- However, in case the son is suffering from any permanent disability of any kind (physical or mental) he is eligible for CGHS benefits even after 25yrs .
- Disability means blindness, low vision, leprosy-cured, hearing impairment, locomotor disability, mental retardation, mental illness. A disability certificate from Medical Board is required.
- Daughter is eligible till she starts earning, or gets married, whichever is earlier (irrespective of age)
23. Are step-children allowed CGHS facilities?
Yes. If they are dependent on card holder: other conditions as in case of dependant sons and daughters.
24. Can dependent in-laws be included under family members for CGHS facilities?
A lady Government servant will be given a choice to include either her parents or parents —in-law for the purpose of availing the benefits under CGHS subject to the condition of dependence and residence, etc., being satisfied.
Such option is not available for male Government servants
25. Me and my wife are both central Govt. employees and have dependant brothers / sisters and parents. Can we make separate cards and include family members?
Yes. Both Government employees have the option to make CGHS Contribution and obtain Two separate CGHS cards and the names of the eligible dependant family members can be included on their respective cards.
Your wife can include the names of her parents brothers sisters and such other eligible dependents in her card, subject to the condition of dependence and residence, etc., being satisfied.
26. Can the CMO or the pharmacist give a different brand than the one prescribed by the specialist?
CGHS shall supply I indent only those medicines, which are included in the CGHS formulary (PI ref to reply to Q 29).
27. What is the procedure for getting lifesaving drugs? In Delhi- through CGHS Medical Store Depot, Gole Market
The documents required are:-
- Prescription of specialist of Govt. Hospital or CGHS approved private Hospital.
- Photocopy of his/ her token card plastic card.
- Copy of permission if his prescription is from CGHS approved private Hospital.
- Utilization certificate in original during subsequent visit
- Indent is placed online through CGHS Wellness centre.
In other cities request is to be submitted to the Addl. Director of City.
28. What are the guidelines for Anti-Cancer and related medicines?
Anti-Cancer and other similar medicines, are supplied on a case to case basis..
29. What are the guidelines for issue of medicines?
- CGHS shall supply medicines as per the available brand name / generic name.
- In case medicines advised by a Specialist are not available they shall be indented by the same brand name though Authorized Local Chemist.
- Anti-Cancer and other similar medicines are however supplied on a case to case basis.
- Medicines for treatment of Chronic illnesses shall be supplied for a maximum period of three months.
- In case of CGHS beneficiaries going abroad, issue of medicines shall be restricted for a maximum period of six months.
30. What should I do if the Wellness Centrel Dispensary does not give all the medicines?
Contact CMO ilc of the concerned Wellness Centre or Add!. Director, CGHS of concerned city or Director, CGHS.
31. How long does it take to get the medicines?
Medicines available in the dispensary are issued immediately. If any medicine is not available and is to be indented through Authorized Local Chemist the same are issued on the next day.
32. Are the prescription of specialists of empanelled hospitals binding on the dispensary?
Medicines are issued on the basis of prescriptions of government doctors. However, in permitted cases medicines are issued on the basis of prescriptions of empanelled hospitals. CGHS shall supply medicines, as per the available brand / generic name. (pli ref to reply under Q 29 above for details).
33. What is the maximum period for which medicines can be given in one go ?
- Medicines upto three month are issued in one go , provided there is a valid prescription.
- In case of a beneficiary visiting a foreign country, medicines up to ‘6’ months are issued, based on valid prescription and documentary support of visit to a foreign country.
Beneficiary is required to submit an application for obtaining permission from ADIJD along with the following documents:-
- Copy of valid CGHS cardl token card.
- Valid prescription for six months counter signed by HOD of Specialty of Govt. Hospital.
- Proof of station leaving like ticket, Visa etc.
34. If some medicines like antibiotics are urgently required and are not available at CGHS Wellness Centre what can be done?
In case some medicines are not available and are urgently required for treatment, there is provision for issue of authority form by CMO i/c for collection of medicines, for a few days like 3-5 days, directly from authorized local chemists .
35. How to get a drug if same is not available in WC & also not supplied by Chemist(ALC)?
Beneficiary, after authorization by CMO i/c can purchase such drugs from open market & claim reimbursement from ALC.
36. What should beneficiary do, if he/ she notice some deterioration in the quality of drugs?
He /she should return the medicine to WC & get replacement. Samples can be sent for testing through CMOI/C.
37. My father is a cancer patient and after operation is bed ridden. Doctors have advised Protein powder. Can I get from CGHS?
Dietary supplements are not permissible under CGHS
38. Is Penfil Injection provided under CGHS
Insulin pen is not supplied under CGHS. But, Insulin pen cartridges are supplied under CGHS
39. Does CGHS provide for reimbursement for treatment taken abroad during a visit under emergency?
There is no provision under CGHGS for reimbursement of expenditure during a visit abroad. It is the responsibility of the individual to make arrangements for medical care while on a visit to a foreign country. However, in case of beneficiaries undergoing treatment for pre-existing chronic diseases, to ensure continuity in treatment medicines are issued for up to ‘6’ months based on valid prescription and documentary support of visit to a foreign country.
Beneficiary is required to submit an application for obtaining permission from AD/JD along with the following documents:-
- Copy of valid CGHS card/ token card.
