CITIZEN’S CHARTER CGHS

(Improving Public Service Delivery)

“The Charter is designed as per the framework recommended by the Department of
Administrative Reforms and Public Grievances (DAR&PG)”.
 INDEX

 Contact details

 Grievance Redressal

 Medical Reimbursement Claim

 Issue of Medicine/Consultation

 Issue of Permission

 Issue of CGHS Card

 Medical Advance
About CGHS

Central Government Health Scheme provides comprehensive health care to the Central
Government employees and pensioners and their dependent family members and some
other categories of beneficiaries like Members of Parliament, Judges of Supreme Court,
ex- judges of High Courts, ex-MPs , etc.,

Presently CGHS provides healthcare facilities to about 43 lakh beneficiaries in 80 cities

all over India through 341 Allopathic & 107 Ayush Units.

CGHS provides health care through following systems of Medicine

● Allopathic
● Homoeopathic
● Indian system of medicine
o Ayurveda
o Unani
o Siddha and
o Yoga

Facilities available under CGHS

 OPD Treatment at Wellness Centres including issue of medicines.

 Specialist Consultation at Polyclinic/Govt. Hospitals and at CGHS empanelled
hospitals after referral by CGHS.
 OPD/ Indoor treatment at Government and empanelled Hospitals.
 Investigations at Government and empanelled Diagnostic centers.
 Cashless facility available for treatment in empanelled hospitals and diagnostic
centers for Pensioners and other identified beneficiaries.
 Reimbursement of expenses for treatment availed in Govt. /Private Hospitals under
emergency and specific treatment advised by Govt. Specialist or Specialist of Private
HCOs duly endorsed by CMO/MO of Wellness Centres.
 Reimbursement of expenses incurred for purchase of hearing aids, artificial limbs,
appliances etc., after obtaining permission.
 Family Welfare, Maternity and Child Health Services.
 Medical consultation and dispensing of medicines in Ayurveda, Homeopathy, Unani
and Siddha system of medicines (AYUSH)
Initiatives taken by CGHS for its beneficiaries:

 CGHS has signed MoAs with Institutes of National Importance, viz., AIIMS , New
Delhi, PGIMER, Chandigarh and JIPMER, Puducherry and AIIMS located at Bhopal,
Bhubaneswar, Jodhpur, Patna, Raipur, Rishikesh, Bilaspur, Rajkot, Kalyani,
Bhatinda and Bibinagar to facilitate cashless treatment facilities to Pensioner
beneficiaries at these premier institutions.

 FAQs have been updated and may be accessed on CGHS website – cghs.gov.in
under the Heading ‘FAQs’

 CGHS Card is valid in any CGHS Wellness Centres and all facilities including
referrals are issued.
Link for relevant OM
https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDQ4Mg==

 Referral to empanelled hospitals without physical presence of beneficiaries who are

not in a position to visit Wellness Centre, through Video call by CMO i/c
Link for relevant OM
https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDQ0NQ==

 Revised guidelines for constitution of Local Advisory Committees at Wellness

Centres and Zonal Advisory Committees to reach out to stake holders.

Link for relevant OM

https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDQxMA==

 When treatment /investigations are advised by AIIMS, New Delhi- no examination

by Standing Technical Committee is required
Link for relevant OM
https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDU4NA==

 Option to CGHS Pensioner beneficiaries to submit medical claim to parent

Wellness Centre or to the CGHS of the city where treatment is taken.

Link for relevant OM

https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDU4Mw==

 Revision of CGHS rates for Consultation, Room rent and ICU charges –on
12.04.2023

Link for relevant OM

https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDQ0NA==

 Revision of CGHS rates for 36 radiological Investigations on 19.06.2023

Link for relevant OM

 https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDY3NA==

 Option to include either parents or parents in law for CGHS benefits in respect of all
Central Government employees

Link for relevant OM

https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDc5Nw==

 Submission of CGHS Subscription by pensioners through Bharatkosh portal only

Link for relevant OM
https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDg1MQ==

 Guidelines for issue of Anti-Cancer Medicines

Link for relevant OM

https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDk4NA==

 Option to purchase OPD Medicines for upto 6 months in case of post –organ
transplant cases.

