Health ministry expands CGHS benefits: Move to provide free treatment in empanelled private hospitals to 45 lakh employees

The ministry of health and family welfare has made it easier for central government employees to avail Central Government Health Scheme (CGHS) benefits from private hospitals. As per a new notification issued by the ministry, central government employees can now avail CGHS benefits from empanelled private hospitals with the same benefits as other CGHS hospitals.

CGHS provides comprehensive medical care facilities to central government employees, pensioners and their dependents residing in CGHS covered cities

The modification in the rules for availing benefits under the CGHS is expected to change how more than 45 lakh central government employees view this facility. The new rule eases the procedure of referral to a private hospital and also makes specific treatment procedures listed under CGHS rate list in private hospitals free.

CGHS. Representational image. PTI

Representational image. PTI

As per the norms existing earlier, a central government employee got a CGHS card through which he or she could avail free treatment in government hospitals and discounts in specific treatment procedures listed under CGHS rate list in private hospitals.

But to avail these discounts in private hospitals, the employee had to go through a rigorous process of referral, where he was required to get a referral letter from the CGHS hospital his name was attached to. The new rules not only do away with this process but also make specific treatment procedures listed under CGHS rate list in private hospitals free.

The new notification says, "It has now been decided that CGHS beneficiaries are allowed to undergo treatment at private hospitals empanelled under CGHS of specific treatment procedures listed under CGHS rate list are advised by a specialist in a central government/ state government specialist hospital or a CGHS medical officer without any requirement of any other referral (permission) letter."

Mayuri Bora, a central government employee told Firstpost that earlier she had to take with her a referral letter from the CGHS hospital to private hospitals where she wanted to be treated. Getting the referral letter was often a difficult task, she added.

"Normally a central government employee has to visit the CGHS doctor two to three days and request for the referral letter. But now, this problem will be solved, as now no referral will be required," Bora said.

Significantly, the new rules also provide for free treatment in empanelled private hospitals to the employees.

The notification says, "Private empanelled hospitals shall perform the treatment on cashless basis in respect of pensioners, ex-MPs, freedom fighters, regular employees of this ministry and other categories of CGHS beneficiaries who are presently eligible for credit facility and shall enclose the prescription issued by government specialist or a CGHS medical officer in original (or a self attested photocopy) along with a hospital bill submitted to the competent authorities."

Arup Baniya, a central government employee told Firstpost that earlier they availed only discounts in empanelled private hospitals but after this new notification, they will be availing free treatment.

"According to the rule which existed earlier, we could benefit from discounted treatments in empanelled private hospitals with the CGHS cards we are given. On the other hand, we used to get free treatment from CGHS hospitals. But from now on, getting ourselves treated in a government hospital or an empanelled private hospital is the same to us, at least in terms of cost of treatment," he said.

Updated Date: Nov 14, 2017 16:19 PM

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