Guidelines for Issue of CGHS Card to serving employees and pensioners – MoHFW OM dated 27.6.2024

Guidelines for Issue of CGHS Card to serving employees and pensioners – MoHFW OM dated 27.6.2024

Key Points of O.M.

A. Serving Employees:

1. Must apply online for a new CGHS card.
2. Submit a signed hard copy with photographs to their department.
3. Required documents: Pay slip, Aadhaar/PAN, disability certificate (if applicable), and photographs.
4. Applications are processed by the Office of Additional Director, CGHS.

B. Pensioners:

1. Eligible pensioners not availing Fixed Medical Allowance (FMA) can apply.
2. Option to avail FMA with an IPD-only CGHS card for cashless indoor treatment.
3. Application with payment proof on Bharatkosh.
4. Contribution rates based on pay level for a lifetime CGHS card.
5. Required documents: PPO, Aadhaar/PAN, disability certificate (if applicable), photographs, Bharat Kosh challan, and FMA proof.

C. Electronic CGHS Card:

1. Accessible via CGHS Website, myCGHS app, and Digilocker.
2. Electronic card is valid like the plastic card.

D. Replacement of CGHS Card:

1. Application for a new plastic card upon loss, mutilation, or renewal with a Rs. 100 fee.
2. No fee for digital card reissue.

E. Other Beneficiaries:

1. Instructions for MPs, ex-MPs, and other eligible groups remain unchanged.

F. Change in Dependency:

1. Beneficiaries must inform CGHS of any changes in family member dependency.
2. Non-compliance may lead to withdrawal of CGHS benefits and further action.

F. No. S.11012/1/2024-EHS(Comp No. 8283407)
I/3687003/2024
Government of India
Ministry of Health & Family Welfare
EHS Section

Nirman Bhawan, New Delhi
Dated 27-06-2024

OFFICE MEMORANDUM

Subject: Guidelines for Issue of CGHS Card to serving employees and pensioners-reg.

In continuation of this Ministry’s OM No . S.11012/3/2011-CGHS(P) dated 29.12.2011, the undersigned is directed to issue the following guidelines, in view of technological changes and change in payment methods of CGHS Contribution, for issuing of CGHS cards to serving employees and pensioners, as follows:

A. Serving Employees

1. Serving employees shall mandatory apply for a new CGHS card online (www.cghs.nic.in) to generate a temporary reference number. After online submission of the application form, they should take a printout of the same and submit the hard copy duly signed and photographs affixed thereon, to the department currently employed, for processing and onward submission to the concerned Office of Additional Director, CGHS for issuing the cards. One copy is to be forwarded to the Additional Director of the concerned City and the other copy is to be retained by the Employer Department of the Central Government (hereinafter referred to as ‘sponsoring authority) for CGHS benefits.
2. The requisition shall be sponsored by the Head of Department/Head of Office of the employee.
3. A Specimen copy of the application form for the New CGHS Card is enclosed at Annexure-1.
4. CGHS shall scrutinize the application based on the documents provided:
   1. Pay Slip indicating the pay scale and CGHS deduction.
   2. Aadhaar Card/PAN card or any other valid document as per RBI guidelines, as ID Proof for Self and Dependent Family Members.
   3. Disability Certificate of Dependant (If applicable) as per OM No.4-24/96-C&P/CGHS(P)/EHS dated 07th May 2018. (Enclosed at Annexure-2)
   4. Photographs of self and Dependant Family Members.

The Standard Operating Procedure is enclosed at Annexure-3.

B. Pensioners

1. CGHS card(s) will be issued to eligible pensioners and family pensioners, drawing pension from Central Civil Estimate and his/her dependent family members, when the pensioner is not availing the Fixed Medical Allowance (FMA).
2. The pensioners also has the option for availing Fixed Medical Allowance with a CGHS card (IPD Card) by paying the full subscription, however, the CGHS ‘IPD only’ card shall be valid only for ‘cashless’ indoor treatment at CGHS Empanelled Private Hospitals/designated Government Hospitals. The beneficiary of ‘IPD only’ CGHS card shall also be eligible for reimbursement of expenses incurred for indoor treatment at any Government/Private Hospital only in case of a Medical Emergency.
3. The pensioners can submit his/her duly filled application form for the new Pensioner CGHS card, in the new Card Application Form (Annexure 3) to the Additional Director of CGHS city concerned.
4. The applications shall be accompanied with payment of CGHS Contribution S.11012/1/2024-EHS I/3687003/2024 on Bharatkosh, along with the Challan generated from Bharatkosh as proof of payment.
5. The contribution (equivalent to 120 times i.e 10 years of existing CGHS contribution rate, at the time of retirement). The existing rates shall be as per the details provided below:

6. CGHS shall scrutinize the application based on the documents provided:
   1. Self-attested PPO/ Provisional PPO or Last pay certificate
   2. Aadhaar card ID/PAN card or any other valid document as per RBI guidelines as ID proof for Self and dependent family members
   3. Disability Certificate of Dependant (If applicable)
   4. Photographs of self and dependent Family Members.
   5. Copy of Bharat Kosh Challan for CGHS subscription paid
   6. Proof of availing/non-availing FMA (if applicable).

The Standard Operating Procedure is enclosed in Annexure-3.

7. Retiring employees have the option to apply for a pensioner card along with pension papers 6 months before the date of Retirement (Online as a pensioner new card). The office shall observe the same procedure as for a serving employee for getting his/her CGHS card(s) prepared.

C. Consequent to verification of CGHS Card, the electronic form of CGHS card shall be accessible to the beneficiary using the option of ‘Beneficiary Login’ on CGHS Website, myCGHS app & Digilocker app for Android/iOS-based mobile devices. The electronic CGHS card shall be at par with CGHS plastic Card for availing benefits. The authenticity of CGHS card can be verified using the option of ‘Verify beneficiary’ available on CGHS Website (www.cghs.nic.in).

D. For the issue of a new CGHS plastic card upon mutilation, renewal or loss of the CGHS Card, application Form AA or BB (Annexure 4 & 5) along with the Bharatkosh Payment challan for Rs. 100/- shall be submitted for issuing a new card to the concerned Additional Director. To encourage the CGHS beneficiaries to use digital CGHS cards, it has also been decided that No fee shall be levied, in case the beneficiary opts for renewal/reissue of card without a fresh printed plastic card.

E. The Instructions issued for the CGHS beneficiaries from Member of Parliament, Ex-Member of Parliament; eligible Autonomous Institutions, Air India and PIB accredited Journalists shall remain as per extant rules.

F. The CGHS Beneficiary shall inform CGHS immediately, if there is any change in dependency criteria of his family members included in the CGHS Card. If he fails to intimate and if CGHS comes to know of the change, then the CGHS facility is liable to be withdrawn and the CGHS shall be free to write to the appropriate authority for recommending action under Service Rules or Pension Rules.

These guidelines issues with the approval of the competent authority and these guidelines shall be effective from one month from the date of issue.

Encl: As above.

(Hemlata Singh)
Under Secretary to the Government of India