CGHS Ward Entitlement and Monthly Subscription in 7th CPC

Revised CGHS Ward Entitlement for Central Government Employees and Pensioners 2024

The entitlement for CGHS wards for Central Government Employees and Pensioners 2023 has been revised. The General Ward Entitlement is applicable to individuals with a Basic Pay of up to Rs. 36500. Employees with a Basic Pay ranging between Rs. 36,501 to Rs. 50500 are entitled to the Semi-Private Ward. On the other hand, the Private Ward is reserved for those with a Basic Pay exceeding Rs. 50500.

CGHS Online Appointment Booking | www.cghs.nic.in Login

Revised Consultation Rates in CGHS 2023

The Ministry of Health and Family Welfare for the Union has made the decision to revise the CGHS package rates for all beneficiaries. The referral process under CGHS has also been simplified for the convenience of employees. After careful consideration of demands from stakeholders and the rise of costs in various healthcare components, the Ministry of Health has proposed the revision of CGHS package rates for consultation fees, ICU charges, and room rent. The revised rates for OPD and IPD consultations are as follows: The existing consultation fee of Rs. 150 for OPD will be revised to Rs. 350, while the existing consultation fee of Rs. 300 for IPD will also be revised to Rs. 350.

ICU Revised Charges in CGHS 2023

The revised charges for ICU in CGHS 2023 now include a fee of Rs 750 for non-NABH hospitals and Rs 862* for NABH hospitals, which covers monitoring, RMO charges, and nursing care. Additionally, the room rent will be determined by the ward entitlement of the beneficiary, with options for a general ward, semi-private ward, or private ward. It is important to note that NABH-accredited hospitals will have a 15% higher charge.

Previously, the rates for NABH hospitals were Rs 862, with room rent determined by ward entitlement.

Under the new revised rates, the cost will be Rs 5,400/- (Rs 862 + Rs 4,500/- for a private ward = 5,362 – rounded to Rs 5,400), which includes accommodation for all ward entitlements.

Revised Room Rent Rates in CGHS 2023

The CGHS has updated its room rent rates effective 2023. The revised rates are as follows: General ward – Previous rate of Rs. 1000/- has been revised to Rs. 1,500/-, Semi-Private ward – Previous rate of Rs. 2,000/- has been revised to Rs. 3,000/-, and Private ward – Previous rate of Rs. 3,000/- has been revised to Rs. 4,500/-. The referral process for CGHS beneficiaries has also been simplified. Previously, beneficiaries had to personally visit the CGHS Wellness Center to obtain a referral to the hospital. However, now a representative can obtain the referral on behalf of the beneficiary by submitting their documents to the wellness center. The medical officer will assess the documents and refer the beneficiary to the hospital accordingly. Additionally, beneficiaries can also obtain referrals through video calls.

Revised Rates of CGHS Subscription

The Department of Health and Family Welfare, under the Ministry of Health and Family Welfare, has issued a notice with regards to the revised rates of subscription for Central Government employees, pensioners, and family pensioners. The updated rates will be implemented in October 2022. You may refer to the official memo provided below for detailed information on the new subscription rates and ward entitlements.

F. No. S.11011/11/2016-CGHS(P)/EHS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
(EHS Section)

Dated, the 28th of October 2022
Nirman Bhawan, New Delhi

OFFICE MEMORANDUM

Subject: Revision of rates of subscription under Central Government Health Scheme due to revision of pay and allowances of Central Government employees and revision of pension/ family pension on account of implementation of recommendations of the Seventh Central Pay Commission.

In partial modification to this Ministry’s O.M. of even number dated 9th January 2017, the undersigned is directed to say that entitlement of wards in private hospitals empanelled under CGHS as contained in Para 3(B) of the O.M. ibid stands revised as under with effect from the date of issue of this O.M.: –

2. This issues with the concurrence of the Department of Expenditure vide their I.D. Note No. 18(1)/EV/2016 dated 11th May 2022 read with I.D. Note dated 6th October 2022.

