Central Government Health Scheme (CGHS)

Why Was Central Government Health Scheme(CGHS) Introduced?

Before CGHS, Central Government employees and pensioners largely depended on medical reimbursement arrangements and other fragmented healthcare facilities.
This could result in delays in accessing treatment and higher upfront medical expenses, particularly for beneficiaries requiring regular or specialised care.

The Government introduced CGHS to create a structured and accessible healthcare system for eligible Central Government beneficiaries. The scheme brought medical services, medicines, diagnostics and specialist care under an organised framework, helping beneficiaries access healthcare with reduced financial burden and greater continuity of care. Similar Central and State Government initiatives, such as Telangana New Employees Health Scheme (NEHS) and Employees’ State Insurance Scheme (ESI), were subsequently developed to extend healthcare and financial protection to other sections of the population.

CGHS Eligibility – Who Can Apply

1. Central Government Employees and Their Families

   Central Government employees covered under the Central Civil Estimates, including eligible work-charged and industrial staff, employees on deputation, and certain employees of autonomous/statutory bodies and institutions.

2. Central Government Pensioners and Their Families

   Central Government pensioners, family pensioners, CPF beneficiaries, eligible pensioners of certain autonomous/statutory bodies, Ordnance factories and Audit & Accounts departments, along with their eligible dependants.

3. Members of Parliament and Constitutional Authorities

   Serving and former Members of Parliament, Parliamentary Secretaries, former Vice-Presidents, former Governors and Lieutenant Governors, and serving/former judges of the Supreme Court and Delhi High Court.

4. Defence, Police and Security Personnel

   Eligible civilian Defence employees, CISF and certain CAPF personnel posted in CGHS-covered cities, military officers on deputation to civil departments, and specified Defence industrial employees.

5. Railway and Audit Personnel

   Railway Board employees, serving and retired Railway Audit staff, and specified retired Divisional Accountants and Accounts Officers.

6. Employees of Specified Government Institutions and Organisations

   Eligible employees of organisations such as Kendriya Vidyalaya Sangathan, certain Ordnance factories, Supreme Court Legal Services Committee, India Pharmacopoeia Commission, and other permitted autonomous/statutory bodies.

7. Special Categories and Other Eligible Beneficiaries

   This includes freedom fighters receiving Central pension, eligible family members of deceased MPs, accredited journalists under specified conditions, PSU absorbees meeting prescribed conditions, certain All India Service pensioners, and members of the National Council's Staff Side.

8. Families Staying in CGHS-Covered Areas

   Eligible families of Central Government employees who are transferred or posted to non-CGHS areas, including specified postings to the North-East, Sikkim, Andaman & Nicobar, Lakshadweep, Ladakh and certain Left-Wing Extremism areas, subject to applicable conditions and payment of CGHS contribution

What the Central Government Health Scheme Covers

What CGHS does not Covered:

• Treatment is billed and reimbursed according to the officially notified CGHS Rate list, costs above this rate at a private hospital may not be fully covered.
• Serving employees must reside in a CGHS-covered city to subscribe; those posted outside CGHS cities are typically covered instead under the Central Services (Medical Attendance) Rules through an Authorised Medical Attendant.
• Ward entitlement (general, semi-private, or private) depends on the beneficiary's pay level, not personal preference.

How to Apply for a CGHS Card

Eligible CGHS applicants can apply for a CGHS card through the official CGHS portal by following these steps:

1. Visit the CGHS Portal

   Visit the official CGHS website (https://cghs.mohfw.gov.in/AHIMSG5/hissso/Login) and select “Apply Card.” Read the instructions, click “Continue,” and verify your mobile number using the OTP received.

2. Select Card Type

   Choose the appropriate category: Serving Employee, Retired Employee, or Employee nearing Superannuation and click “Apply Here.”

3. Fill in the Application Form

   Enter your personal, department and employment details, and upload the required documents, including a photograph, identity proof and residence proof. Add details and supporting documents for eligible dependants and complete the nominee details.

4. Review and submit the Application form

   Click “Next,” read and accept the undertaking, then select “Preview” to verify the information. Click “Save” to submit the application.

5. Make Payment, If Applicable

   Pensioners and employees nearing superannuation are required to pay the applicable CGHS contribution. After approval, payment can be made through Bharatkosh using the payment link sent by SMS or available on the portal dashboard.

6. Forward the Application

   Serving employees must print the submitted application and forward it through their parent department, duly endorsed by the Head of Department (HOD).

Documents Required to Fill the CGHS Application Form

• Filled CGHS application form
• Recent passport-size photograph
• Proof of residence in a CGHS-covered city (for serving employees)
• Proof of dependants (for family members to be added)
• Age proof for dependent children
• For pensioners: Pension Payment Order (PPO), or provisional PPO/Last Pay Certificate if the PPO has not yet been issued

How to Check Your Application Status and download

• CGHS beneficiaries can check their card status and download their digital CGHS card through the official CGHS portal or the myCGHS 2.0 mobile application.

Log in to the CGHS Web Application on cghs.gov.in under the "Beneficiaries" section to check card status and details.

Through the CGHS Portal

1. Visit the official CGHS website.
2. Log in using your Beneficiary Login credentials.
3. Go to “Beneficiary Details” to view your card information and status.
4. Select “Download Card” to view and save the digital CGHS card in PDF format.

Through the myCGHS 2.0 App

1. Open the myCGHS 2.0 app and log in.
2. Go to the “Family Detail” section.
3. Select the relevant beneficiary account.
4. Tap “Plastic Card” to view and save the digital CGHS card.

For queries related to medical claims, application status or grievances, beneficiaries can use the Grievances section on the CGHS portal or contact the CGHS helpline.

What to Do If You Have a Grievance

CGHS beneficiaries can lodge and track grievances online through the official CGHS portal.

1. Visit the official CGHS website.
2. Log in using your Beneficiary Login credentials.
3. Go to the “Grievance Desk” section.
4. Select “Lodge Grievance” to submit a new complaint.
5. Use the same section to track the status of your submitted grievance.

CGHS and Other Health Schemes

Telangana New Employees Health Scheme (NEHS): A state government healthcare scheme providing cashless treatment to Telangana Government employees, pensioners and their eligible dependants.

West Bengal Health Scheme (WBHS): A healthcare scheme for eligible West Bengal Government employees, pensioners and their families, offering medical treatment through government and empanelled healthcare facilities.

Helpline and Support for CGHS