.4600/-,Rs.4800/- Rs.5400/- Rs.6600/- |
Rs.325/- |
| Rs. 7600/- and above |
Rs. 500/- |
Pensioners who want to avail CGHS facilities can make contribution either
on yearly basis or one time ( ten yrs ) contribution for whole life
validity.
Payment can be made by Demand Draft in favour of " P.A.O. CGHS
Delhi" if in Delhi or " Additional Director of the CGHS City "
Contribution in respect of Pensioners are calculated on the basis of grade
pay they are entitled had they been in service , but for superannuation.
|
| 6. |
What is the system for the services of
specialists in Dispensaries? |
|
Prior registration is required appointment
with the CGHS Wellness Centre, where specialist services are available. However,
In case of emergency contact CMO i/c of dispensary of Wellness Centre for
consulting specialist without prior appointment. |
|
|
|
| 7. |
Is there any interactive mechanism at
dispensary level? |
|
At the Wellness Centre 'Local Advisory
Committees' are formed. CMO i/c holds a meeting with Local Advisory committee
members to discuss local dispensary related issues. |
|
|
|
| 8. |
How long does it take to get the CGHS
Cards? |
|
Normally computerized printout of index card is issued on the same day.
Plastic cards are sent to the residence in '3' weeks time.
|
|
|
|
| 9. |
Whom Should I approach in case the CGHS
Card is not issued to me in the prescribed time? |
|
Contact Joint Director (HQ), CGHS, Bikaner House, New Delhi in case of
Delhi and Addl. Director of City in case of other cities.
|
|
|
|
| 10. |
What should I do if I lose my CGHS Cards
? |
|
Application is to be submitted to AD/JD along with two photographs and a
IPO for Rs. 50/- for issue of duplicate card. Indian Postal Order payable to "
P.A.O. CGHS Delhi" if in Delhi or " Additional Director of the CGHS City " in
respect of other cities
|
|
|
|
| 11. |
What should I do if the details on the
Card viz. name, date of birth, entitlement, etc. are wrong? |
|
Kindly bring the anomalies to the notice of
Joint Director, CGHS (HQ), and Bikaner House in Delhi and to the Addl. Director,
Joint Director of concerned CGHS City in other cities. |
| _____ |
_____ |
|
| 12. |
Is there a colour scheme for plastic
cards? What are the details? |
|
|
CGHS Plastic cards have the following colour at the
top: |
|
i. |
Serving Government employees - Blue
|
|
ii. |
Pensioners, ex-MPs , Freedom Fighters,
etc., - Green |
|
iii. |
Member of Parliament - Red
|
|
iv. |
Beneficiaries of Autonomous Bodies / Journalist -Yellow
|
|
|
|
| 13. |
I retired in 1998 from Central Govt.
but, I never made a CGHS card. Can I get a card now? |
|
|
Pensioners can apply for CGHS card with relevant
documents. However, the subscriptions as applicable at current rates shall have
to be paid. |
|
|
|
| 14. |
My husband/wife is also employed under
Central Government and is eligible for a separate CGHS Card. Is it necessary
that separate cards are to be obtained? |
|
|
No. Spouse drawing higher pay shall make the card and
other spouse is eligible to avail CGHS benefits as member. |
|
|
|
| 15. |
My husband / wife retired in 2002. He
/she was paying CGHS subscription every year. After his death can I get Card on
my name. Do have I to pay extra. Shall I get Life Time Valid card |
|
Yes, the ownership of card can be
transferred in the name of spouse on submission of required documents. Addl.
Director of concerned city shall transfer the ownership of Card in the computer
Data base and same CGHS plastic cards with same Beneficiary ID can be
used |
|
1. |
No extra payment to be made, in case of life time
cards. |
|
2. |
However in other cases one has to pay 10 years subscription for life time
card
For example, if the spouse had contributed for seven years before he
expired , balance payment for the remaining three years is to be paid for a life
time card.
|
|
3. |
Documents required :
Application in prescribed format
Proof of Family Pension with its break up from Bank
|
|
4. |
Prescribed contribution if, card is not for life
time |
|
|
|
| 16. |
How to transfer CGHS card from one WC to
other in the same city? |
|
If there is any change in residential
address , CMO i/c may be approached with proof of residence for transferring the
data from one Wellness Centre to another in the same city. |
|
CMO i/c of the new Wellness Centre will
accept the data of transferred card. |
|
In respect of serving employees the request
is to be forwarded by his/her office / department. |
|
|
|
| 17. |
I am CGHS beneficiary at Kanpur.