3. Hindi Version follows.

sd/-
(Guite Elsy Gat Biak Lun)
Under Secretary to Govt. of India

Click to View or Download the Revised CGHS Ward Entitlement Order 2022 PDF

Revised CGHS Monthly Contribution after 7th CPC

CGHS Contribution for Pensioners: The revised monthly contribution for CGHS after the 7th CPC is determined by the corresponding levels in Pay Matrix. Individuals falling under Level 1 to 5 of the Pay Matrix must pay Rs. 250 per month, while those under Level 6 must pay Rs. 450 per month. Similarly, those falling under Level 7 to 11 must pay Rs. 650 per month, and individuals under Level 12 and above must pay Rs. 1,000 per month. Pensioners and Family Pensioners are also required to contribute to CGHS, at the same amount they had subscribed to at the time of their retirement or the death of the government servant. If both spouses are employed by the Central Government, only the one with a higher salary will be responsible for the contribution. Further information can be found in the attached orders issued by CGHS on 9th January and 13th January 2017.

CGHS Subscription Rates Clarification Order 13 January 2017

No.S.11011/11/2016-CGHS (P)/EHS
Government of India
Ministry of Health and Family Welfare
EHS Section

Nirman Bhawan, New Delhi
Dated the 13th January 2017

OFFICE MEMORANDUM

Sub: Revision of rates of subscription under Central Government Health Scheme due to revision of pay and allowances of Central Government employees and revision of pension/ family pension on account of implementation of recommendations of the Seventh Central Pay Commission.

In partial modification to this Ministry’s OM of even No. dated 9th January 2017 on the subject mentioned above, the undersigned is directed to say that the revised rates will be effective from 1st February 2017 instead of 1st January 2017.

2. Other contents of the above-said OM will remain unchanged.

sd/-
(Sunil Kumar Gupta)
Under Secretary to the Government of India
Tel. 23061986

CGHS Subscription Rates Order 9 January 2017

No. S.11011/11/2016 CGHS (P)/EHS
Government of India
Ministry of Health and Family Welfare
EHS Section

Nirman Bhawan, New Delhi
Dated the 9th January 2017

OFFICE MEMORANDUM

Sub: Revision of rates of subscription under Central Government Health Scheme due to revision of pay and allowances of Central Government employees and revision of pension/family pension on account of implementation of recommendations of the Seventh Central Pay Commission.

The undersigned is directed to refer to this Ministry’s OM No. S.11011/2/2008-CGHS (P) dated 20th May 2009 vide which orders were issued revising the rates of monthly subscription for availing CGHS facility, as also the entitlement for free diet, entitlement of accommodation in private empanelled hospitals under CGHS, etc.

2. Consequent upon revision of pay on the basis of the implementation of the recommendations of the 7th Central Pay Commission, it has been decided to revise the rates of subscriptions, to be made by employees/pensioners, for availing benefits under the CGHS, with effect from 1st January 2017. It has also been decided to revise the monetary ceiling limits for various entitlements of the beneficiaries for availing CGHS facilities.

3. In supersession of all earlier instructions, the following revisions are being made, in so far as it relates to the facilities mentioned below:

(A) Monthly Contributions for availing CGHS facility:

(B) Entitlement of wards in private hospitals empanelled under CGHS:

(e) Monetary Ceiling for Free Diet: The monetary ceiling for free diet for CGHS beneficiaries is revised to pay/pension/family pension of Rs. 44,900/- per month.

(D) Monetary ceiling for free diet for beneficiaries suffering from TB or mental disease): The monetary ceiling for free diet in case of beneficiary suffering from TB or Mental disease is revised to pay / pension/family pension of Rs. 69,700/- per month.

(E) Pay slab for determining the entitlement of Nursing Home facilities in Government / State Government / Municipal Hospitals: The monetary ceiling for determining the entitlement of nursing home facilities in Central Government / State Government / Municipals Hospitals is revised to pay / pension/family pension Rs. 47,600/- per month and above.

(F) Monetary Ceiling for direct consultation with Specialists in Central Government / State Government / Municipal Hospitals:

The monetary ceiling for determining the entitlement for direct consultation with Specialists in Central Government / State Government / Municipal Hospitals will continue at the existing rates until the revision of the same after consultation with the Ministry of Finance.

