CGHS Rules: Government changed the rules of this scheme for central employees, see details here

CGHS Rules Revised: If you are a central government employee then this news may be of use to you. Actually, there has been a change in the guidelines for Central Government Health Scheme (CGHS) cardholders. Information about the revised guidelines has been given in an Office Memorandum (OM) of the Union Health Ministry.

What is the amended rule?

As per the revised rules, cardholders will not require referral in case of emergency. In this situation, cardholders will be able to avail cashless treatment and avail services directly at all major government hospitals including All India Institute of Medical Sciences (AIIMS) or Tata Memorial. Additionally, a single referral from the Central Government Health Scheme (CGHS) Wellness Center will be valid for 3 months, allowing beneficiaries to consult up to three specialists. A maximum of six consultations are allowed during this period.

When is a referral needed?

CGHS cardholders do not require additional approval within the three-month referral period for routine check-ups and minor procedures. Referral will be necessary for specialized tests costing more than Rs 3,000. Similarly, procedures requiring hospitalization will also require prior approval.

The age limit to access these services has been reduced from 75 years to 70 years, thereby expanding eligibility to more beneficiaries. These amendments are expected to increase access to health services for CGHS beneficiaries.

What is CGHS?

Let us tell you that CGHS is a health insurance scheme. Under this, the central government provides health services to its employees and their families. Beneficiaries get coverage of medical expenses under this scheme. Central employees can avail cashless treatment in any empaneled hospital or dispensary in the country through CGHS card.