Clarifications regarding Plastic Cards for Individual CGHS beneficiaries

F.No.11-1/2004-C&P/Pt-XII

Government of India

Ministry of Health & Family Welfare
Department of Health & Family Welfare

Department of Health & Family Welfare

CGHS (P) Division

Nirman Bhawan, Maulan Azad Road,
New Delhi - 110011.

Dated the 15th May, 2009

OFFICE MEMORANDUM

Sub: Clarifications regarding Plastic Cards for Individual CGHS beneficiaries-

With reference to the above mentioned matter the undersigned is directed to state that individual Plastic Cards are being issued to all CGHS beneficiaries in Delhi and NCRT in place of Family Cards. In this regard this office has beenreceiving several queries seeking clarifications and therefore, this Ministry has decided to issue an Office MemorandumClarifying the issues.

It is clarified that:

1. Data of CGHS beneficiaries is available on Data base of Servers located at NIC Headquarters.

2.The individual Plastic Cards are only Identity cards bearing a unique number for each beneficiary, validity for CGHS facilities, name of wellness Centre are available in Data base.

3.The Plastic Cards are issued for a maximum period of Five Years or till entitlled for CGHS benefits, whichever may be earlier. In case of CGHS pensioners who have paid for 'Rest of Life' facilities a new Plastic Cards shall be issued after 'Fiver Years' without any additional contribution. Similarly, New Plastic Cards shall be issued to serving employees after 'Five Years'.

4. The Plastic Cards bear a colour strip on the top side of Card. The Colour of Strip is Blue in case of Serving employees, Green in case of Pensioner beneficiaries, Freedom Fighters etc.,, Yellow in case of Autonomous Bodies and other and Red in case of Members of Parliament.

5. As of now computerization is under process in cities other than Delhi. After computerization of allCGHS coverd Cities the Plastic Cards will be valid all over India and there is no need for obtaining temporaryattachment while on a visit to another CGHS City.

6. In case of Pensioners applying for CGHS Cards applying for the first time in Delhi, an acknowledgment slip is issued immediately on submission of complete Set of Documents and prescribed subscription fee. The print out Slip is valid for availing CGHS facilities till Plastic Cards are issued. Individual Plastic Cards are issued within '7' Days after receiving the same from agency appointed for preparation of Plastic Cards. The acknowledgment slips are valid for availing treatment from empanelled hospitals with permission / under emergency.

7. Beneficiaries / Empanelled Hospitals / Diagnostic Centres can verify the Data at

8. Permissions for treatment shall be granted on the basis of ben ID (Beneficiary Identity Number) printed on Plastic Cards. While granting permission Data like the name of Serving employee / Pensioner and the relationship of Individual family member etc., can be verified at http:/cghs.nic.in/welcome.jsp , in case a beneficiary is admitted under emergency.

9. At the time of Submission of Medical Claim the Ben ID number of Serving employee or Pensioner shall be entered on Modified Medical 2004 form as he / she shall be the claimant. Copy of Plastic Card of Patient shall be enclosed along withMedical Reimbursement Claim.

10. In case of loss of Plastic Cards, Serving employee / Pensioner shall apply at CGHS (HQ) for Duplicate Plastic Card along with IPO for Rs.50 / a copy of FIR lodged with Police, a copy of lod Card. A 'print out slip' shall be issued immediately for availing CGHS facilities and Plastic Card after '7' Days. In case of serving employees the application shall be forwarded by the his / her department.

11. In case of change in residential address and shifting from one dispenasry to another, CMO I/C of Dispensary shall make modifications in Data base and transfer the cards to new dispensary. CMO i/c of new dispensary shall accept transfer of Card and Data shall be transferred to new dispensary.

12. In case of superannuation / transfer to another city, serving employees get the card deleted from Data base at Dispensary andobtain a certificate from CMO i/c and surrender the card to his / her department. Department shall issue a surrendercertificate to employee for getting a new Card at another city (if covered under CGHS) or for obtaining a pensioners CGHS card in case of superannuation.

13. It is compulsory to bring original Plastic Cards every time for availing CGHS benefits.

14. All nenficiaries entitled for semi-private ward in empanelled private hospitals are eligible for Nursing Home facilities in Govt. Hospitals and those entitled for Private ward are eligible for Direct Consultation with specialists in Govt. Hospitals. Similarly, beneficiaries entitled for Private ward in empanelled private hospitals are also eligible for Private ward facilities at A.I.I.M.S., New Delhi. No separate endorsement is required for these criteria.

JAIPRAKASH

UNDER SECRETARY TO GOVERNMENT OF INDIA