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The CGHS – Central Government Health Scheme – provides healthcare services to government employees and their families. The scheme covers both outpatient (OPD) and inpatient (IPD) treatments, and offers medical advancement to its beneficiaries. In this regard, a clarification has been issued on the grant of medical advance for all treatments under the CGHS/CS(MS) rules. This is a welcome move as it ensures that all beneficiaries have access to necessary medical treatment without any financial burden.
F-No.Z.15025/8/2021/DIR/CGHS
Government of India
Ministry of Health & Family Welfare
Department of Health
Nirman Bhawan, New Delhi
Dated the September 2021
Office Memoranudm
Sub: Grant of Medical Advance for all treatment (OPD and IPD) under CGHS / CS(MS) Rules – clarification regarding
The undersigned is directed to refer to this Ministry’s O.M. No 14025/18/2015-MS/EHSS dated 17.10.2016 on the subject mentioned above and to say that a numbers of references seeking clarification on grant of medical advance to CGHS/CS(MA) beneficiaries in respect of treatment procedures for which there are no prescribed CGHS package Dates, are being received in this ministry.
2. In view of the difficulties being faced by CGHS / CS(MA) beneficiaries, the matter has been examined in this Ministry and it has been decided that in case of treatment procedures without Package rates, the admissible amount is calculated item-wise at CGHS rate. Item(s) for which there are no CGHS rates, AIIMS rates shall be considered. If there is no CGHS/AIIMS rate, actual estimate for the procedure shall be considered.
3. The Hospital seeking advance shall provide item-wise break-up of the estimate to facilitate processing of the requests for medical advance, 90% of the admissible rates arrived at, as per para (2) above, would be considered for grant of Medical advance.
4. The other terms and conditions mentioned in the OM No 14025/18/2015-MS/EHSS dated 17th October 2016 shall remain unchanged.
Signed by Rajender Kumar
Date: 22-09-2021 11:37:15
Reason: Approved
(Rajender Kumar)
Under Secretary to Government of India
Click to Download the CGHS Order in PDF
What is CGHS Medical Advance for OPD Treatment?
CGHS Medical Advance for OPD Treatment is a scheme by the Central Government Health Scheme that provides advance money to its beneficiaries for medical expenses that are incurred during OPD (Outpatient Department) treatment.
Who can avail of the CGHS Medical Advance for OPD Treatment?
All the beneficiaries of the CGHS scheme, including Central Government employees and their dependents, pensioners, and their dependents, are eligible for availing the CGHS Medical Advance for OPD Treatment.
What are the benefits of CGHS Medical Advance for OPD Treatment?
The CGHS Medical Advance for OPD Treatment enables beneficiaries to avail of medical treatment without worrying about financial constraints. This scheme provides advance money for medical expenses that can be reimbursed later.
What documents are required for availing CGHS Medical Advance for OPD Treatment?
The required documents for availing CGHS Medical Advance for OPD Treatment are the CGHS card, a prescription from a CGHS medical officer, a request form for advance, and the estimate of treatment cost from the hospital.
How can one apply for CGHS Medical Advance for OPD Treatment?
The application for availing CGHS Medical Advance for OPD Treatment needs to be submitted to the respective dispensary or wellness center, where the beneficiary is registered. The CGHS medical officer then verifies the documents and approves the advance.
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