Reimbursement of expenses in indoor treatment to pensioners living in Non-CGHS towns

Reimbursement of expenses in indoor treatment to pensioners living in Non-CGHS towns: 48th NC JCM Meeting

Minutes of the 48th Meeting of the National Council (JCM) held on 26.06.2021 vide DoP&T OM No.3/4/2021-JCA dated 14th July, 2021

5.1. Item No. NC-47/13/19: Reimbursement of expenses in indoor treatment to pensioners living in Non-CGHS towns.

The demand in brief is that some arrangement may be made to reimburse expenditure on indoor treatment of pensioners living in Non -CG HS Towns.

This issue was discussed at the last meeting of the NC. It was informed that pensioners residing in non-CGHS areas have been provided the following options to avail medical facilities: –

• FMA @Rs.1000/ – p.m.
• Benefit of CGHS (OPD and IPD) by registering themselves in the nearest CGHS city after making the required subscription.
• Option to avail FMA for OPD treatment and CGHS for IPD treatments after making the required subscription as per CGHS guidelines . A copy of the relevant OM issued by MoHFW has been made available to Staff side.

Secretary (Health) reiterated the above provisions and further stated that since 2019, the CGHS network coverage has expanded significantly. Against the earlier 38 cities, CGHS has now been extended to 70 cities. Further, DoE has approved the proposal to set up 16 more dispensaries in cities like Panchkula, Itanagar etc., which will raise the number of cities with CGHS coverage to 86.

Shri K.K.N . Kutty, Member, Staff Side, stated that the present scheme is not sufficient, and either health insurance or a reimbursement scheme for pensioners in mofussil areas may be introduced.

Decision: Chairman stated that the MoHFW may continue with the expansion programme of CGHS network and directed that the Health Insurance Scheme and Reimbursement Scheme issues, as requested by the Staff Side, may be discussed with DoE to find a way forward at the earliest.

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