look news india
Amidst the hustle and bustle of preparations and recommendations of the 8th Pay Commission for more than 49 lakh working central employees and lakhs of pensioners across the country, the Central Government has taken a big historic and relief decision. The EHS Section under the Ministry of Health and Family Welfare has issued a new Official Office Memorandum (OM) making comprehensive amendments to the rules of the Central Government Health Scheme (CGHS).
Through this new order, the government has completely abolished the old and complex ‘5 KM Geographical Restriction’ mandatory condition applicable around CGHS Wellness Centres. Lakhs of central employees posted in metros like Delhi, Lucknow, Mumbai, Patna, Jaipur, Kolkata, Bengaluru and Chandigarh to remote towns and non-CGHS areas will now be able to directly avail cashless healthcare services at top empaneled private and super-speciality hospitals in the country.
Under the old rules implemented in 2018, CGHS facility for central employees was largely limited to the geographical scope of their residence or place of posting:
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Old system: A CGHS Beneficiary Card was issued only if an employee lived or was posted within a radius of 5 kilometers of an active CGHS Wellness Centre.
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Compulsion of CS(MA) Rules 1944: Employees who were posted outside this radius of 5 kilometers or in small towns where there was no wellness center were covered under the Central Services (Medical Attendance) Rules, i.e. CS(MA) Rules 1944.
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Hassle of treatment and bill clearance: Under CS(MA) rules, employees first had to pay huge amounts from their own pockets for treatment in private or referral hospitals and later had to visit departmental offices for months for bill reimbursement. Due to lack of cashless treatment facilities in emergency situations, employees and their families had to face serious financial crisis.
According to the latest office memorandum (OM No. Z. 16025/227/2026/CGHS-III/EHS) issued by the Health Ministry, the government has now dispensed with this old scale related to distance with immediate effect.
Serving Central employees who are presently covered under CS(MA) Rules 1944 due to residing or working outside the CGHS covered area, will now be given a ‘One-time option’ (lump sum option) is given. Under this option, employees can choose the CGHS scheme of their choice and get an official CGHS plastic card or digital ABHA linked card for themselves and their entire family.
The Health Ministry has set some clear and strict rules to avail this one-time option, which will be mandatory for every employee to follow:
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Final decision at once (Final & Binding): This opportunity to choose CGHS will be available only once. Once an option is selected and the form is submitted, this decision will be considered final and cannot be changed in future.
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Uniform rules for the whole family: The decision taken by the employee will be applicable to his entire family and all eligible dependents. There will be no permission to divide some members of the family into CGHS and some into CS(MA).
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Monthly subscription required: Employees who opt for CGHS will be required to regularly deduct the prescribed CGHS contribution based on their monthly salary (Pay Matrix Level), irrespective of the state or district of their posting or residence.
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Strict restrictions on taking double benefits: No employee or his family member will be able to claim medical claim or treatment under both the schemes—CGHS and CS(MA)—simultaneously. For this the employee will have to give a mandatory undertaking (affidavit). Disciplinary action and recovery will be taken if any incorrect information is found.
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Mandatory for covered areas: It will be mandatory for employees who are already posted within CGHS covered areas (such as district headquarters where wellness centers are located) to remain in CGHS; They cannot opt-out of the plan.
Amidst the process of implementation of the upcoming 8th Pay Commission recommendations from the reference date of January 1, 2026 and the demands being put forward by the employee organizations, this decision is being considered as a historic step to improve the standard of living and social security of the central employees. Now Central Armed Police Forces (CAPF), Defense Civilian personnel, Railways, Department of Posts and personnel of various Central Ministries deployed in any remote corner of the country, North-Eastern States or on rural borders will be able to get quality and cashless treatment of serious diseases in their home town or in any CGHS network hospital across the country.