Visiting Mumbai for 6 months. Can I get CGHS facilities at Mumbai .Can same card
of Kanpur continue or a separate card to be made. From where to get permission
for the same? |
|
Subsequent to computerization no separate
permission is required and CGHS card is valid for availing facilities from any
CGHS Wellness Centre in India. For any assistance , Addl. Director of the city
may be contacted. |
| 18. |
.I have been advised some investigations
by Specialist of Govt. Hospital. What is the procedure to obtain the
permission? |
|
No separate permission letter is required.
Once a Government specialist / medical officer of a CGHS Wellness Centre advises
a test listed investigations can be undertaken from any of the CGHS empanelled
laboratories on the basis of the advice given by Govt. Specialist / Medical
Officer of CGHS Wellness Centre. Original or self attested photo copy of
prescription is to be submitted along with a copy of CGHS card. |
|
|
|
| 19. |
Who is competent to delete name of sons
who have crossed age of 25 years? |
|
CMO i/c of Wellness Centre is competent to
delete the name of son aged 25 yrs and above. Computer system does not allow
sons aged 25 and above to avail medical facilities. |
|
|
|
| 20. |
After retirement in 2007 I got a Life
time Pensioner CGHS card made in Delhi. Now I am shifting to Dehra Dun. Can I
use the same card. Do I pay again? |
|
Pensioners shifting from one CGHS covered
city to another, will have to apply to the Addl. Director of concerned city for
transfer of card. The card shall be transferred online and a receipt will be
issued to the beneficiary , on the basis of which , Addl. Director of new city (
say Dehradun) shall receive the data. Same Plastic cards and same Ben ID will be
valid. No contribution is required to be paid in respect of pensioner
beneficiaries holding life time cards. |
|
|
|
| 21. |
I live in Gurgaon but my office is in
Saket. Can I avail facilities from both the places because it is convenient for
me. |
|
Yes. Subsequent to computerization CGHS
facilities can be availed from any Wellness Centre in India. |
|
|
|
| 22. |
Is there any age limit for sons /
daughters as dependant in CGHS Card ? |
|
1. |
Son is eligible till he starts earning or attains the
age of 25 years or gets married whichever is earlier. |
|
2. |
However, in case the son is suffering from any
permanent disability of any kind (physical or mental) he is eligible for CGHS
benefits even after 25yrs. |
|
3. |
Disability means blindness, low vision, leprosy-cured,
hearing impairment, locomotor disability, mental retardation, mental illness. A
disability certificate from Medical Board is required. |
|
4. |
Daughter is eligible till she starts earning, or gets
married, whichever is earlier (irrespective of age) |
|
|
|
| 23. |
Are step-children allowed CGHS
facilities? |
|
Yes. If they are dependent on card holder:
other conditions as in case of dependant sons and daughters. |
|
|
|
| 24. |
Can dependent in-laws be included under
family members for CGHS facilities? |
|
A lady Government servant will be given a choice to include either her
parents or parents -in-law for the purpose of availing the benefits under CGHS
subject to the condition of dependence and residence, etc., being
satisfied.
Such option is not available for male Government servants
|
|
|
|
| 25. |
Me and my wife are both central Govt.
employees and have dependant brothers / sisters and parents. Can we make
separate cards and include family members? |
|
Yes. Both Government employees have the option to make CGHS Contribution
and obtain Two separate CGHS cards and the names of the eligible dependant
family members can be included on their respective cards.
Your wife can include the names of her parents/ brothers / sisters and such
other eligible dependants in her card, subject to the condition of dependence
and residence, etc., being satisfied.
|
| 26. |
Can the CMO or the pharmacist give a
different brand than the one prescribed by the specialist? |
|
CGHS shall supply/indent only those medicines, which are included in the
CGHS formulary (Pl ref to reply to Q29).
|
| 27. |
What is the procedure for getting life
saving drugs ? |
|
In Delhi- through CGHS Medical Store Depot, Gole Market
The documents required are:-
|
|
1. |
Prescription of specialist. of Govt. Hospital or CGHS
approved private Hospital. |
|
2. |
Photocopy of his/ her token card/ plastic
card. |
|
3. |
Copy of permission if his prescription is from CGHS
approved private Hospital. |
|
4. |
Utilization certificate in original during subsequent
visit. |
|
5. |
Indent is also placed online through CGHS Wellness
centre. |
|
In other cities request is to be submitted
to the Addl. Director of City. |
|
|
|
| 28. |
What are the guidelines for Anti-Cancer
and related medicines? |
|
Anti-Cancer and other similar medicines, are supplied on a case to
case
basis..
