Text of MH & FW, O.M. No. Misc. 11006/2000-JD(R & H)/CGHS(P), dated 11/6/2001

Fixation of Ceiling Limit for nebulizer to be reimbursed under CGHS and CS(MA) Rules

The undersigned is directed to say that the matter regarding fixation of ceiling limit for reimbursement of the cost of Nebulizer has been under consideration of the Government for some time past. It has now been decided to fix the ceiling with regard to he purchase of Nebulizer at Rs. 3,000/- or the actual cost whichever is less.

2. Permission for use of Nebulizer/ex-post-facto approval may be given only on the advice of Senior Physician or above or Medical Specialist of equivalent rank of a Government Hospital.

3. Keeping in view the average life of a Nebulizer as 5 years, replacement may be permitted on the basis of a certificate of condemnation obtained from the treating physician/specialist as indicated above. The cost of maintenance will be borne by the beneficiary concerned. No request for provision of another Nebulizer may be entertained within 5 years from the date of initial purchase.

4. Reimbursement will be done from Service Head in case of serving Government employees, serving employees and pensioners of autonomous bodies in case of autonomous bodies, and by Lok Sabha / Rajya Sabha Secretariat, as the case may be, in case of MPs and from CGHS Head in case of pensioners, Ex-MPs and Freedom Fighters.

5. These orders will be applicable from the date of issue.

6. These orders will be applicable for beneficiaries covered under CS(MA) Rules, 1944 also.

7. This issues with the concurrence of Finance Division vide their Dy. No. 3674/2001-JS(FA) dated 7.6.2001.

Rates of Contribution

CGHS contribution rates effective from 1/5/1998 are as under:

Sl.No.

Pay-Range (Rs. p.m.)

Pension (Rs. p.m.)

Contribution Rates (Rs. p.m.)

1

2

3

4

5

Up to Rs. 1,500

Rs. 3,001 to 6,000

Rs. 6,001 to 10,000

Rs. 10,001 to 15,000

Rs. 15,001 and above

Up to Rs. 1,500

Rs. 1,501 to 3,000

Rs. 3,001 to 5,000

Rs. 5,001 to 7,500

Rs. 7,501 and above

15.00

40.00

70.00

100.00

150.00

 

Issue of Identity Card to Serving Employees:

  1. The Central Government Health Scheme Directorate shall supply the blank Index as well as Identity Cards bearing identical serial numbers to the Central Government offices as per their requisition.

  2. The issuing authority shall get the Index and Identity cards filled up by the employee concerned in duplicate mentioning the name of the Card holder and details of family members eligible for CGHS facilities, their date of birth, relationship with the employee etc.

  3. The Index Card/Identity Card so filled by the employees has three parts. The first part shall be retained by the issuing authority, second part shall be forwarded to the Deputy Director/Chief Medical Officer of CGHS of the respective cities, and the third part handed over to the employee concerned.

  4. An attested photograph of the family members of the beneficiary shall be affixed on the Identity Card duly signed by the officer issuing the card.

  5. The employee shall deposit the Index Card with the Medical Officer Incharge of the allotted dispensary and retain the Identity Card with himself. The fact of submitting the Index Card should be acknowledged or endorsed on the Identity Card.

  6. For availing medical facilities, the beneficiary must show his Identity Card on every visit to the Medical Officer posted at the dispensary.

Issue of Two Separate Identity Cards

    1. Where the family members wholly dependent on the Government Servant, are residing permanently in some other city covered under the Scheme, the Issuing Authority, after ensuring the above fact, may issue two separate CGHS Cards (bearing the same serial number) – one for the employee and the other for his/her family members.

    2. The card shall be signed by an officer not below the rank of an Under Secretary

    3. The card shall be issued for a period not exceeding one year at a time and shall be renewed every year, if the employee furnishes a certificate that his family members are residing in the same city/area.

Issue of Temporary Family Permit

  1. Temporary family permits can be issued to families of those employees who are already availing CGHS facilities and are transferred to a city covered under CGHS.

  2. If the employee is transferred to a station where CGHS is not in operation, temporary family permits cannot be issued, even if the family continues to stay in an area covered under the scheme. In such cases, the employee and his/her family will be governed by CS (MA) Rules, 1944.

