CGEPHIS SCHEME

CGEPHIS

Central Government Employees and Pensioners Health Insurance Scheme (CGEPHIS)

Government of India Introduces Health Insurance Scheme for Central Government Employees and Pensioners and their dependant family members

1. Who can Join the Scheme :

– All Central Government Employees

– India Service Officers

– Retired Employees

– who covered existing CGHS and CS (MA) Rules

2. This scheme is compulsory for new employees and pensioners, and voluntary basis for existing employees.

3. CGEPHIS Structure

–          This scheme shall provide coverage for all expenses relating to hospitalization of beneficiary members up to Rs. 500,000/- per family per year – subject to limits on cashless basis through smart cards.

4. Pre-existing diseases covers under the scheme from day one.

5. Insurance Premium :

–   The beneficiary will have to pay an annual premium.

–   The estimated annual premium for a standard family size will be in a range   of Rs. 8000 to Rs. 12000/- per annum.

–    The premium amount will vary according to grade pay of the beneficiary

–    The premium amount shall be decided by the insurance companies.

–    For serving employees, the premium would be detected by the Drawing & Disbursing Officers

–    Pensioners would be required to authorize the Bank Branch from which they are drawing their pension amount, to deduct the Insurance premium.

6. Insurance Coverage

The Following shall be covered insurance policy under this scheme :

  1. Pre-existing diseases
  2. Day-one Coverage for all diseases
  3. Maternity benefit
  4. Pre and Post hospitalization cover of 30 days and 60 days respectively
  5. New-born babies
  6. Domiciliary Hospitalization

7. CGEPHIS Scheme for Family  :

–   Employees :  This Scheme will cover for self, spouse, two dependant children and dependant parents. New born will be covered as a part of insured family member during currency of the policy.

–   Retired Employees : – This Scheme will cover for self, spouse, two dependant children and dependant parents

–   Additional dependant family members can be covered under the scheme by paying an additional premium.

15 COMMENTS

  1. the scheme has not been launched yet. even its format has not been finalised. Why include details in this cite i wonder

  2. When will it be implemented as more than two years have elapsed.May be after the death of most of the retd employees who have opted out of CGHS for no fault of their and are managing with the meagre rs 300 per month doled out by the govt.
    T.R.Subramanian
    [email protected]

  3. Sir,
    I am retired Central Govt.Employee. At present I am not covered under above scheme as I am staying out of CGHS. Is there will be any chance to open CGHS Dispensary in the area near to Dombivili/Kalyan, Dist.Thane,Maharashtra. If I opted for above scheme I have to go Mulud (Mumbai) for this purpose.Is there is time limit to join this Scheme.How I will get the Form.

  4. Sir,
    I am retired central govt.employee.from when this scheme will be applicable and when forms should be filled in

  5. What is the latest developement ofthe scheme, is it still in paper? Concerned authorities may take immediate action to implement the scheme.

  6. The govt.and the some federation leaders playing hide and seek in the health care issue of poor central govt officers and pensioners.Both of them may have hidden agendas. My dear friends we will hear the good news only if and when these two get satisfied with their ordeals.Govt is not sinceare in their promises until a court order is slapped on them. Curse your destiny and keep quiet.

  7. Sir,
    I am working in Indian Bureau of Mines, a government organisation of ministry of mines.  I am interested to enroll for self and family under CGEPHIS scheme. Kindly enlighten me regarding the rules, regulations  and procedures to be followed  for becoming a member of the scheme, along with its benefits and terms-conditions.
    Yours faithfully
    BPRavi
    [email protected]

  8. I made a request to know the effective date from which the CGEPHIS scheme is actually made effective. The membership could be obtained by those needy who are otherwise deprived of the CGHS facilities in areas where the same is not available.

    The government should get it implemented quickly.

    May I know when it is likely to be made effective?

  9. The CGEPHIS scheme is much talked about. Almost each and every pensioner is eagerly waiting for its introduction. May I know when this scheme is likely to be made effective?

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