|
|
|
|
| 29. |
What are the guidelines for issue of
medicines? |
|
a) |
CGHS shall supply medicines as per the available brand
name / generic name. |
|
b) |
In case medicines advised by a Specialist are not
available theyshall be indented by the same brand name though Authorized Local
Chemist. |
|
c) |
Anti-Cancer and other similar medicines are however
supplied on a case to case basis. |
|
d) |
Medicines for treatment of Chronic illnesses shall be
supplied for a maximum period of three months. |
|
e) |
In case of CGHS beneficiaries going abroad, issue of
medicines shall be restricted for a maximum period of six months. |
|
|
|
| 30. |
What should I do if the Wellness
Centre/Dispensary does not give all the medicines? |
|
Contact CMO i/c of the concerned Wellness
Centre or Addl. Director, CGHS of concerned city or Director, CGHS. |
|
|
| 31. |
How long does it take to get the
medicines ? |
|
Medicines available in the dispensary 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. |
|
|
|
| 32. |
Are the prescription of specialists of
empanelled hospitals binding on the dispensary ? |
|
Medicines are issued on the basis of
prescriptions of government doctors. However, in permitted cases medicines are
issued on the basis of prescriptions of empanelled hospitals and medicines will
be issued as per the available brand / generic names. |
|
|
|
| 33. |
What is the maximum period for which
medicines can be given in one go ? |
|
i. |
Medicines upto three month are issued in one go ,
provided there is a valid prescription. |
|
ii. |
In case of a beneficiary visiting a foreign country ,
medicines upto '6' months are issued in respect of cronic illnesses , based on
valid prescription and documentary support of visit to a foreign
country. |
|
|
Beneficiary is required to submit an application for obtaining permission
from AD/JD along with the following documents:-
Copy of valid CGHS card/ token card.
Valid prescription for six months counter signed by HOD of Specialty of
Govt. Hospital.
Proof of station leaving like ticket, Visa etc.
|
|
|
|
| 34. |
If some medicines like antibiotics are
urgently required and are not available at CGHS Wellness Centre what can be
done? |
|
In case some medicines are not available
and are urgently required for treatment , there is provision for issue of
authority form by CMO i/c for collection of medicines, for a few days like 3-5
days, directly from authorized local chemists . |
|
|
|
| 35. |
How to get a drug if same is not
available in WC & also not supplied by Chemist(ALC)? |
|
Beneficiary, after authorization by CMO i/c
can purchase such drugs from open market & claim reimbursement from
ALC. |
|
|
|
| 36. |
What should beneficiary do, if he/ she
notice some deterioration in the quality of drugs? |
|
He /she should return the medicine to WC
& get replacement. Samples can be sent for testing through CMOI/C. |
|
|
|
| 37. |
My father is a cancer patient and after
operation is bed ridden. Doctors have advised Protein powder. Can I get from
CGHS? |
|
Dietary supplements are not permissible
under CGHS. |
|
|
|
| 38. |
Is Penfill Injection provided under
CGHS |
|
Insulin pen is not supplied under CGHS.
But, Insulin pen catridges are supplied under CGHS |
|
|
|
|
|
|
| 39. |
Does CGHS provide for reimbursement for
treatment taken abroad during a visit under emergency? |
|
There is no provision under CGHGS for reimbursement of expenditure during a
visit abroad. It is the responsibility of the individual to make arrangements
for medical care while on a visit to a foreign country.
However, in case of beneficiaries undergoing treatment for pre-existing
chronic diseases, to ensure continuity in treatment medicines are issued for up
to ‘6’ months based on valid prescription and documentary support of visit to a
foreign country.
Beneficiary is required to submit an application for obtaining permission
from AD/JD along with the following documents:-
Copy of valid CGHS card/ token card.
Valid prescription for six months counter signed by HOD of Specialty of
Govt. Hospital.