Link for relevant OM
https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDkzNw==

 Treatment on Cashless basis at Tata Cancer Hospital, Mumbai in respect of

Pensioner beneficiaries

Link for relevant OM

https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDAxMA==

 Treatment on Cashless basis at Chittaranjan National Cancer Institute (CNCI),

Kolkata in respect of Pensioner beneficiaries

Link for relevant OM

https://cghs.gov.in/CghsGovIn/faces/ViewPage.xhtml?id=NDEzMw==

Digital initiatives in CGHS :

 Tele-consultation through C-DAC’s E-Sanjeevani Portal:-

(https://esanjeevani.mohfw.gov.in) Teleconsultation through eSanjeevani is a
service that enables beneficiaries, particularly senior citizens, to consult specialists
online. CGHS Specialists are available for Internal Medicine, Psychiatry,
Orthopedics, Ophthalmology, and ENT from 9.30am to 6.00pm Monday to Friday,
and 7.30am to 2.00pm on Saturdays.
  Online access to CGHS card: CGHS beneficiaries have the option to download the
CGHS beneficiary card and index card online, which is valid for availing all the CGHS
facilities. The CGHS card can be stored in Digilocker, accessed through myCGHS
app and can be transferred online on transfer/shifting of residence.

 Online appointment system: CGHS beneficiaries can take advantage of the online
appointment system (OAS) to book a slot to consult a general OPD doctor or
specialist at any Wellness Centre across the country. Half hour time slots are
available for booking and the roster of doctors for each month is mapped online.

 Mobile Application: CGHS has its own mobile app, 'myCGHS', available on Google
Playstore and soon to be available on App Store, to provide access to a digital CGHS
card and other information like the history of medicines issued, permissions, details
of family, etc. The app also allows the beneficiary to book online appointments to
consult a CGHS doctor or specialist, and provides geolocations of CGHS Wellness
Centres and AD Offices, including the location of the nearby Wellness Centre.

 CGHS own grievance portal: The Central Government Health Scheme (CGHS) has
developed a grievance module, enabling beneficiaries to lodge their complaints
online on the web portal.

 Linking of CGHS Ben ID with ABHA ID (Ayushman Bharat Health Account): This
has been enabled online for portability of health records across health ecosystems
once all health organizations on board Ayushman Bharat Digital Mission.

Modalities of Grievance Redressal :-

 Helpline Number:- 1800 208 8900

 CGHS Website portal (https://cghs.gov.in under “Grievances”)

 CGHS Web Application (https://cghs.gov.in under “Beneficiaries”)

 CPGRAMs/E-mail

 Local Advisory and Zonal Advisory Committee meetings

 CGHS E-mail Help Desk: cghs-helpdesk@lsmgr.nic.in

Information & Facilitation Services:-

 CGHS Helpline Number:- A 24x7 National CGHS Helpline service is available on a

toll free number 1800 208 8900. It is a bilingual (Hindi and English) service which is
universally accessible ( through landline or mobile of any service provider). The
beneficiaries can seek all CGHS service related information through this Helpline.
 The helpline is also entrusted with the task of helping beneficiaries by directing their
grievances to the concerned officers.

 CGHS Youtube Channel :- (https://youtube.com/@cghsindia ). The YouTube

channel is a repository of videos and gallery of images of important events in
CGHS as well as the videos of webinars and CMEs on various topics including
digital initiatives in CGHS.

 CGHS Webinar:- Webinar on Clinical topics are held every 2nd & 4th Tuesday of the
Month in which 4th Tuesday particularly for Ayush. Webinars on recent digital
initiatives in CGHS are held on every 3rd Tuesday

 CGHS Website: Procedure for availing facilities in CGHS are present under
“Beneficiary Corner”. In addition, there are FAQs under “Beneficiary Corner”, as well
as FAQs related to Medical Claims, referral and CGHS plastic cards. Contact list of
all CGHS functionaries is available on the website under “Contact us”
 CGHS Directorate contact details – Please see “Contact us” under
cghs.gov.in

City-wise list of empanelled hospitals-Please see “Beneficiary corner”

“search for empaneled hospitals, diagnostic centres and CGHS rates”
under cghs.gov.in
 Citizen’s Charters

