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Friday, June 4, 2010

Central government employees health insurance scheme (CGEHS)


Demand Survey


Governmet of India is contemplating introduction of a helath Insurance Scheme for central government employees and pensioners and their dependant family members all over india. Ministry of Health & Family Welfae intends to assess the demand for the above scheme fromthe prospective beneficiaies through this survey for taking further steps in this direction.

Who can Join

All the personnel of the central government including all India service officers, serving and retired and others who are covered under the existing CGHS (Central government Health Scheme) and under CS (MA) Rules can join the scheme. The scheme is proposed to be implemented on voluntary basis for existing employees and pensioners and compulsarily for future employees and pensioners.

Insurance Coverage

The scheme shall provide coverage for meeting expense of hospitalization and surgical procedures for beneficiary members up to Rs. 5.00 Lakh per family per year subject to limits, in any of the network hospitals. the benefit to the family will be on floater basis. ie. the total reimbursment of Rs. 5 lakh can be availed of individually or collectively by members of the family.

All diseases under the proposed scheme shall be covered from day one.

Insurance premium.

The beneficiary will have to pay an annual premium which will be determined after the formal introduction of the scheme. It will vary according to the grade pay of the officer. The estimated annual premium for a standard family size will be in the range of Rs. 8000 to Rs 120000 pa. It is however proposed to be subsidised by the government to a considerable extent. The amount of premium shall be decided by the transparent process of bidding amongst the insurance companies paticipating in the scheme. In case of srving employees, the premium would be deducted by the Drawing & Disbursing officer, In the case of Pensioners they would be required to authorise the Bank branch from which they are drawing their pension, to deduct the insurance premium.

Family Size

In case of serving employees, self, spouse, two dependent children and dependant parents would be covered. New born will be covered as a part of insured family member during the currency of the policy.

In case of retired employees, self, spouse,two dependent children and dependent parents would be covered.

Additional dependent family member can be covered under the scheme by paying an additional premium per additional dependent family member. The premium shall be borne by the beneficiary and there would be no govt subsidy for the same.

List of cities where CGHS is currently functioning.

Ahemdabad, Allahabad, Bangalore, Bhubaneswar, Bhopal, chandigarh, Chennai, Delhi, Dehradun, Guwahati, Hyderabad, Jaipur, Jabalpur, Jammu, Kanpur, Kolkata, Lucknow, Meeru, Mumbai, Nagpur, Patna, Pune, Ranchi, Shillong, Trivandrum.
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