Proof of station leaving like ticket, Visa etc.
|
|
|
|
| 40. |
What do I do if I am unwell at odd
hours, say late in night? |
|
CGHS beneficiaries have the option to go to
any of the 24 hr functional dispensaries in Delhi, a nearby govt. hospital /
empanelled private hospital or even any private hospital , in case of
emergency. |
|
|
|
| 41. |
Whom should I contact if the doctors are
not present in the Wellness Centre / Dispensary? |
|
Contact CMO i/c of the concerned Wellness
Centre or Addl. Director, CGHS of concerned city or Director, CGHS. |
|
|
|
| 42. |
In emergency who are all entitled to get
treatment at Pvt Empanelled Hospital |
|
Any beneficiary holding a Valid CGHS
card. |
|
|
|
| 43. |
What should I do in case of
emergency? |
|
CGHS beneficiaries have the option to go to any of the 24 hr functional
dispensaries in Delhi, a nearby govt. hospital / empanelled private hospital or
even any private hospital
|
| 44. |
What are the papers to be submitted for
any investigation by an empanelled diagnostic centre? |
|
Original or self attested copy of
prescription of CGHS Doctor / Government specialist |
|
Copy of CGHS Card of the patient and main
card holder (head of family). |
|
|
|
| 45. |
What are the criteria for Entitlement of
Treatment endorsed on CGHS Card like General ward / Semi-Pvt ward or Pvt. Ward
in CGHS Empanelled Hospitals? |
|
Endorsement of entitlement for general/semi- private/private ward facility
is done according to their basic pay / basic pension as under :
Upto Rs. 13,950/- per month - Entitlement : General
Ward
Rs. 13,960/- to 9,530/- per month -Entitlement: Semi-private
Ward
Rs. 19,540/- and above - per month - Entitlement : Private
Ward
|
|
|
|
| 46. |
Which are the categories eligible for
cashless treatment? |
|
|
Hospitals shall provide credit facility to the following categories of CGHS
beneficiaries (including dependant family members, whose names are entered on
CGHS Card):
Members of Parliament;
Pensioners of Central Government drawing pension from central
estimates;
former Vice-presidents, Former Governors and former Prime Ministers;
Ex-Members of Parliament;
Freedom Fighters;
serving employees of Ministry of Health & Family Welfare (including
attached / subordinate offices under the Ministry of Health & Family
Welfare)
|
|
|
|
| 47. |
What should I do if the empanelled
hospital refuses to entertain or give a step-motherly treatment? |
|
Contact CMO i/c of the concerned Wellness
Centre or Addl. Director, CGHS of concerned city or the nodal officer for
grievances. |
|
|
|
| 48. |
I am a serving employee of an autonomous
body, holding CGHS card. Who will give me permission for treatment on the
recommendation of Govt. specialist? |
|
Permission for specific treatment procedure
as advised by a Govt. Specialist at private empanelled hospitals shall be
granted by the Head of Autonomous body in respect of serving employees as well
as pensioners of Autonomous bodies covered under CGHS. |
|
|
|
| 49. |
What is the time within which my medical
claim is to be reimbursed? |
|
If all documentation is complete medical
claims of pensioners are cleared in 45 days. |
|
|
|
| 50. |
What can I do if my claim is
unnecessarily delayed? |
|
Pensioner beneficiaries can contact the
Additional Directors of concerned city / zone on any Wednesday between 11 A.M.
and 1 P.M. |
|
|
|
| 51. |
I am a CGHS Pensioner. My wife was
admitted in pvt hospital in emergency state. How to get reimbursement of money
spent on her treatment? |
|
|
Apply to CMO I/c of WC with :
- MRC
forms duly filled in as per Check list
- Copy
of Discharge summary
- Hospital
bills with break-up
- Receipts
in original
- Copy
of the valid CGHS Card
- Copies
of other documents issued by hospital
MRC forms are available with CMO I/c and can also be downloaded from CGHS
Websitehttp://msotransparent.nic.in/cghsnew/index.asp
Serving employee in similar cases shall submit the medical claim to his
department.
|
|
|
|
| 52. |
My original papers having bills,
Receipts of hospital treatment are lost. Can I claim on duplicate
papers? |
|
Yes.With affidavits on Stamp paper.Details
of Draft for Affidavit may be seen in the instructions sheet appended to Medical
Claim Form available
at http://msotransparent.nic.in/cghsnew/index.asp and CMO i/c. |
|
|
|
| 53. |
My husband/wife was a CGHS card holder.
