Is Online Application For CGHS Card Mandatory?

The Ministry of Health and Family Welfare (MoHFW) has released new guidelines about the Central Government Health Scheme (CGHS) Cards. These new changes now require beneficiaries to complete the application for the CGHS card online through the official portal. The Ministry confirmed this in the Office Memorandum dated June 27, 2024.

This update makes the application for a new CGHS card online process more efficient for serving employees as well as pensioners.

What Is The CGHS Card?

A CGHS card is an identification card issued to beneficiaries under the central government health scheme card system. It serves as proof of identity and enables access to health services across CGHS wellness centres and empanelled hospitals.

Beneficiaries can now also apply CGHS card online using the updated CGHS portal, making the enrolment process smoother.

Key Features Of The CGHS Card

• Proof of Identity: The Card provides Proof of identity for every CGHS beneficiary.

• Coverage: It includes employees of the central government, retired employees pensioners, their dependents and other re-affiliated individuals.

• Once Employed/Cardholder Employees: The card remains valid for the primary Central Government employee/pensioner but after the primary cardholder dies, family members will have to seek new cards. Online access to records, renewal, and CGHS card download facility.

• Nature of Issued Cards: Issued cards differ in colour for active employees and retired ones who are both issued these cards. Pensioners can fill the CGHS application form for pensioners on the portal to activate benefits.

• Web Application: Beneficiaries may now apply for a CGHS card or renewal of the CGHS card online through the CGHS website.

Benefits Of The CGHS Scheme And CGHS Card

Pensioners require the PPO and can use the digital central government health scheme card apply portal. The CGHS card provides numerous benefits to its holders due to its wide beneficiary base. Let us have a look at them!

• Healthcare Accessibility: The scheme is applicable in 80 cities across India and provides accessible healthcare facilities to its beneficiaries. The CGHS Cities list can be accessed here.

• Affordable Healthcare: The treatment provided under the cghs card download scheme is affordable since the government covers the expenses incurred for most of the treatments.

• OPD Treatment: The scheme applies to outpatient treatments wherein regular OPD appointments and the expenses incurred under them are covered.

• Hospitalisation Expenses: In-patient services such as hospitalisation and surgery are also covered under this government scheme. Furthermore, treatments under AYUSH are also provided.

• Healthcare Devices: The cghs beneficiary scheme covers the provision of medical devices such as hearing aids, wheelchairs, crutches, etc. This enables a beneficiary to seek proper rehabilitation facilities.

• Maternity and Child Healthcare: Prenatal and postnatal care is covered for both mother and child under the scheme. The scheme covers all maternity treatments required. Women not covered under this scheme can also avail of maternity benefits under the Pradhan Mantri Surakshit Matritva Vandana Yojana.

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Who Can Avail Benefits Under This Scheme?

The following people related to the beneficiary are also covered and can avail benefits of the Central Government Health Scheme Card Download:

• Husband/Wife (First wife only)
• Dependant parents or parents-in-law
• The first wife of an adoptive father having multiple wives.
• Son till he attains the age of 25 or starts earning; whichever is earlier.
• Daughter till she starts earning or gets married; whichever is earlier.
• Dependent divorced/abandoned or separated from their husband/widowed daughters and dependent unmarried/divorced abandoned or separated from their husband/widowed sisters: irrespective of age limit.
• Dependent minor brother(s) till they attain majority.
• Dependent minor children of widowed/separated daughters till they become majors.
• Dependent family members apart from a spouse, residing with the beneficiary earning less than 9000/-+ DA per month.
• Son who is suffering from any permanent disability of any kind (physical or mental) as defined below: Irrespective of age limit.

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Document Requirements For CGHS Scheme

To apply for the Central Government Health Scheme (CGHS), some documentation has to be handed over for verification. The kind of documentation that needs to be provided will depend on whether the applicant is a serving central government official or a pensioner. Here is a list of the general documents that are required:

For Serving Employees

• Duly filled CGHS application form (available on the net or at the wellness centre)
• Identity Proof: Aadhaar Card, PAN Card, or any government ID
• Address Proof: Light and Heating bills, passport, Aadhaar card or any official papers confirming the residence
• Employment Certificate: Issued by the employer
• Passport sized photograph
• Dependent documents: For enrolling dependents (parents, children), submit a copy of identification, age proof and income details if applicable
• Pay Slip/Salary Certificate: Submission is required for Pay level and necessary for CGHS subscription calculation(DEBUG log)

For Pensioners

• Pension Payment Order (PPO): Issued at the time of retirement and contains the details of pension lump sum and regular payment.
• Duly filled CGHS application form
• Identity Proof: Aadhaar Card, PAN Card, etc.
• Address proof: Same as for serving employees.
• Photograph of the applicant: Sized to passport.
• Bank Account details: Pensions are paid into the bank accounts maintained by the pensioners.
• Spouse/Dependent Documents: In case of family coverage, a copy of the spouse's Aadhaar card or any other proof along with a birth certificate or dependant document for children is required.