Grievance Redressal

Sr. Service Rendered Process Indicative Document Required if Contact details of

No. timefram any the responsible
e for
disposal Officer
1. Grievances received from CGHS Acknowledged within 1-3 1 month Grievance along with Concerned Zonal
beneficiaries through working days and on supportive documents ADs/ADs outside Delhi
Dak/Email/by hand regarding case to case basis to be provided.
difficulties at Wellness Centres forwarded to concerned Details available at
level i.e. non- issue of City/Zone for further www.cghs.gov.in
medicines/Indent Medicines/ necessary action.
behavior of Doctors and Staff/
Internet Connectivity/Cleanliness
etc.
2. Grievances received from Taken up with concerned Interim reply Grievance along with Concerned ADs office
PMO/President Secretariat/Cabinet City/Zone within 7 within 24 hrs & supportive documents in Delhi and outside
Secretariat/Hon’ble MPs/Ex.MPs working days and submit Final reply 1 to be provided. Delhi.
and other VIPs/VVIPs. suitable reply to higher month.
Authority within 1 month.
Details available at
www.cghs.gov.in
3. Grievance received from online Taken up with concerned 1 Month Concerned ADs office
public grievance (CPGRAMS) City/Zone As above. in Delhi and outside
portal. Delhi.

Details available at
www.cghs.gov.in
4. Grievance received from Examined and taken up Acknowledged 1. Copy of Joint Director
Pensioner CGHS beneficiaries the matter with the within 5 working Discharge (Grievance), CGHS
against Private Empanelled HCOs concerned HCOs by days and final Summary. (HQ), Sector-13, R.
1. Denial of Credit Facility. 2. Copy of Bill receipt.
issuing Show Cause decision within 3- 3. Copy of CGHS Card.
K.Puram, New Delhi.
2. Denial of Notice as per MOA
Admission/treatment. 4 month. 4. Copy of referral Details available at
3. Overcharging. followed by reminders. /endorsement of www.cghs.gov.in Or
4. Misbehavior/Harassment Action initiated as per MO/CMO of CGHS Concerned ADs office
/ Discrimination. MOA with the approval of WC/Prescription of of outside Delhi.
5. Others.
the Competent Authority. Govt.
Specialist/permission
letter /emergency
certificate.
5. Copy of
Calculation Sheet
of admissible in
case of
overcharging and
other relevant
documents if any.
5. Grievance received from Serving Examined and taken up Acknowledged 1. Copy of Joint Director
CGHS beneficiaries (through with the concerned HCOs within 5 working Discharge (Grievance), CGHS
proper channel) against Private by issuing Show Cause days and final Summary. (HQ), Sector-13, R. K.
2. Copy of Bill receipt.
Empanelled HCOs Notice as per MOA decision within 3- 3. Copy of CGHS Card. Puram, New Delhi.
1. Denial of Credit Facility. followed by reminders. 4 month. 4. Copy of referral
2. Denial of
Admission/treatment. /endorsement of Or
3. Overcharging. MO/CMO of CGHS
4. Misbehavior/Harassment Action initiated as per WC/Prescription of Concerned ADs
/ Discrimination. MOA with the approval of
5. Others. Govt. Specialist office of
the Competent Authority. /permission letter outside Delhi.
/emergency Details available at
certificate. www.cghs.gov.in
5. Copy of Calculation
Sheet of admissible
amount in
case of
overcharging , any
other relevant
documents.
6. CGHS Online Portal Beneficiary can login to Grievance along with Joint Director
supportive documents to
Grievance portal either be provided. (Grievance), CGHS
through cghs.gov.in (under (HQ), Sector-13, R. K.
“Grievances”) or through Puram, New Delhi.
cghs.nic.in (under Within 3 days
“Beneficiaries”). The Or
beneficiary enters his Ben
Id and is authenticated Concerned ADs
through OTP sent on his office of
registered mobile number. outside Delhi. Details
The beneficiary choses the available at
grievance category and www.cghs.gov.in
sub-category which is
mapped at the back end to
the officer dealing with the
matter. Once the
beneficiary enters the
details of the grievance
and clicks on “submit”, the
grievance reaches the
inbox of the concerned
officer in real time.
Grievances that are not
addressed in 03 working
days appear as red in the
concerned officer’s module
and it gets auto-escalated
to the next level officer,
who is again given 03
working days time to
resolve the grievance.
Urgent life saving matters
are to be resolved within
24 hours.
 Medical Reimbursement Claim –

