CGHS covers eligible Central Government serving employees, pensioners and their eligible dependent family members in notified CGHS cities.

Yes. The spouse is an independent CGHS beneficiary and remains eligible according to the applicable CGHS rules.

Yes, provided they satisfy the prescribed dependency conditions and are declared accordingly.

Normally no. Either parents or parents-in-law may be included, subject to eligibility and dependency conditions.

Yes. A son with qualifying permanent disability may continue to remain eligible beyond the normal age limit, subject to the prescribed certificate.

Ideally about six weeks before retirement so that the pensioner card becomes effective without interruption after superannuation.

Yes. The printed card is usable immediately while waiting for the plastic card.

CGHS generally sends an SMS once the plastic card is printed and ready for collection.

Yes. Change of Wellness Centre is permitted through the prescribed CGHS procedure.

Yes. Consultation and treatment at Government Hospitals, AIIMS and other Institutions of National Importance do not require a CGHS referral.

Yes. Planned consultation in an empanelled private hospital generally requires referral from a CGHS Medical Officer unless specifically exempted.

A specialist referral remains valid for three months.

Eligible beneficiaries aged 70 years and above enjoy the relaxation permitting direct consultation with empanelled specialists under the 2024 guidelines.

Yes. High-value investigations such as CT, MRI and PET generally require the prescribed endorsement under the referral guidelines.

No. Genuine emergency treatment should not be denied merely because referral papers are unavailable.

Empanelled hospitals are expected to provide the cashless credit facility in genuine emergencies as per CGHS instructions.

Yes, in a genuine emergency. Reimbursement is considered according to the applicable CGHS rules and admissible rates.

Claim Form, original bills, discharge summary, prescriptions, investigation reports, CGHS card copy and other supporting documents wherever applicable.

Medical reimbursement claims should normally be submitted within six months of treatment.

Serving employees submit through their Department, whereas pensioners ordinarily submit to their CGHS Wellness Centre.

Normally medicines are issued through your registered CGHS Wellness Centre. Change of Wellness Centre is permitted through the prescribed procedure.

The medicine may be indented through an authorised chemist under the CGHS indented medicine system.

CGHS generally supplies medicines according to the approved formulary and procurement policy. The treating doctor decides the appropriate medicine.

The slip remains valid for the prescribed period, enabling collection from the authorised chemist without obtaining a fresh prescription.

Yes. Long-term treatment for chronic illnesses may be prescribed according to the applicable CGHS guidelines.

Routine blood investigations advised by the authorised doctor are generally admissible without separate specialist referral.

MRI is one of the specified investigations that normally requires the prescribed endorsement under the referral guidelines.

Yes, where medically indicated and performed in accordance with the applicable referral and empanelment guidelines.

They should ordinarily be carried out in CGHS empanelled diagnostic centres or Government institutions, unless otherwise admissible.

Within the validity period, consultations with up to three specialists and a maximum of six specialist visits are permissible where recommended.

No. Immediate emergency treatment takes priority over referral formalities.

Yes, in a genuine emergency. Necessary documentation may be completed subsequently.

Yes. Genuine emergency treatment may be taken at the nearest suitable hospital, subject to admissibility under CGHS rules.

Absolutely. Original bills and receipts are essential for reimbursement claims.

Where admissible under CGHS provisions and supported by the required documents, ambulance charges may be considered.

Yes. Pensioners may opt for the prescribed lifetime contribution instead of periodic contribution.

Yes, subject to the applicable CGHS eligibility provisions.

No. Usually only the Wellness Centre and address records need to be updated through the prescribed procedure.

Yes. A duplicate CGHS card may be issued after following the prescribed replacement procedure.

Yes. Addition, deletion or correction of eligible family member details is permitted upon submission of the required documents.

No. Original bills and payment receipts are ordinarily required unless specifically permitted by the competent authority.

Admissible reimbursement is governed by CGHS package rates and applicable Government instructions, not simply by the GST amount shown on the bill.

Yes, provided the treatment is admissible under CGHS rules and the claim is submitted with all required supporting documents.

Yes. The discharge summary is one of the most important documents supporting a reimbursement claim.

Yes. Prescriptions, investigation reports and supporting medical records help establish the admissibility of the claim.

Routine claims are generally processed within about 30 days, although the actual timeline may vary depending on scrutiny and document completeness.

Yes. Eligible reimbursement is ordinarily released through the prescribed electronic payment system after claim approval.

For many pensioner reimbursement claims, a cancelled cheque is required to verify the bank account details.

Yes, where the bills relate to the same admissible treatment episode and the prescribed claim procedure is followed.

Yes. CGHS reimbursement claims should normally be submitted within six months of treatment.

Yes. Pensioners may change their Wellness Centre after shifting residence by following the prescribed CGHS procedure.

Yes. Eligible beneficiaries may avail treatment in Government hospitals and empanelled facilities according to the applicable CGHS guidelines.

No. Lifetime membership remains valid subject to the applicable CGHS rules and eligibility conditions.

Necessary updates may be required, but eligible family pensioners continue to enjoy CGHS benefits under the applicable provisions.

Yes. The Pension Payment Order is an important document for processing pensioner CGHS applications.