For Dependent Family Members

• For Parents: Residing Children Affidavit both parents’ income (net income must be less than rupees nine thousand plus dearness allowance).
• For Spouse and Children: Aadhaar Card, children's birth certificate, Adult children's income proof, spouse's marriage certificate

Additional Documents

• In case of fresh pensioners: Provisional Pension Payment Order PPO or Last Pay Certificate.

All documents must be completed and lodged with the application filed at the CGHS wellness centre so that it can be attended to as required.

How To Download Central Government Health Scheme (CGHS) Card

Downloading the CGHS card involves a few simple steps that can be done online. Follow the steps below to download the CGHS card:

Visit the Official Website

• Open your browser and go to the CGHS official portal: CGHS Website.

Login to Your Account

• Use your beneficiary ID and the password to log in to your CGHS account.

• If you do not have a password or have forgotten it, you can generate a One-Time Password (OTP) using your registered mobile number.

Navigate to the CGHS Card Section

• After logging in, you will see an option for "Print Card" or "Download CGHS Card" in the user dashboard.
• Click on this option.

Download the Card

• You will be prompted to select your details (like the cardholder’s name or family member details).
• After selection, you can choose the "Download" option to save the CGHS card in PDF format.

Print the CGHS Card

• Once downloaded, you can take a printout of the card, which is valid for use at any CGHS wellness centre or empanelled hospital.

Ensure that all details on the downloaded card are accurate. If there are any discrepancies, you may need to contact your nearest CGHS office for corrections.

How To Check The Validity Of CGHS Card

You can check the validity of your Central Government Health Scheme (CGHS) card both online and offline. Here's how:

1. Online Method:

Step 1: Visit the CGHS official website.
Step 2: Navigate to the “Beneficiary” section on the homepage.
Step 3: Select "Check CGHS Card Validity."
Step 4: Enter your Beneficiary ID and other required details.
Step 5: Click on Submit. The portal will display the current status and validity of your CGHS card.

2. Offline Method:

• Step 1: Visit your nearest CGHS Wellness Centre with your CGHS card.
• Step 2: Request the wellness center staff to check the validity status of your CGHS card.
• Step 3: They will verify the card's validity in their system and provide the details.

Which States/Cities Can You Avail Of CGHS Facility

The Central Government Health Scheme (CGHS) is available in several states and cities across India, offering healthcare facilities to central government employees, pensioners, and their dependents. Here's a list of some of the cities where CGHS services are available:

Treatments Not Covered Under CGHS Scheme

The Central Government Health Scheme (CGHS) is very comprehensive when it comes to offering a diverse amount of medical treatments to the beneficiaries as it has its limits. Inapplicability of certain features is what these exclusions refer to:

Plastic Surgery:

• There are some surgeries done for beauty purposes only. An example of these would be facelifts, liposuction and transplants among other surgeries.

In Vitro Fertilization:

• Include but are not limited to procedures or medicines for infertility problems such as IVFs, artificial insemination and all forms of assisted reproductive operations.

Non Harris Non-allopathic Treatments:

• Irrespective of Akree or Kiraly, or any recognized traditional system such as Allopathic, Ayurveda, Homeopathy, Unani, Siddha and yoga, no non-allopathic treatment will be covered. Claims for Naturopathy and Acupuncture treatment until and unless the institute is licensed to practice medicine are excluded.

Genetic Research:

• There is no reimbursement available for the patients for any type of genetic screening or genetic counseling when classical genetic conditions or predispositions are searched for.

Diagnosis Outside CGHS – Private Doctor Consultation :

• Treatments taken from any private authorities or a consultant other than the specified empaneled cgsh network is own charge.

Executive Health Check-Ups Other than CCD – Exclusive template:

• Health checkups for any other medical or non-medical reasons that are not part of the preventive ‘health care benefits’ of the CGHS are excluded except to the extent that such health checks may be advised by a sanctioned health practitioner or for identifiable health reasons.

Personal Comfort Services:

• It does not provide coverage for additional care that includes private nursing, personal attendants or other such comfort related facilities within a hospital.”

Cost of Hearing Aids, Spectacles and Dentures:

• For example, though CGHS has some medical aids, there is no coverage for advanced hearing supplements, spectacles, and denture appliances beyond level one.

Treatment at Non-Empanelled Hospitals:

• Treatment received from hospitals that are not on the CGHS empanelled list unless in cases of emergencies are excluded from the CGHS cover.

Alternative Medicine Not in the Approved List:

• About number eleven, payment will not be made for treatment with non-conventional medicine not on the approved CGHS lists.

Conclusion

The central government health scheme card provides a bundle of benefits and healthcare and reasonable rates to its beneficiaries. Such schemes ensure employee welfare and promote the generation of such working environments at a national level.

For easier access, the CGHS details and help can be sought through myCGHS App.
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