1. Pensioners

Sl. Service Fee/Charg Process Indicative Document Contact

No. Rendered es if timeframe Required details of the
any responsible
Officer
1 Settlement of Medical Nil The MR Claims received from the 30 days depending MRC form and the
Reimbursement various on check list for the Concerned ADs
Claims. WC’s are scrutinized and whether the file documents required office in Delhi and
admissible amount calculated as needs to be sent for to be submitted are outside
per CGHS guidelines and rate list. approval/expert available on the Delhi.
After financial approval of opinion, STC, HPC. CGHS Website. Details available
admissible amount from Beneficiary can also at
competent authority bills are track the MRC Non-admissible in www.cghs.gov.in
prepared and sent to PAO for through online admission as per the
ECS to claimant. tracking module by OM
using user ID & dated01.08.2013
Password at https://cghs.gov.in/C
www.cghs.nic.in ghsGovIn/faces/Vie
wPage.xhtml?id=Mj
A0OA==

2. Serving Employees.
MRC of Serving CGHS beneficiaries are to be processed and reimbursed by their respective department/Ministry.
 Issue of Medicines -

Sl. Service Fee/Charg Process Indicative timeframe Document Contact details of the
No. Rendered es Required if responsible
if any any Officer
1. Issue of Medicine Nil After registration Available medicine issued CGHSCard/Prescri CMO I/c of Wellness
ption, show at
at Wellness centre, and visit to the on the same day. Indented medicines Centres in Delhi and
available/indent. Doctor of medicine issued on next distribution counter. outside Delhi.
Wellness working day from the day of If the beneficiary is
unable to come to
Centres indent wellness centre
authority letter Details available at
along with Photo ID
proof is mandatory www.cghs.gov.in
to collect medicine
on behalf of
beneficiary.
Photo copy of valid
prescription is
required if cost of
single medicine is
more than Rs.
5000/-.
List of Non-
permissible
medicine is
available as per the
OM dated
23.07.2009
https://cghs.gov.in/
CghsGovIn/faces/V
iewPage.xhtml?id=
MjE0Ng==
2. Nil
Providing anticancer & other Based on valid Next working day from the As per check list
restricted drug to CGHS prescription of day of indent. available in wellness CMO (Drugs) 011-2140863,
beneficiaries on case to case Oncologist / treating centres or
basis from Medical Store specialist & online indent
Depot. Gole Market, by respective wellness CMO I/c of Wellness Centres
Delhi/AD of City concerned. centre, medicines are in Delhi and outside Delhi.
made available to
the beneficiary Details available at
www.cghs.gov.in
 Issue of Permission

Sl. Service Rendered Fee/Charg Process Indicative Document Contact details of

No. es if timeframe Required the
any if any responsibl
e Officer
1. Nil Online Referral and Within 1 working Referral Concerned CMO I/c of
endorsement module of the day letter/Doctor Wellness Centre.
Wellness Centre. Prescription slip
Permission for listed
investigation/Procedure

2 Permission for unlisted Nil The applications for Advice from treating
Concerned ADs office
permission in Delhi
investigation/procedure/impla forwarded from CGHS Depending doctor, copy of card, and outside
nts. W.C’s are processed and upon the estimate for the Delhi.
after approval of competent competent investigation
authority permission letter authority with /procedure/implant Details available
issued to the beneficiary. s etc. at
delegated
Financial power www.cghs.gov.in
and approval by
Standing
Technical
Committee if
required.
Issue of CGHS Card