- Valid prescription for six months counter signed by HOD of
- Specialty of Govt. Hospital.
- Proof of station leaving like ticket, Visa etc.
- Receipts in original
- Copy of the valid CGHS Card
- Copies of other documents issued by hospital
MRC forms are available with CMO I/c and can also be downloaded from CGHS Website http://msotransparent.nic.in/cghsnew/index.asp
Serving employee in similar cases shall submit the medical claim to his department.
52. My original papers having bills, Receipts of hospital treatment are lost. Can I claim on duplicate papers?
Yes. With affidavits on Stamp paper. Details of Draft for Affidavit may be seen in the instructions sheet appended to Medical Claim Form available at http://msotransparent.nic.in/cghsnew/index.asp and CMO i/c.
53. My husband/wife was a CGHS card holder. He/She was sick and died while in hospital. How do I get MRC?
Apply to CMO I/c of WC with :
- MRC forms duly filled in as per Check list
- Copy of Death summary
- Hospital bills with break-up
- Vouchers in original
- Copy of the valid CGHS Card
- Death Certificate
- Affidavit on Stamp paper of yourself being Legal Heir and NOC from other legal heirs in favour of claimant
- Copies of other documents issued by hospital
Draft for affidavit may be seen in the instructions sheet appended to the Medical
Claim Form available at CGHS Web site at
54. I retired in Dec 2011. Due to certain reasons I had to go to my native place in Uttranchal and could not make pensioner’s CGHS card. In May 2012 I came to Delhi and had Heart attack. In emergency I was treated in pvt hospital. I got CGHS Card made after discharge but I have been refused reimbursement of the expenditure incurred.
After retirement three months grace period is given to get CGHS card made. The treatment taken and expenditure incurred thereon within the grace period of three months from the date of retirement will be allowed and expenditure reimbursable subject to the condition that the beneficiary has either obtained or limited to CGHS rates or actual, whichever may be lower. Since, non-empanelled private hospitals often charge at rates different from the CGHS rates there will be difference in the amount reimbursed if the private hospital charges are higher than CGHS rates.
60. I want to get my Cataract Surgery done at Pvt empanelled hospital? How can I get it done
Beneficiaries are required to obtain advice from a Govt. Specialist I CMO i/C for Cataract surgery. Pensioners can apply to CMO l/c of WC for permission to obtain the treatment at one ofthe empanelled hospitals of his Iher choice. Serving employees to apply to his I her Department I office.
61. Is it necessary that the Govt specialist should write ‘referred to CGHS empanelled Hospital’ for obtaining permission?
Advice of Government specialist is required only for the specific treatment procedure I investigation to be undertaken. There is no need to specifically refer to any empanelled hospital! diagnostic lab. It is the choice of beneficiary to under treatment I investigations at any of the empanelled hospitals I diagnostic laboratories after obtaining permission from competent authority.
62. CMO Incharge does not refer me to Pvt. Hospitals on my request?
As per CGHS guidelines there is no provision for OPO referrals to private empanelled hospitals except in satellite towns of NCR
63. I am an accredited journalist with CGHS Card Can I seek treatment in Pvt. empanelled Hospitals in emergency and get credit facility?
No. Journalists are entitled only for OPO treatment from dispensaries and treatment from Dr.RML Hospital. Journalists are not entitled for reimbursementfor treatment from empanelled hospitals.
64. What are the facilities available to me if I am a pensioner in a non- CGHS area?
- Pensioner residing in non- CGHS covered areas have the option to become CGHS beneficiary and avail CGHS facilities from the nearest CGHS covered city.
- Pensioners residing in non-CGHS areas have also the option to avail Fixed Medical Allowance of Rs5001- per month and opt not to avail CGHS facility.
- Pensioners residing in non-CGHS areas have also the option to avail Fixed Medical Allowance of Rs500/- per month for OPO treatment and obtain CGHS card from nearest CGHS covered city for inpatient facilities under CGHS. No OPD medicines shall be issued in such cases.
- CGHS pensioner beneficiaries (and their dependant and eligible family members) who are holding a valid CGHS Card and residing in a non-CGHS area shall be eligible to obtain inpatient medical treatment and also follow up treatment from Govt. Hospitals I CS(MA) IECHS approved hospitals on proper referral from CGHS dispensary and submit the medical reimbursement claim to the Add!. Directorl Joint Director of CGHS of city where the CGHS card is registered.
65. I am a serving employee residing in a place close to a city covered under CGHS. Can I get CGHS card issued from the nearest CGHS city?
There is no provision to avail CGHS facilities in respect of serving government employees residing in non-CGHS covered areas. They are covered under CS(MA) Rules 1944.
66. I have retired from Delhi. Now I want to settle in a city where no CGHS facility is available. How to cover my family for medical care?
Pensioners are eligible for CGHS facilities and can obtain CGHS card from the nearest CGHS covered city.
67. Can general public-avail treatment at CGHS Wellness Centres?
FREE CONSULTATION IS EXTENDED TO SENIOR CITIZENS (AGED 60 VI’s. AND AROVE)of GENERAL PUBLIC AT 26 CGHS WELLNESS CENTRES UNDER CGHS DELHI FROM 1.00 P.M. TO 2.00 P.M” W.E.F. 1.09.2014 ON PILOT BASIS