  3. In case of a Government servant who is a CGHS beneficiary and who goes on deputation on foreign assignment/deputation outside India, his family members if left behind in a CGHS covered area, will continue to avail of medical facilities under CGHS.

  4. Temporary family permits will be issued to the family members of Government employees posted in North Eastern Region, Andaman and Nicobar Islands or Lakshadweep, if the family members continue to stay in an area covered under CGHS.

Surrender/Cancellation of Identity Card

  1. The CGHS Identity Card should be surrendered to the concerned department at the time of retirement/resignation/on being relieved from the Department/Office.

  2. A certificate for surrender of Identity Card and the contribution recovered up to date, shall be issued to the retiring employee, so as to enable him/her apply for CGHS Pensioner Card.

Issue of Identity Cards to Pensioners

  1. Pensioners are required to apply in the prescribed form, for issue of CGHS Identity Cards, alongwith photograph of the dependent family members and a copy of Pension Payment Order (PPO).

  2. Contribution (based on last pay drawn or basic pension at the option of pensioner), shall be payable alongwith the application, by way of bank draft drawn on a nationalized bank or postal order. Subsequent contributions shall be payable in advance for six months. For rates of contribution and other details relating thereto, refer Chapter ‘Contribution’.

  3. A permanent CGHS Card for whole life can also be issued on payment of ten-years contribution in lump sum. In case contribution for some years has already been paid and a permanent Identity Card is desired on a later date, the amount of contribution payable shall be proportionately reduced.

  4. Pensioners are allowed a grace period of three months for depositing the contribution and getting their Identity Cards issued/renewed. If the card is issued/renewed after expiry of grace period, the pensioner shall not be entitled to reimbursement for any treatment taken during the period after expiry of grace period and the actual date of issue/renewal of the card.

  5. Identity Cards to pensioners are issued by Additional Director/Joint Director of the concerned city.

  6. Pensioners can avail CGHS facilities on the basis of their Identity Cards with photograph, in all cities having CGHS facilities, which they (including dependent family members) may be visiting.

Loss of Identity Card :

In case the Identity Card is lost, the beneficiary should lodge a complaint with the police and also report the matter to the C.M.O. Incharge of Dispensary concerned and to the Additional /Deputy Director, CGHS in the city.

A duplicate identity Card shall be issued if the original card is lost, by the authority who had issued the original card, on receipt of an application this respect alongwith following documents:

    1. Copy of FIR from Police Station;

    2. Copy of complaint lodge with the Police about the loss of original card;

    3. Charges for issue of a duplicate card by way of a Postal Order favouring PAO, CGHS of the respective region, for a sum of Rs. 5/- (for the first loss), or Rs.7/- (for the second loss) or Rs. 10/- (for third and subsequent loss).

Replacement of Mutilated Identity Card:

  1. If an Identity Card gets mutilated, the cardholder shall apply to the Issuing Authority, for issue of a duplicate card alongwith the mutilated card.

  2. The issuing Authority shall forward the application to the Additional Director/Deputy Director CGHS who, in turn, shall send a blank duplicate CGHS Card to the Issuing Authority.

  3. The Issuing Authority shall issue the duplicate card under his seal, bearing number of the original card.

  4. No. charges shall be payable by the cardholder if the original (mutilated) card was issued more than five years back.

  5. If the request for issue of duplicate card is made within five years if issue of original (mutilated) card, then the card holder shall be liable to pay Rs. 5/- (for first time) or Rs.7/- (for second time) or Rs. 10/- (for third and subsequent time), by way of a Postal Order.

Change of Dispensary:

  1. Change of dispensary is permissible only if the beneficiary changes his residence to place, which is served by another dispensary.

  2. When there is a change of residence involving change of dispensary, the employee concerned shall apply in prescribed from (in duplicate) to the card Issuing Authority together with CGHS Identity Card. The Issuing Authority shall make entry in the Identity Card and Index Card and attest the same in the appropriate column.

  3. The employee shall then submit two forms to the Medical Officer Incharge of the old dispensary who shall make entry in his records and hand over the Index Card to the employee with the direction that the same may be submitted to the Medical Officer Incharge of new dispensary.