Ministries, Departments have been decentralized and delegated powers to manage all cases of reimbursement. At the earlier time, claims amount more than INR. 2 lakhs required approval by the department of Health & Family Welfare Ministry.
Under CGHS rules, financial control, power has already been shifted to the Additional Directors of the cities or zones. He has the right to approve settlement of medical claims up to INR 5 Lakhs for pensioner beneficiaries, if there is no compulsion of rules is included.
Is CGHS Contribution Compulsory for CGHS Covered Areas Members?
Yes. For both working and retired central Govt employees, CGHS contribution is compulsory. Pensioners, who need to have CGHS facilities, can contribute either on a yearly basis or one time contribution of 10 years for whole lifelong validity. The Contribution can be issued by DD in favor of “P.A.O. CGHS, Delhi” in Delhi state or “Addl. Director by CGHS City name” for other cities. Contributions in respect of Pensioners are calculated on the basis of grade payment they have received during the service period, but for superannuation.
Need to increase Imprest money
Sufficient imprest money is not available in dispensaries so CMOs are not being able to provide minor items of work. For avoidance of delay in minor items of work, the limit of Imprest Money with CMO has been increased to INR. 20,000/- per annum.
Special services: Dental services in 13 dispensaries in Delhi have so far been outsourced to a private service provider.
Case studies: Reimbursement
Query: I retired in Dec 2012 and I had to shift to my native village in Uttaranchal for some reasons. So, I was unable to make a pensioner’s CGHS card. In June 2013, I came back to Delhi and had suffered from Heart attack. Immediately, I was admitted in a private hospital. After discharge from hospital, I had received CGHS Card but I was refused for reimbursement of the expenditure incurred during treatment. Please suggest?…..R.D. Bhardwaj
Answer: After 3 months of retirement, the grace period is over for making a CGHS card. Within this 3 month grace period, the reimbursement of expenses for treatment can be done. In this case of Mr. Bhardwaj, the amount spent on treatment is only after the expiry of the grace period of 3 months from retirement date. That’s why, it will not be reimbursable.
Remember
But if the beneficiary has received a valid card of CGHS or has applied for a CGHS card for pensioner with all satisfactory documents and proper requisite of CGHS before such treatment, then he will be able to receive reimbursement. In order to take advantages of CGHS facility, the retired employees need to apply for a new Pensioner CGHS card within 3 months grace period after retirement and it could save him/her from huge losses.
When a Govt. servant joins in the middle of the month or after 20th of the month, whether the CGHS subscription deductible at proportionate rate (No. of days of joining in the joining month). Please clarify.
Yes it is..
kINDLY QUOTE THE RELEVANT SECTION OF CGHS RULES WHERE SUCH PROVISION IS MADE.
In my crpf department I opted cghs .. during pension.my monthly medical allowance stopped.But due to non cghs area Sahaswan 243638 I could not taken registration in cghs .l request to my department to cancel cghs option and continue for medical allowance.but they refused asking that only one time option maybe done .Now not receiving allowance nor getting Cghs facility due to noncghs area . please suggest what should I do to received monthly medical allowance.Thanks
My husband was retired from department of Post as Sub Post Master and died in the year of 2005 . He never applied for a CGHS card. Can I get a new CGHS card now ? If yes, let me know the procedure. I reside in Jaipur.
Yes you can at CGHS Director Office..
i am transferred from delhi to non cghs city Raebareli UP on Feb 2017 but cghs deduction not stop by account office. what is ruling for cghs deduction for non cghs city.
I am central govt employee reside in CGHS covered area. I have not applied for CGHS card. But I took the medicine from AMA hospital at the CGHS rate. When I applied my medical bills for reimbursement the department told me you are not get the medical reimbursement of the AMA hospital as you are living in CGHS covered area. But at that time I didn’t have CGHS card then how can I take referal from CGHS dispensary. But department said you didn’t get the reimbursement of AMA hospital bills or you have to take medicine from govt hospital.
Please clarify it how can u get the amount of my medical bills
Sir
I have contributed Rs 12000/- from my salary towards CGHS. Am I eligible to claim tax exemption under section 80 D. Please clarify.
Yes, you can..
M BRO (ministry of defence) m hu..or apna cghs card . Babnwana chahta hu.. Isk Liye kya krna hoga
IS IS COMPULSORY TO GIVE CGHS CONTRIBUTION, EVEN IF I AM NOT AVAILING CGHS SERVICES, AS MY SPOUSE IS IN RAILWAYS AND I WANT TO GET AWAY WITH MY AUTONOMOUS CGHS CARD.
Retired on 31/12/2017. On paying 12000 got pensioners cghs card for one year during Feb 2018, i.e. previous FY. During the financial year I am planning to 98000 for remaining 9 years towards contribution to life time CGHS pensioner card. Kindly indicate whether I can claim tax exemption for FY 2017-18, 2018-19.
U can get monthly payment of 500 in lieu of OPD besides stoppage of monthly contribution. For this u have to give letter or undertaking to cghs directly or thru yr office with advance copy to cghs addl director of the concerned earlier cghs city opting for this. If u r in service then u can always claim medical reimbursement from locally approved or empanelled drs.n hospitals without need to pay any cghs monthly subscription in case of noncgus cities. So ask yr accounts officer to stop cghs deductions. Very strange why despite clear orders not to deuct for noncghs cities, they still do the same
Ate retired border roads pesonal eligible for availing CGHS facility.My farher retires in 1985 and never made CGHS. Is he stil eligible
Can I have the circular for compulsory deduction of CGHS contribution for covered area?
मेरा नाम योगेश् कुमार है मै 223 abod suranussi जालंधर में कार्यरत हूँ मैने august 2019 में cghs कार्ड के लिए आवेदन किया था परंतु आज तक ना तो मेरा कार्ड बनाया गया है और ना ही कोई मेसेज आया है
If I want to clear my all CGHS bills directly through medical superintendent after clearance is there will be still deduction from my service bank account..
How can I clear all the CGHS bill at the low rate ..
I was in deputation in NCB, Kolkata Zone since April,2015 to April 2019 from CISF. During my tenure in NCB Rs. 650/ was deducted in every month from my salary. Although my permanent address was not under CGHS area.due to that reason I did not make CGHS card and nor any medical claim was not produced before my authority. Inspite of repeated request NCB authority did not stop my contribution. when I did not avail any facility from CGHS, why such large amount since April,2015 to April,2019 was deducted from my salary. My question is , shall it be possible to reimburse the deducted amount of last 04 years (April,2015 to April,2019). If yes , what is the procedure for reimbursement. Please convey me.
I am posted in non CGHS area, however accounts deducted CGHS fee for last one year. There is no CGHS card issued to me. Is there any OM for refund of such deduction?
If you have any issue regarding CGHS card or bill payment or contribution then you can login through CGHS login and avail the services provided by the online portal