Reimbursement of Medical Claims under CS (MA) Rules

Reimbursement of Medical Claims under Central Services (Medical Attendance) Rules 1944

The Department of Controller General of Defence Accounts (CGDA) issued an important order regarding medical claims under CS (MA) Rules for Pensioners residing in CGHS covered and non CGHS areas.

As per the order, the Health Ministry has clarified that CS (MA) Rules 1944 are not applicable to pensioners till date. The Ministry has issued the following guidelines for medical facilities to Central Government pensioners :-

Also check: CGHS Subscription Rates as per 7th CPC

Pensioners residing in CGHS covered areas

1. They can get themselves registered in CGHS dispensary after making requisite contribution and can avail both OPD and IPD facilities.
2. Pensioners residing in CGHS areas cannot opt out of CGHS and avail any other medical facility (i.e. Fixed Medical Allowance). Such pensioners, if they do not choose to avail CGHS facility by depositing the required contributions, cannot be granted Fixed Medical allowance in lieu of CGHS.

Also check: Time limit for submission of final claims reimbursement of medical expenses under CGHS

Pensioners residing in non-CGHS areas

1. They can avail Fixed Medical Allowance (FMA) @ Rs. 500/- per month revised to Rs. 1000 from 1.7.2017.
2. They can also avail benefits of CGHS (OPD and IPD) by registering themselves in the nearest CGHS city after making the required subscription.
3. They also have the option to avail FMA, for OPD treatment and CGHS for IPD treatments after making the required subscriptions as per CGHS guidelines.

Also check: Contribution for Life Time CGHS Card for Pensioners