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Comprehensive Update on CGHS Ward Eligibility for Pensioners Following 7th Central Pay Commission Recommendations

The Central Government Health Scheme (CGHS) has undergone significant changes, particularly regarding the ward eligibility for pensioners, including family pensioners, following the recommendations of the 7th Central Pay Commission (CPC). This article delves into the modifications, the application process for new or revised CGHS cards, and the number of complaints received, especially in the National Capital Territory (NCT) of Delhi.

Modification of Ward Eligibility for Pensioners

As per the Office Memorandum No. S.11011/1/2016-CGHS(P)/EHS dated 28th October 2022, the Government of India revised the ward entitlement for CGHS beneficiaries. This revision was a partial modification of the earlier guidelines issued on 9th January 2017. The updated ward entitlements are as follows:

• General Ward: For officers drawing a corresponding basic pay up to Rs. 47,600/- (previously up to Rs. 36,500)
• Semi-private Ward: For officers with a basic pay from Rs. 47,601/- to Rs. 63,100/- (previously Rs. 36,501 to Rs. 50,500)
• Private Ward: For officers with a basic pay above Rs. 63,101/- (previously above Rs. 50,500)

These changes aim to align the ward eligibility with the revised pay scales post the 7th CPC, ensuring better healthcare access for the pensioners.

No Proposal for Pre-7th CPC Pensioners

Currently, there is no proposal to implement revised ward eligibility for pensioners or family pensioners who retired before the implementation of the 7th CPC recommendations. This means that those who superannuated prior to these recommendations will continue with the previous ward entitlements unless further changes are announced.

Application Process for CGHS Card Updates

The process for updating ward eligibility in CGHS cards is straightforward:

1. Application Submission: Eligible beneficiaries must submit their applications for ward updation. This includes both new CGHS card applications and requests for card revisions.
2. Processing: Applications are processed on a first-come, first-served basis at CGHS wellness centres.
3. Issuance of Cards: Upon processing, beneficiaries receive a printed Index Card reflecting their revised ward entitlement immediately. Additionally, beneficiaries can download their e-CGHS card through their online CGHS account, providing convenience and ease of access.

Complaints and Issues in Delhi

Despite these streamlined processes, there have been reports of some pensioners, including family pensioners, being denied the modified eligibility. Complaints indicate that certain CGHS wellness centres are not accepting applications for change, leading to dissatisfaction among the beneficiaries.

To address these issues, the Ministry of Health and Family Welfare monitors and resolves complaints. As of the latest data, several complaints have been received regarding this matter, with a significant number from the National Capital Territory (NCT) of Delhi. These complaints are categorized state/UT-wise to ensure targeted resolution.

Conclusion

The revision of CGHS ward eligibility post-7th CPC recommendations marks a significant step towards better healthcare provision for pensioners. However, the process is not without its challenges, particularly for those who retired before the implementation of these recommendations. The Ministry of Health and Family Welfare continues to address complaints and improve the application process to ensure all beneficiaries receive their entitled healthcare benefits.