CGHS Beneficiaries will now get Treatment at Private Hospitals without Referral Letter

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The central govt. has simplified the rules for getting treatment in private hospitals under Central Government Health Scheme (CGHS). Subsequently, all the CGHS beneficiaries will now get treatment at any em-paneled private hospital without the referral letter of any doctor/ hospital. For this reason, govt. provides an order letter (dated 9 November) for all ministries and departments under central government.

Health Ministry has released the notification that all beneficiaries will now get treatment at private hospitals according to procedures under CGHS rate list, without the need of referral (permission) letter. Subsequently, the beneficiaries will get cashless treatment in respect of pensioners, ex-MPs, freedom fighters, regular employees of CGHS and CS [MA] of the ministry and other categories who are eligible for credit facility.

Beneficiaries should submit the original prescription of the govt. specialist or CGHS Medical officer with the hospital bill to the concerned authorities. Govt. has simplified the rules due to a large number of requests of the people for treatment at the em-paneled private hospitals.

Need to Change Rules for CGHS Beneficiaries

Previously, central govt. employees / pensioner or their dependents have to take prescription of the CGHS Medical officers to undergo treatment at the CGHS em-paneled private hospital. The whole process was difficult as the individual has to firstly consult a local dispensary. Afterwards with the permission of specialist, candidates have to complete the paperwork to avail treatment.

According to the data of Health Ministry, there are a total number of 949 general hospitals in India which includes dental and eye care hospital. Subsequently, there are 118 general hospitals, 104 eye care and 52 dental care hospitals in Delhi alone. In addition to this, Delhi also has 61 diagnostic centers under CGHS category.

So to ease the process of getting treatment, there was a need to change the existing rules. So, the Health Ministry has decided to change the rules to simplify the whole process.

New Order for CGHS Beneficiaries

a) According to the new order, government employees must enclose prescription of government specialist / CGHS Medical officer (original) for submission of medical claim to the concerned ministry / department / office for reimbursement.
b) The job of the CGHS medical officer / government specialist will not refer the candidates to particular hospital by name. Subsequently, they will specify the treatment procedure and have to mention “referred to any CGHS em-paneled center”.

Facilities under Central Government Health Scheme (CGHS)

Under the CGHS and OPD treatment, the facilities available are as follows:-

Issue of medicines
Consultation from specialists at various polyclinics / government hospitals.
Facility of Indoor treatment at several government and em-paneled private hospitals
Investigations at the diagnostic centers.

According to Health Ministry, central govt. will provide cashless treatment to the pensioners and other eligible beneficiaries. Subsequently, all the patients admitted in emergency in private hospitals will get reimbursement of expenses. Furthermore, central govt. will also provide reimbursement of expenses for purchasing hearing aids, artificial limbs and appliances.


— To see the Central Government Health Scheme in detail, please click the link given below:-
Central Government health Scheme (CGHS)

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