You should apply for change of Wellness Centre and update your CGHS records after joining the new station.

CGHS provides the prescribed procedure for updating beneficiary details, including change of Wellness Centre where applicable.

Normally the existing beneficiary record is updated; a fresh card is not always necessary.

For smooth service, beneficiaries should update their address and Wellness Centre as soon as practicable after relocation.

The selected Wellness Centre should ordinarily correspond with the beneficiary’s recognised place of residence under the applicable CGHS procedure.

Yes. Consultation and treatment at AIIMS and other notified Institutions of National Importance do not require a CGHS referral.

No. Government hospitals notified under CGHS may be accessed directly without referral for consultation and treatment.

Yes. Within the validity period, referral permits consultation with up to three specialists and a maximum of six specialist visits where medically required.

No. The referral remains valid for three months from the date of issue.

Referral is issued according to medical necessity and the applicable CGHS guidelines. The Medical Officer records the clinical justification.

Beneficiaries should ordinarily obtain medicines through the authorised CGHS supply system. Self-purchase is admissible only where permitted under the applicable reimbursement provisions.

Normally medicines are issued against prescriptions recognised under the CGHS procedure. A CGHS Medical Officer may prescribe or endorse treatment as required.

Yes. CGHS follows the approved formulary and Government procurement policy while ensuring therapeutic equivalence.

Yes, where the beneficiary and Wellness Centre follow the prescribed identification and authorisation procedure.

Yes. Chronic disease medicines may be prescribed for longer durations in accordance with CGHS guidelines.

Yes. CT Scan is admissible where medically indicated and performed according to the applicable referral guidelines.

Yes. MRI may be performed in an empanelled diagnostic centre after the prescribed referral or endorsement wherever required.

Yes. PET-CT is covered when medically indicated and undertaken in accordance with the applicable CGHS provisions.

Routine investigations advised by the authorised doctor are generally admissible under the prescribed procedure.

Yes, where the beneficiary fulfils the applicable referral and empanelment conditions.

Yes. Beneficiaries should immediately approach the nearest suitable hospital in a genuine emergency.

No. Prior permission is not required when delay is likely to endanger life, limb or essential organ function.

Admissible ICU charges are governed by CGHS package rates and the applicable reimbursement rules.

Yes. Eligible beneficiaries may avail the CGHS cashless facility for admissible treatment in empanelled hospitals.

Yes. Emergency medical treatment is available round the clock, and necessary CGHS documentation may follow subsequently.

Yes, subject to the prescribed dependency and eligibility conditions applicable under CGHS.

Ordinarily no, except where specifically permitted under the applicable Government instructions.

Yes. Legally adopted children are eligible in accordance with the applicable CGHS provisions.

Ordinarily up to 25 years, unless eligible for continued coverage under the disability provisions.

Yes. All eligible dependent children may be included on the beneficiary card.

Apply for a duplicate CGHS card through the prescribed replacement procedure with the required documents.

Yes. Beneficiary details, including photographs, may be updated through the prescribed procedure.

Yes. Contact details may be updated in accordance with the CGHS beneficiary update procedure.

Yes. The printed or digitally generated CGHS card is ordinarily accepted while the plastic card is awaited.

No. A beneficiary should possess only one valid CGHS identity linked to the applicable entitlement.

No. Ward entitlement is determined according to the applicable CGHS pay level criteria notified by the Government.

CGHS reimbursement is generally restricted to the beneficiary’s admissible entitlement unless otherwise provided in the rules.

ICU treatment is governed by the applicable CGHS package provisions and is distinct from ordinary ward accommodation.

Yes. Entitlement changes whenever the beneficiary moves to the applicable higher pay level.

Pensioner entitlement is determined according to the applicable CGHS pensioner provisions and corresponding pay level criteria.

Yes, subject to the applicable CGHS and deputation rules governing eligibility.

Eligible beneficiaries ordinarily continue to enjoy CGHS benefits during admissible periods of service.

Yes. Dental treatment is covered to the extent admissible under the CGHS package and applicable guidelines.

Only where specifically admissible under the applicable CGHS provisions and Government instructions.

Yes, where admissible and supported by the prescribed medical recommendation and approval process.

CGHS provides admissible coverage for eligible transplant procedures in accordance with Government guidelines.

Yes, where the beneficiary fulfils the applicable eligibility and referral requirements.

Yes. Dialysis is an admissible treatment for eligible beneficiaries under the prescribed CGHS provisions.

CGHS treatment follows the Government instructions and package rates applicable to the notified disease and period.

Home delivery is available only where specifically provided under the applicable CGHS arrangements.

Yes. A representation may be submitted to the competent authority along with supporting documents.

Beneficiary identification follows the procedure prescribed by CGHS for the concerned service.

Yes. Eligible family member details may be updated by submitting the prescribed declaration and supporting documents.

Ordinarily CGHS is intended for treatment within India unless specifically provided under separate Government provisions.

The Ministry of Health & Family Welfare and the official CGHS portal publish the latest Office Memorandums, beneficiary guidelines and notifications. Staffcorner regularly updates this guide whenever new CGHS instructions are issued.