Reimbursement of expenses on indoor treatment to pensioners living in non-CGHS towns: Agenda Item 47th NC (JCM) Meeting

[Part of the Minutes of the 47th Meeting of National Council (JCM) held on 13th April, 2019 issued by DoPT vide OM No. 3/1/2019-JCA dated 13.06.2019]

Staff Side stated that there are many Central Government Pensioners who are living in towns/villages etc. not covered by CGHS. who have been granted Rs. 1000/- p.m. by way of FMA in lieu of outdoor treatment. There is no scheme for reimbursement of expenses on account of indoor treatment for critical diseases like heart ailments, etc. The demand for extending the CS(MA) Rules to pensioners has not been accepted. As such, many pensioners who got their indoor treatment in private Hospitals had to go to High Court/CAT and get the expenses incurred by them reimbursed under Court orders. Some arrangement may be made to reimburse the expenditure on indoor treatment of pensioners residing in Non-CGHS Towns.

Reply of the Official Side:

Pensioners residing in non-CGHS areas have been provided the following options to avail medical facilities:-

i) FMA @ Rs. 1,000/- per month.

ii) Benefits of CGHS (OPD & IPD) by registering themselves in the nearest CGHS city after making the required subscription.

iii) Option to avail FMA for OPD treatment, and CGHS for IPD treatments after making the required subscription as per CGHS guidelines.

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DoPT Order: Minutes of the 47th Meeting of National Council (JCM) held on 13th April, 2019.