(G) Pay slab for determining the entitlement of accommodation in AIIMS, New Delhi. The revised entitlement, as per the pay drawn by the officials, is as follows:

4. It is clarified that the reference to pay in this order relates to the pay drawn in the level of pay.

5. Pensioners have the option to get their CGHS pensioner card made by either making a CGHS contribution on an annual basis (twelve months) or by making a contribution for 10 (ten) years {120 (one hundred and twenty) months} for getting a pensioner CGHS card with life-time validity. It is clarified that:

(i) Contribution to be made by pensioners/family pensioners would be the amount that they were subscribing at the time of their retirement or at the time of death of the Government servant;

(ii) Pensioner beneficiaries, who have already obtained CGHS cards with lifetime validity by paying a lump sum amount equivalent to 10 years’ contribution, will not be required to pay any additional amount as a result of the revision in the rates of contribution for availing CGHS facility;

(iii) Entitlement of pensioners/family pensioners, who have already deposited their contribution for lifetime CGHS facility, will not be changed.

(iv) Pensioners/family pensioners who are contributing to the CGHS on an annual basis and wish to continue to avail of CGHS benefits will have to contribute at the revised rates up to the time of contribution needed to cover a period of a total of ten years from the time pensioner CGHS card was issued for the first time to them. The revised rate of contribution for the remaining period would be with reference to the level of pay that he/she would have drawn in the post held by him/her (at the time of his / her retirement/death) had he/she continued to be in service now but for his / her retirement/ death; and

(v) Any pensioner/family pensioner who is entitled to avail CGHS facility has not so far got his / her pensioner CGHS card made, the rate of contribution in such cases will be with reference to the level of pay that he/she would have drawn in the post held by him/her (at the time of his / her retirement/death) had he/she continued to be in service now but for his/ her retirement/death.

6. This issues with the concurrence of the Department of Expenditure vide their I.D. Note No. 18(1)/EV/2016, dated 24/11/2016.

7. Hindi version will follow.

sd/-
(Sunil Kumar Gupta)
Under Secretary to the Government of India

Contribution for One Time (Single Payment) CGHS Card for Pensioners

LIFETIME CENTRAL GOVERNMENT HEALTH SCHEME (CGHS) CARD
Monthly Subscription in CGHS (Calculation Example in 7th CPC Basic Pay)
Pensioners can join the scheme of CGHS on yearly basis also. It should be a full calendar year from January to December. If one joins in the middle of the year, the calculation of subscription is carried out up to the month of December of next year. For example, a pensioner retired at the pay level of 6 and he wants to join the scheme of CGHS for one year from December. To obtain the CGHS card, he has to pay the amount for 13 months of subscription. A total of Rs. 5850 (13 x 450=5850).
Lifetime Subscription in CGHS (Calculation with example)
The lifetime membership registration in CGHS is very simple. Pensioners have to pay the subscription according to your pay level as per 7th CPC amount for ten years (120 months) as a one-time payment for a lifetime membership. For example, a pensioner retired at the pay level of 6 and he wants to join the scheme of CGHS for a lifetime membership. To obtain the CGHS card, he has to pay the amount for 120 months of subscription. A total of Rs. 54,000 (120 x 450=54000).

CGHS Lifetime Contribution Calculation CGHS Approved Empanelled Hospital List 2023

CGHS 7th CPC Room Rent 2023

Central Government Health Scheme (CGHS) Revised Room Charges for CGHS Beneficiaries

The maximum room rent (accommodation charges) admissible for different categories of wards is given below and is applicable only for treatment procedures for which there is no CGHS-prescribed package rate.

• General ward: Rs. 1000 per day
• Semi-private ward: Rs. 2000 per day
• Private ward: Rs. 3000 per day
• Daycare (6 to 8 Hrs.): Rs. 500 (same for all categories)

Room rent will include charges for occupation of bed, die for the patient, charges for water and electricity supply, linen charges, nursing charges and routine upkeep. During the treatment in ICCU or ICU, no separate room rent will be admissible.

CGHS Ward Entitlement 2023

7th CPC Basic Pay Limits for CGHS Hospital Accommodation Category: The eligibility of Ward Entitlement in Government Hospitals, Private Empanelled Hospitals and Nursing Homes for Central Government employees as per the basic pay. The detailed CGHS hospital room category eigibility table is given below.

CGHS Monetary Ceiling for Free Diet

The monetary ceiling for free diet for CGHS beneficiaries is revised to pay, pension and family pension of Rs. 44,900 per month.

Monetary ceiling for free diet for beneficiaries suffering from TB or Mental disease.

