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Enhanced Ward Eligibility for Pensioners under CGHS: Impact of 7th Central Pay Commission

The Central Government Health Scheme (CGHS) has long been a cornerstone of healthcare for government employees, retirees, and their families. In line with the recommendations of the 7th Central Pay Commission, significant modifications have been made to the ‘ward eligibility’ under CGHS for all pensioners, including family pensioners. This article delves into these changes, offering a comprehensive overview of the new entitlements, their implications, and the process for obtaining revised CGHS cards.

Government's Modification of Ward Eligibility under CGHS

The Ministry of Health and Family Welfare, through its Office Memorandum (OM) No. S.11011/1/2016-CGHS(P)/EHS dated 28th October 2022, announced revisions in the ward eligibility for CGHS beneficiaries. This modification is a partial adjustment to the earlier OM dated 9th January 2017. The revised ward eligibility is categorized based on the corresponding basic pay drawn by officers, impacting the quality of healthcare access for numerous pensioners and their families.

Details of the Revised Ward Entitlement

Under the revised guidelines, the ward entitlement for CGHS beneficiaries is now as follows:

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

These changes reflect a more equitable distribution of healthcare services, ensuring that pensioners and their families receive appropriate care corresponding to their pay grades.

No Implementation for Pre-7th CPC Pensioners

It is important to note that there is currently no proposal to extend these revised ward entitlements to pensioners and family pensioners who retired before the implementation of the 7th Central Pay Commission. This decision has been a point of contention and discussion among the retired community, seeking similar benefits.

Application and Processing of Revised CGHS Cards

For pensioners and family pensioners eligible under the new entitlements, the process of updating ward eligibility is straightforward. Applications for new CGHS cards or revisions to existing cards are processed on a first-come-first-serve basis. Beneficiaries can expect:

  • Immediate issuance of a printed Index Card reflecting the revised ward entitlement.
  • Option to download the e-CGHS card through their online CGHS account.

CGHS wellness centers are responsible for processing these applications efficiently, ensuring that all eligible beneficiaries receive their updated entitlements without unnecessary delays.

Addressing Concerns and Complaints

Despite the streamlined process, there have been reports of pensioners, including family pensioners, facing issues with the acceptance and processing of their applications at CGHS wellness centers. The Ministry has received complaints regarding these challenges, particularly from the National Capital Territory of Delhi. The government is committed to addressing these concerns promptly to ensure all eligible pensioners receive their entitled benefits.

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