He/She was sick and died while in hospital. How do I get MRC? |
|
Apply to CMO I/c of WC with : |
|
|
1. MRC forms duly filled in as per Check list
2. Copy of Death summary
3. Hospital bills with break-up
4. Vouchers in original
5. Copy of the valid CGHS Card
6. Death Certificate
7. Affidavit on Stamp paper of yourself being Legal Heir and NOC from other
legal heirs in favour of claimant
8. Copies of other documents issued by hospital
|
|
Draft for affidavit may be seen in the
instructions sheet appended to the Medical Claim Form available at CGHS Web site
at http://msotransparent.nic.in/cghsnew/index.asp |
|
|
|
| 54. |
I retired in Dec 2011. Due to certain
reasons I had to go to my native place in Uttranchal and could not make
pensioner's CGHS card. In May 2012 I came to Delhi and had Heart attack. In
emergency I was treated in pvt hospital .I got CGHS Card made after discharge
but I have been refused reimbursement of the expenditure incurred. |
|
After retirement three months grace period is given to get CGHS card
made.
The treatment taken and expenditure incurred thereon within the grace
period of three months from the date of retirement will be allowed and
expenditure reimbursable subject to the condition that the beneficiary has
either obtained or applied for CGHS pensioner card with all documents and
requisite CGHS subscription within one month of expiry of the grace period of
three months.
The expenditure on treatment taken after the grace period of three months
from date of retirement will not be reimbursable unless the beneficiary has
obtained a valid CGHS card or has applied for CGHS pensioner card with all
documents and requisite CGHS subscription prior to taking such
treatment.
|
|
|
|
| 55. |
I went to Hyderabad to visit my son and
had fracture of leg bone. I received treatment from a pvt hospital. Shall I get
full reimbursement? |
|
|
Reimbursement for treatment taken in a private
hospital under medical emergency shall be considered as per CGHS rates
only. |
|
|
|
| 56. |
Is treatment for IVF
reimbursable? |
|
|
IVF treatment is approved under CGHS. The details may
be seen as per Office Memorandum Z.15025/5/2011/CGHS III/CGHS(P) dated
22.11.2011 , which can be downloaded from CGHS Website
at http://msotransparent.nic.in/cghsnew/index.asp |
|
|
|
| 57. |
Are ambulance charges
reimbursable? |
|
|
Yes. Ambulance charges are reimbursable within the
city , if there is a certificate from treating doctor that conveyance by any
other mode would definitely endanger patient's life or would grossly aggravate
his/her condition. |
|
|
|
| 58. |
I have a Mediclaim Insurance Policy. Due
to emergency received treatment in a pvt hospital. Some amount was paid by
Insurance Co. can I get balance from CGHS |
|
Yes. First Bills are submitted to Insurance Company.Duplicate bills with
certificate from Insurance Company may be claimed from CGHS by Pensioner CGHS
beneficiaries.CGHS shall consider reimbursement at CGHS rates or actual
whichever may be less. However, the total reimbursement from both sources should
not exceed actual expenditure.
Serving employees shall submit claim to department for
reimbursement.
|
|
|
|
| 59. |
I submitted MRC for Rs. 1 Lac 20
thousand but I was reimbursed only Rs. 45,800/-. Why total amount was not
reimbursed? |
|
Government has no agreement with private
hospitals , which are not empanelled under CGHS for charging CGHS rates.
However, if treatment is undertaken at private non- empanelled hospitals under
emergency , reimbursement will be limited to CGHS rates or actual, whichever may
be lower. Since, non empanelled private hospitals often charge at rates
different from the CGHS rates there will be difference in the amount reimbursed
if the private hospital chatges are higher than CGHS rates. |
|
|
|
| 60. |
I want to get my Cataract Surgery done
at Pvt empanelled hospital ? How can I get it done |
|
Beneficiaries are required to obtain advice from a Govt. Specialist / CMO
i/c for Cataract surgery. Pensioners can apply to CMO I/c of WC for permission
to obtain the treatment at one of the empanelled hospitals of his /her
choice.
Serving employees to apply to his / her Department /
office.
|
|
|
|
| 61. |
Is it necessary that the Govt specialist
should write 'referred to CGHS empanelled Hospital' for obtaining
permission? |
|
Advice of Government specialist is required
only for the specific treatment procedure / investigation to be undertaken.
There is no need to specifically refer to any empanelled hospital/ diagnostic
lab. It is the choice of beneficiary to under treatment / investigations at any
of the empanelled hospitals / diagnostic laboratories after obtaining permission
from competent authority. |
|
|
|
| 62. |
CMO Incharge does not refer me to Pvt.
