Eligibility Criterion
'Residence' alone (and not the Headquarters) is to be considered as criterion for determining the eligibility of a Central Government servant for availing medical facilities under Central Government Health Scheme. Thus, Central Government employees and their family members etc. residing in any of the 27 notified cities (list given in previous chapter) shall be covered under the Scheme. The scheme has recently been extended to the cities of Chandigarh, Bhopal and Shillong.
Persons Eligible under the C.G.H. Scheme
Following persons are eligible to avail medical facilities under the Central Government Health Scheme:
- All Central Government employees paid from civil estimates (except Railways and Delhi Administration) including their families.
- Pensioners of Central Government (except pensioners belonging to Railways and Armed Forces) and their families.
- Pensioners retiring with Contributory Provident Fund benefits and their families.
- Widows of Central Government Pensioners, getting family pension.
- Delhi Police Personnel and their families.
- Civilian employees of Defence paid from Defence Service Estimates (except at Mumbai when the scheme is in operation).
- Child drawing pension on death of a Central Government employee including minor brothers and sisters of such child.
- Ex-Governors and their families.
- Ex-Vice President and their families.
- Central Government employees on leave preparatory to retirement.
- Central Government servants who are deputed to semi-Government and autonomous bodies receiving substantial grant from or financed by the Central Government and their family members.
- Military Officers while on deputation to civil departments and getting their emoluments from Civil Estimates.
- Families of 'CGHS covered government servants' who are on temporary transfer outside Delhi/CGHS centers for a short period up to six months provided they deposit six months contribution in advance.
- Pensioners visiting CGHS covered cities and staying at a place falling in CGHS covered cities.
- Employees of CGHS not residing in the CGHS covered cities.
- Ministers/Deputy Ministers of the Central Government/State Government and their families.
- Parliamentary Secretaries of the Central Government and their families.
- Members of Parliament and their families.
- Ex-Members of Parliament including those who are not in receipt of any pension.
- Retired judges of the Supreme Court and High Court residing in CGHS covered areas besides Delhi/New Delhi.
- Work charged and Industrial Staff working in establishments run by various Ministers/Departments of Central Government, immediately from the date of their joining the service.
- Employees of Kendriya Vidyalaya Sangathan stationed at Calcutta, Madras and Bombay.
- Employees of Ordnance Factory Board Headquarters, Calcutta and Ordnance Equipment Factories Headquarters, Kanpur.
- Ad-hoc employees of CGHS organization outside Delhi.
- All India Service Pensioners who retire while serving under the State at their option.
- Freedom Fighters and members of their family receiving central pension under the Swatantra Sainik Samman Pension Scheme.
- Family member of the deceased Ex-Members of Parliament.
- Pensioners of the Ordnance Factories.
- Members of staff side of the National Council of the Joint Consultative Machinery even though not serving as Central Government employees.
- Persons employed in semi-government and autonomous bodies who are permitted to join the CGH Scheme.
- Accredited Journalists who produce a certificate from the Press Council of India stating that he is the member of the Press Association, New Delhi.
- Retired employees of Indian Council of Agricultural Research.
- Employees of statutory canteens in CGHS covered cities if not covered under any other medical scheme.
- Employees of Central Council of Indian Medicine.
- Retired Divisional Accountants of the Indian Audit and Accounts Department.
Persons Not Eligible under CGH Scheme.
The following categories of persons are not entitled to avail CGHS facilities-
- Family members who are not longer dependent upon the government servant though staying with him/her.
- Independent brothers or sisters, even if minor.
- Married (but not separated) daughter staying with her parents.
- Government servants and their family members staying in an area not covered under CGHS.
- Government servant transferred to State Government or an ineligible department or are deputed to a foreign service. However, their families may be issued temporary permits for availing CGHS facilities on pre-payment of prescribed charged.
Dependent family members
Meaning of Family
The term 'family means and includes:-
- Husband/wife including more than one wife and a judicially separated wife,
- Parents (excluding step parents,) subject to the following:
- In case of adoption, adoptive parents and not real parents,
- If adoptive father has more than one wife, only the first wife; and
- In case of female employees, parents or parents-in-law, at her option, subject to the conditions of dependency and residence etc. being satisfied.
Note: Option to include either her parents or parents-in-law is not available to a female family pensioner.
- Children including step children, legally adopted children, children taken as wards by the Government servant under the Guardians and Ward Act, 1980, provided such a ward lives with him, treated as a family member and is given the status of a natural-born child through a special will executed by that Government Servant.
Notes:- (i) Son is eligible till he starts earning (irrespective of age)(ii) Daughter is eligible till she starts earning or gets married, which ever is earlier (irrespective of age) - Sons suffering from permanent disability either physically or mentally, without any age-limit.
- Windowed daughters (irrespective of age)
- Unmarried/widowed sisters (irrespective of age).
- Dependent Brothers (irrespective of age).
- Divorced/Separated daughters.
- Step-mother.
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