Sr. Service Rendered Fee/Charges if any Process Indicative Document Required if Contact
No. any details of the
timeframe
respons
ibl e
Officer
1. Preparing of The CGHS contribution 1. Entering the 1. Paper The following
CGHS plastic not received directly by detail of the card is Documents are CMO
cards of the the Central Government beneficiaries issued in required for preparing (Card).
Central Employees. The CGHS in the 1 to 2 the CGHS plastic 011-
Government contribution deducted computer week. cards:- 2086347
Employees. by the department of the data base. 2. 30-45 1. For serving 5
Employees. 2. Transfer days employees of
Present rate as follows:- of data to (approx.) the Central Addition
a. Level 1 to 5 Rs. 250/- al
the from the Government/
Per month. Director
b. Level 6 Rs. 450/- Per outsource date of Autonomous/Stat
month. d agency. modificati uary (Admn.)
c. Level 7 to 3. After printing on. Bodies/Journalist 011-20863475
11 Rs. 650/- Per. the CGHS .
month. plastic cards The a. Application forms And;
d. Level 12 and are delivered beneficiarie duly forwarded
s may take by the Concerned
above Rs. 1000/- to CGHS
2. Preparatio printout of Administrative ADs office
Per month. (HQ).
n of the CGHS branch of the outside
The pensioners have to 4. The CGHS
CGHS card by concern Delhi.
contribute for CGHS cards are
plastic entering the department. Details
plastic cards as follows:- collected by
cards of ID’s b. Residence Proof. available at
Level 1 to 5 Rs. 250/- per Zones from
the month (For whole life Rs. CGHS number and c. Age Proof of www.cghs.g
pensioner 30,000/-). (HQ). password the ov.in
s. Level 6 Rs. 450/- Per 5. The CGHS received by Government
month(For whole life Rs. cards are computer Servant and
54,000/- ) distributed generated the
Level 7 to 11 Rs. 650/- WC wise by SMS. dependents.
Per month(For whole life the Zones. d. Salary Slip.
Rs. 78,000/-) Level 12 Beneficiaries e. Passport size
and above Rs. 1000/- are informed by photograph of
Per month(For whole life computer self and
Rs. generated SMS dependent.
1,20,000/-) to collect the f. Valid ID’s card of
CGHS card PIB (For Journalist).
3. Rs. 15368/- per from the
card per annum in respective 2. Pensioners of
advance. Wellness Central
Centre Government/Auto
4. Rs. 1067/- per
card per annum in nomo u s
advance. Bodies/Ex-MP.
a. Application form.
(Note:- Ward b. Copy of the PPO.
Entitlement Slab c. Surrendered
Private Ward:- Certificate of
50,501 and above CGHS card issued
Semi-Private:- during service
36,501 -50,500 period if any.
General:- Up to d. Residence proof.
36500)
 e. LPC (Last Pay
3. Preparation of 5. Rs. 1000/- per month Certificate)
CGHS plastic (for whole life Rs. f. Membership
cards of the 1,20,000/-) Certificate from the
Autonomous/St Lok Sabha/Rajya
atutor y Bodies. (Note- The aforesaid Sabha for
4. Preparatio contribution is to be secretariat(for EX-
n of made through Bharat MP only)
CGHS Kosh)
plastic g. FMA (Fixed
cards of Medical
*Serving Beneficiaries
the Allowance)- Letter
in Left Wing Extremist
Journalist. from Bank showing
areas/ North East/J&K pension break up.
5. Preparatio and Journalists will
n of CGHS
plastic also deposit
cards Ex- contribution through
MP. Bharat Kosh.

Please see YouTube

video for making
payment through
Bharat Kosh at the link:
https://youtu.be/EwPHj
Mp_mts?si=3lchQDv78
Pmr3gxd
 Medical Advance

Sr. Service Fee/Charg Process Indicative Document Required if Contact details

No. Rendered es if timeframe any of the
any responsible
Officer
1. Medical Nil Request received Within 7 working Request along with In-charge,
Advance from CGHS days on receipt original estimate from Hospital Cell,
(90% of beneficiary at of all documents govt. specialist, copy of CGHS (HQ),
estimate) for zonal offices, at concerned prescription, mandate Delhi 011-
pensioners in forwarded to AD ADs office. form/cancelled cheque 20863438,
case of (HQ). CMO (HC) of Govt. hospital A/c, Or Concerned ADs
treatment at process the case. copy of CGHS Card. If office outside Delhi.
Govt. Sanctioned by AD (HQ) not within Delegated Details available at
hospitals and sent to PAO for Financial Power www.cghs.gov.in
payment. ,approval of competent
authority is required.
2. Settlement Nil In-charge, Hospital
of Request received from 30 days (Within Request along with original Cell, CGHS
Medical CGHS beneficiary submission of final bills & utilization certificate
sanctioned from bills) from govt. hospital, copy of (HQ), Delhi 011-
Advance Competent Authority as prescription, mandate 20863438,
(10% of per CGHS existing form/cancelled cheque of Or Concerned ADs
guidelines. CGHS beneficiary A/c, copy
estimate) for of CGHS Card office outside
pensioners in Delhi. Details
available at
case of www.cghs.gov.in
treatment at
Govt.
hospitals