Hospitals on my request? |
|
As per CGHS guidelines there is no
provision for OPD referrals to private empanelled hospitals except in satellite
towns of NCR |
|
|
|
| 63. |
I am an accredited journalist with CGHS
Card Can I seek treatment in Pvt. empanelled Hospitals in emergency and get
credit facility? |
|
No. Journalists are entitled only for OPD
treatment from dispensaries and treatment from Dr.RML Hospital. Journalists are
not entitled for reimbursement for treatment from empanelled
hospitals. |
|
|
|
| 64. |
What are the facilities available to me
if I am a pensioner in a non- CGHS area ? |
|
i |
a. |
Pensioner residing in non- CGHS covered areas have the option to
become CGHS beneficiary and avail CGHS facilities from the nearest CGHS covered
city. |
|
|
b. |
Pensioners residing in non-CGHS areas have also the option to
avail Fixed Medical Allowance of Rs500/- per month and opt not to avail
CGHS facility. |
|
|
c. |
Pensioners residing in non-CGHS areas have also the option to
avail Fixed Medical Allowance of Rs500/- per month for OPD treatment and
obtain CGHS card from nearest CGHS covered city for inpatient facilities under
CGHS. No OPD medicines shall be issued in such cases. |
|
|
d. |
CGHS pensioner beneficiaries (and their dependant and eligible
family members) who are holding a valid CGHS Card and residing in a non-CGHS
area shall be eligible to obtain inpatient medical treatment and also follow up
treatment from Govt. Hospitals / CS(MA) /ECHS approved hospitals on proper
referral from CGHS dispensary and submit the medical reimbursement claim to the
Addl. Director/ Joint Director of CGHS of city where the CGHS card is
registered. |
|
|
|
|
|
ii. |
In case of medical emergency , treatment may be
obtained from any hospital and medical claim shall be submitted to AD/JD , CGHS
of the concerned city. |
|
iii. |
Reimbursement shall be limited to the CGHS rates of
the city where the card is registered and as per the ceiling rates and ward
entitlements or as per actuals, whichever may be less. |
|
|
_____ |
|
| 65. |
I am a serving employee residing in a
place close to a city covered under CGHS. Can I get CGHS card issued from the
nearest CGHS city? |
|
There is no provision to avail CGHS
facilities in respect of serving government employees residing in non-CGHS
covered areas. They are covered under CS(MA) Rules 1944. |
|
|
|
| 66. |
I have retired from Delhi. Now I want to
settle in a city where no CGHS facility is available . How to cover my family
for medical care? |
|
Pensioners are eligible for CGHS facilities
and can obtain CGHS card from the nearest CGHS covered city. |
|
|
|
| 67. |
Can general public-avail treatment at
CGHS Wellness Centres? |
|
FREE CONSULTATION IS EXTENDED TO SENIOR CITIZENS (AGED 60 VI's. AND AROVE)
of GENERAL PUBLIC AT 26 CGHS WELLNESS CENTRES UNDER CGHS DELHI
FROM 1.00 P.M. TO 2.00 P.M" W.E.F. 1.09.2014 ON PI LOT BASIS
AT THE FOLLOWING CGHS WELLNESS CENTRES
| ALLOPATHY |
|
|
| PUSA ROAD |
DARYAGANJ |
CHANDNI CHOWK |
| VASANT VIHAR |
SAROJINI NAGAR-L Block |
SAROJINI NAGAR -SY Block |
| JANGPURA |
CHANAKYAPURI |
PANDARA ROAD |
| GREATER NOIDA |
SHAHIBABAD |
KALKAJI-II |
| VASANT KUNJ |
KASTURBA NAGAR-ii |
SARITA VIHAR |
| RAJPUR ROAD |
NOIDA SECT-82 |
GURGOAN SECT-55 |
| KALIBARI |
MAYUR VIHAR |
|
|
|
|
| AYURVEDIC |
|
|
| KALI BBARI |
JANAKPURI |
|
|
|
|
| HOMEOPATHIC |
|
|
| KALKAJI-II |
RK PURAM SECTOR-III |
|
|
|
|
| UNANI |
|
|
| SAROJINI NAGAR |
|
|
|
|
|
| SIDHA |
|
|
| LODHI ROAD |
|
|
|
|
|
|
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