The monetary ceiling for free diet in case of beneficiaries suffering from TB or Mental diseases was revised to a pay-pension-family pension of Rs 69,700 per month.

Pay slab for determining the entitlement of Nursing Home facilities in Government – State Government – Municipal Hospitals 

The monetary ceiling for determining the entitlement The monetary ceiling of nursing home facilities in Central Government – State Government – Municipal Hospitals is revised to pay – pension – family pension Rs. 47,600 per month and above.

Monetary Ceiling for direct consultation with Specialists in Central Government / State Government / Municipal Hospital

The monetary ceiling for determining the entitlement for direct consultation with Specialists in Central Government – State Government /Municipal Hospitals will continue at the existing rates until the revision of the Same after consultation with the Ministry of Finance.

Pay slab for determining the entitlement of accommodation in AIIMS, New Delhi.

The revised entitlement, as per the pay drawn by the officials, is as follows:

CGHS Package Rate as per CS(MA) Rules

The package rate includes all the expenses for in-patient treatment, daycare, and diagnostic procedures. As per the CS(MA) Rules beneficiary has been permitted by the competent authority or for treatment under emergency from the time of admission to the time of discharge, including (but not limited to):

• Registration charges
• Admission charges
• Accommodation charges
• Diet charges
• Operation charges
• Injection charges
• Dressing charges
• Doctor consultant charges
• ICU/ICCU charges
• Monitoring charges
• Transfusion charges
• Anesthesia charges
• Operation theatre charges
• Procedural charges
• Surgeon fee
• Surgical disposables cost
• Medicines cost
• Physiotherapy charges
• Nursing charges

The cost of implants is reimbursable in addition to package rates as per CGHS ceiling rates for implants. Treatment charges for newborn babies are separately reimbursable in addition to delivery charges for mothers.

Calculation of CGHS Life Time Subscription for Pensioners

The choice is with the individual. One can apply for Life time card by paying 10 years of contribution together or one can apply for one year, two years etc. [Click to read continue]

Monthly Contribution for availing CGHS facility as per 7th CPC :

The CGHS Subscription Old Rates with effect from 1st June 2009 (Grade Pay as per 6th CPC) with monthly subscription details are given below…

The monthly subscription is five times for Pay Matrix Level 1 to Level 5 as per the 7th CPC comparison to the 6th CPC. Pensioners should pay their subscription lifetime and also on a yearly base. Monthly Contributions for availing of the CGHS facility as per the 7th CPC and 6th CPC are given above. Government orders on the subject of a revision of rates of subscription under the Central Government Health Scheme as per the 7th CPC were issued on 9th and 13th January 2017. [Click to view orders]

Latest CGHS Subscription Rates

CGHS’s latest revised monthly subscription rates (not old and annual rates) for Central Government Pensioners after the 7th pay commission

• Rs. 250 per month for the pensioners retired in the pay matrix level between 1 and 5
• Rs. 450 per month for the pensioners retired in the pay matrix level 6
• Rs. 650 per month for the pensioners retired in the pay matrix level between 7 and 11
• Rs. 1000 per month for the pensioners retired in the pay matrix level from 12 and above

What is the Central Government Health Scheme?

The Central Government Health Scheme (CGHS) is a health program for central government employees and pensioners and their dependent family members.

What is the reason for revising the rates of subscription under CGHS?

The rates of subscription under CGHS have been revised due to the revision of pay and allowances of Central Government employees and revision of pension/family pension on account of implementation of recommendations of the Seventh Central Pay Commission.

What is the effective date of the revision of subscription rates?

The effective date of the revision of subscription rates is the date of issuance of the relevant order.

How has the entitlement of wards in private hospitals under CGHS been revised?

The entitlement of wards in private hospitals under CGHS has been revised based on the corresponding basic pay drawn by the officer in 7thCPC per month, as follows:

1. Up to Rs. 36,500 – General
2. Rs. 36,501 to Rs. 50,500 – Semi-Private
3. Above Rs. 50,500 – Private

What was the previous entitlement of wards in private hospitals under CGHS?

The previous entitlement of wards in private hospitals under CGHS is not mentioned in the given information. However, it is indicated that the entitlement has been revised in partial modification to a previous order dated 9th January, 2017.